Survivorship: Health Concerns After Orchiectomy
Treatment for testicular cancer typically includes the removal of one or both testicles. This is called orchiectomy. The testicles are responsible for producing and storing sperm and producing the male hormone testosterone.
If you have had one or both testicles removed, you may be at risk for hypogonadism (producing little or no testosterone). This risk is higher if you had both testicles removed. Low levels of testosterone can cause:
- Infertility, erectile dysfunction and decreased sex drive (libido).
- Fatigue, muscle loss or weakness.
- Gynecomastia (enlargement of breast tissue).
- Decreased beard and body hair growth.
- Higher BMI (body mass index, a measure of height and weight).
- Elevated blood pressure.
You should be monitored for hypogonadism using a blood test that measures testosterone, FSH (follicle stimulating hormone) and LH (luteinizing hormone) levels. These are hormones made by the pituitary gland that stimulate the testes to make testosterone. You may need to take testosterone, which you can speak to your care provider about.
Low sperm count can be an issue both before and after treatment. Often survivors are found to have normal sperm counts within a few years after treatment. Because you can father a child even with low sperm counts, it is important to use birth control/protection if you do not wish to father a child. If both testicles are removed, you can no longer make sperm and are infertile. If you have had only one testicle removed and you wish to have children you should ask to speak to a fertility specialist.
A low testosterone level can lead to osteoporosis. The risk is highest if you had both testes removed. You can decrease your risk of developing osteoporosis by getting enough calcium and vitamin D in your diet (or supplements if your diet is lacking) and doing regular weight bearing exercise. Your provider may order a dexa scan, which is a test to look at the strength of your bones.
Oldenburg, J. (2015). Hypogonadism and fertility issues following primary treatment for testicular cancer. Urologic Oncology: Seminars and Original Investigations, 33(9), 407–412.Long-Term Complications After Testicular Cancer Treatment. (2016, January 8). Retrieved January 30, 2019, from Genitourinary Cancers Symposium website: https://gucasym.org/daily-news/long-term-complications-after-testicular-cancer-treatment