Orchiectomy

What is an Orchiectomy?

An orchiectomy is a surgical treatment of testicular cancer that consists of the removal of the entire affected testicle(s). Contrary to popular belief, removing a testicle does not decrease a male’s sexual prowess. Males only need one testicle in order to be fertile and produce a normal amount of male hormones. In addition, removing a testicle does not cause impotence (the loss of the ability to have an erection). Some males choose to have a gel-filled prosthesis implanted in the scrotum to replace the missing testicle, but the majority of males find this to be unnecessary.

Fortunately, 95 percent of males who have testicular cancer survive the disease. However, the survival rate drops to 75 percent if treatment does not begin until the latest stages of the cancer's development, in which it spreads to other organs. Thus it is important to treat the disease as early as possible. Doctors treat testicular cancer with any of, or any combination of, the following three methods:

•    Orchiectomy

•    Radiation therapy: The use of radiation to kill cancerous cells. This is often done to eliminate any cancer that remains in the body after surgery.

•    Chemotherapy: The use of anti-cancer drugs. This method is also often used following surgery. Most of these drugs are injected into the body.

 Doctors might also choose to remove the lymph nodes surrounding the groin area so that the cancer cannot spread to them. With any of these processes, it is possible that the patient may lose the ability to ejaculate, leaving him only able to have dry orgasms and rendering him infertile. Therefore, males with testicular cancer who wish to have children in the future may want to ask a doctor about sperm banking.2

Self-Examination

Although testicular cancer is not as common or as deadly as many other cancers that occur in males, such as prostate cancer, it is important for males to be aware of the symptoms and risk factors so that they can detect the disease in its earliest stages. Because testicular cancer is the most common form of cancer in young males, some individuals choose to regularly perform a testicular self-examination. This examination can easily be performed after a bath or shower. To examine yourself, first face a mirror and hold the penis away from the testicles, so you can see them more easily. Then, one after the other, hold each testicle between your thumb and index finger and roll gently so that you can feel if there are any lumps or enlargements in the testes. If you feel any symptoms or have any concerns, see a doctor as soon as possible.2

Testicular Cancer and Masculinity

It might seem that having a disease that threatens their reproductive organs would make males feel as if they were being robbed of part of their masculinity. They might feel that, along with losing one or both of their testicles, they are losing part of their manhood. This feeling can also stem from the fact that surgical treatments for testicular cancer can render males infertile. In the long term, most testicular cancer survivors feel that their masculinity is the same as before they had the disease, and some even think that their masculinity increases because of the cancer.

 It is common for males who undergo treatment for testicular cancer to feel a loss of masculinity immediately following treatment. This is because immediately following medical treatment, males cannot function sexually nearly as well as they did before. However, males regain their normal levels of sexual functioning, and their feelings of masculinity return to their original levels. One male described his experience:

“At the beginning, when I first lost my testicle, I thought, Oh my God, I'm only half a male now. But that really went away quickly. Once I had been through my surgery and stuff like that, and after I was feeling better, we went back to, to you know, making love. It was easy. I did not feel stifled.”1

Many survivors feel an elevated sense of manliness after dealing with the disease. Males often think of their condition as a "fight" in which they must bravely and confidently assert themselves against a life-threatening force. One male described his battle with cancer as “defiance against castration.”1

Masculinity is not a major concern for some patients. One male from a study of cancer survivors told an interviewer that he chose to have a prosthesis implanted in his scrotum to replace the lost testicle, but not for reasons concerning masculinity. The male, who was single and in his twenties, chose to have the prosthesis implanted because he wanted to look “normal” to his sexual partners and so that he could tell partners about his fight with cancer at a time of his own choosing. For him, the decision was less about masculinity and more about personal freedom.

In October 1996, Lance Armstrong (pictured) was diagnosed with testicular cancer that had spread to his brain, lungs and abdomen. Armstrong had an orchiectomy in 1997.

Although testicular cancer can negatively affect males physically, mentally, and emotionally, it does not necessarily rob males of their masculinity. Whether they think of their experience with cancer as a test of their manhood or choose to regain and assert their masculinity in different ways, survivors of testicular cancer do not and should not feel that they are less than whole as males.

 

References

1. Gordon, D.F. (1995). Testicular cancer and masculinity. Men's Health and Illness: Gender, Power, and the Body. Thousand Oaks: Sage.

2. Hyde, J.S., & DeLameter, J.D. (2006). Understanding Human Sexuality (9th ed). New York: McGraw-Hill.

Last updated 13 May 2014.