What is the surgical treatment of testicular cancer
After the diagnosis of testicular cancer is made, the stage and determination of the type of disease are started. These steps assist in the choice of treatment, which also takes into account factors such as the patient’s overall health status, preferences, and possible adverse effects. Surgery for testicular cancer is often the treatment of choice. It can be used alone or in combination with chemotherapy and/or radiotherapy.
Surgery for testicular cancer usually involves removing the tumor and, in some cases, some of the adjacent tissue (located around it).
Types of surgery for testicular cancer
Surgeries performed for testicular cancer include different procedures, the main ones being:
- Radical inguinal orchiectomy – involves the removal of the testicle that harbors the tumor. An incision is made in the groin, where the testicle is removed from the scrotum. This type of surgical technique applies to all stages of testicular cancer;
- Retroperitoneal lymph node dissection – complex surgery done to remove the retroperitoneal lymph nodes found in the back of the abdomen. Depending on the type and stage of cancer, lymph nodes located around large blood vessels (aorta and inferior vena cava) may be removed during orchiectomy or later in a second operation. Not all people with testicular cancer need to have their lymph nodes removed;
- Laparoscopic surgery – procedure reserved for early-stage cases of non-seminoma tumors (malignant tumor of the germ cells, which are responsible for forming the lineages that will give rise to male and female gametes), where the lymph nodes contain the disease. If confirmed, the patient will also undergo chemotherapy.
Possible adverse effects of surgery
Removing a single testicle does not affect a man’s ability to have an erection and sexual intercourse. However, when both are removed, semen can no longer be produced and the patient becomes infertile. In addition, without the testes, a man does not produce enough testosterone, which can reduce his libido and affect his ability to have and maintain an erection.
Other effects that may be seen include:
- Hot flashes (hot flashes); and
- Muscle mass loss.
These effects can be avoided or controlled by the use of testosterone-based supplements, in the form of a gel, patch, or injection.
Although more serious complications are infrequent with surgery to remove the retroperitoneal lymph node, they can occur. About 5% to 10% of patients experience problems shortly after surgery, such as infection or intestinal obstruction.
This procedure does not cause impotence, but it can damage some of the nerves that control ejaculation. As a consequence, when a man ejaculates, semen does not exit through the urethra and returns to the bladder. This phenomenon is called retrograde ejaculation and it can prevent him from having children.