Managing side effects

How treatment affects fertility

Most men who have had one testicle removed can have children naturally. However, if you have anejaculation after RPLND, you won’t be able to conceive naturally.

You may be given medicine to help the semen come out of the penis, or you may be able to have sperm extracted.

Both chemotherapy and radiation therapy treatments can decrease sperm production and cause unhealthy sperm. These effects may be temporary or permanent. It may take one or more years before there are enough healthy sperm to conceive a child.

Before cancer treatment starts, you may be able to collect and store some sperm. The sperm is frozen until needed. Sperm can be frozen for many years. Although there is a cost involved, most sperm banks have payment plans to make it more affordable.

Ask your cancer specialist to refer you to a fertility specialist so you can find out about your options.

Cancer and fertility

“Before having one of my testicles removed, I went to the sperm bank as a safeguard. But after 2 years, I was able to father a child normally.” DJ

Changes to sex and intimacy

Treatment for testicular cancer may affect your sex life, feelings of pleasure, and intimacy.

• Surgery – Removing one testicle will not stop you from having erections or orgasms but can affect testosterone levels. RPLND may damage nerves, causing anejaculation. This still feels like an orgasm, but no semen will come out.
• Chemotherapy – Your ability to get and keep an erection may be affected for a few weeks after chemotherapy. This is usually temporary. You may also find you have a lower sex drive (libido).
• Radiation therapy – Radiation therapy to the abdomen may temporarily stop you making semen. You will still feel the sensations of an orgasm but will ejaculate little or no semen. In most cases, semen production returns to normal after a few months.

Sexuality and intimacy

How you might feel

If you had a testicle removed, it may affect how you feel about yourself. You may feel less confident and less sexually desirable. Some men adjust quickly to having one testicle, while others find that it takes some time.

If you had an RPLND, you may feel selfconscious about the scar across your abdomen. Any type of cancer treatment can change the way you feel about yourself (your self-esteem).

You may feel less sure of who you are and what you can do, particularly if your body has changed physically. Some men find that their sense of identity or masculinity is affected by their cancer experience.

You may find it helpful to talk to a psychologist if you are having trouble adjusting to any changes – ask your general practitioner (GP) for a referral.

Give yourself time to get used to any changes to your body. Talk to other people who have had a similar experience. Call Cancer Council 13 11 20 to find out about peer support programs or visit the Cancer Council Online Community.