It is common to feel tired and lack energy while having chemotherapy or radiation therapy, particularly as treatment progresses. The tiredness often lasts for a few weeks after treatment is finished. Try doing some gentle exercise as this can help with fatigue. Plan your activities so you can rest regularly during the day. Talk to your family and friends about how they can help you.

Some chemotherapy drugs can make you feel ill (nausea) or vomit. You will usually be given anti-nausea medicine before and after having chemotherapy to prevent or reduce nausea and vomiting. These are available in many forms, including tablets that you swallow, wafers that dissolve on the tongue and suppositories to put in your bottom (rectum). If you have radiation therapy to the abdomen, you could have some minor stomach-aches, nausea or bloating. Your doctor may prescribe medicines to prevent these symptoms from occurring or to treat them if they do occur.

Sometimes chemotherapy drugs can affect the nerve endings in the bowel, making it hard to pass a bowel motion and causing constipation. More often, constipation occurs as a side effect of the anti-nausea medicines. Your medical team can prescribe medicines to help treat constipation. Radiation therapy sometimes causes diarrhoea and cramping. These bowel irritations are usually minor and do not need treatment.

Radiation therapy may cause the bladder and urinary tract to become irritated and inflamed. Drinking plenty of fluids will help, but avoid alcoholic or caffeinated drinks, as they can irritate the bladder further.

Chemotherapy often causes hair loss from the head and body. Radiation therapy may cause you to lose pubic and abdominal hair in the treatment area. After treatment, the hair will usually grow back.

Chemotherapy often causes hair loss from the head and body. Radiation therapy may cause you to lose pubic and abdominal hair in the treatment area. After treatment, the hair will usually grow back.

Some chemotherapy drugs can cause short-term ringing or buzzing in the ears (tinnitus) and affect the ability to hear high-pitched sounds.

Some drugs can damage the lungs or kidneys. You may have lung and kidney function tests to check the effects of the drugs on your organs.

Having chemotherapy for testicular cancer can affect the heart and blood vessels. This can increase the longer-term risk of developing heart disease, stroke or blood circulation problems. Having high cholesterol levels, high blood pressure, high blood sugar levels or carrying excess weight can increase this risk. Many people can manage their cholesterol and blood pressure levels with regular exercise and a balanced diet. Other people may be prescribed medicines. 

People who have chemotherapy for testicular cancer are at a slightly higher risk of developing leukaemia, which is a blood cancer. Having chemotherapy may also increase the risk of developing a new unrelated solid cancer. People who have radiation therapy for testicular cancer have a slightly increased risk of developing a second cancer in or near the area exposed to radiation. The risk of developing a second cancer is very low.

Some people will develop low testosterone levels after treatment for testicular cancer (known as hypogonadism). Having chemotherapy after surgery can increase the risk. Low testosterone levels may cause a range of issues, including tiredness, muscle loss and reduced sex drive. Testosterone levels will be checked as part of follow-up care and some people may need testosterone replacement therapy.

The removal of one testicle won’t affect erections or orgasms but it can affect testosterone levels. RPLND may damage nerves, causing semen to travel backwards into the bladder instead of forwards out of the penis. This still feels like an orgasm, but no semen will come out. 

Chemotherapy drugs may remain in your system and be present in your semen for a few days. For a few weeks after chemotherapy, you may have some trouble getting and keeping an erection. Radiation therapy to the pelvis may temporarily stop semen production. You will still feel the sensations of an orgasm but will ejaculate little or no semen (dry orgasm). In most cases, semen production will return to normal after a few months.

Some tips for managing changes to your sexuality include:

• Be gentle the first few times you are sexually active after treatment. Start with touching, and tell your partner what feels good.
• Talk openly with your doctor or sexual health counsellor about any challenges. They may be able to help and reassure you.
• Protect your partner from any drugs in your semen by using barrier contraception, such as condoms, during chemotherapy and for a number of days afterwards, as advised by your doctor.
• Accept that tiredness and worry may lower your interest in sex and remember that sex drive usually returns when treatment ends.

Most people who have had one testicle removed can go on to have children naturally. If you have had both testicles removed (rarely required), you will no longer produce sperm and will be infertile. People who experience retrograde ejaculation after retroperitoneal lymph node dissection will also be infertile.

Both chemotherapy and radiation therapy can temporarily decrease sperm production and cause unhealthy sperm. It may take one or more years before there are enough healthy sperm to conceive a child. In some cases, infertility may be permanent.

Some tips for managing changes to your fertility include:

• Use sperm banking to store sperm before cancer treatment for use at a later date. Samples can be stored for many years. 
• Avoid pregnancy until sperm are healthy again by using contraception for 6 to 12 months after chemotherapy or radiation therapy, as advised by your doctor. You may need a sperm analysis test to determine this.
• If infertility appears to be permanent, talk to a counsellor or family member about how you are feeling. Infertility can be very upsetting for you and your family, and you may have many mixed emotions about the future.
  
  

Any type of cancer treatment can change the way you feel about yourself. You may feel less confident about who you are and what you can do, particularly if your body has changed physically. Some people find that their sense of identity or masculinity is affected by their cancer experience.

Some tips for adjusting to changes to your body include:

• Give yourself time to get used to any changes to your body. Try to see yourself as a whole person (body, mind and personality) instead of focusing on the parts of you that have changed.
• Try talking to other men who have had a similar experience. You can call Cancer Council 13 11 20 to find out about our peer support programs.
• Let your partner, if you have one, know how you are feeling. 
• You may also find it helpful to talk to a psychologist if you are having trouble adjusting to any changes. 
• If you continue to be concerned about your appearance, you may wish to speak to your medical team about getting an artificial testicle (prosthesis).