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Which surgery for testicular cancer?

Men and woman discussing testicular cancer

This page is about surgery for testicular cancer. Below there is information about

 

A quick guide to what's on this page

Removing a testicle

Most men have the whole testicle removed in order to diagnose the cancer. This operation is called an orchidectomy or orchiectomy. Your surgeon can replace the testicle with a false one, called a prosthesis. This will mean that your scrotum appears normal after your operation. In some men with a very small tumour the surgeon may remove only the area of the cancer (a partial orchidectomy), but this is very rare. You usually have this operation as a day case. Most men are back to normal activities after 2 weeks.

Your ability to have an erection and father a child will not be affected as long as only one testicle is removed. Having cancer in both testicles is rare. If you do have both testicles removed, you will no longer be able to father children. You will also need to have male hormone replacement treatment.

Surgery to remove lymph nodes

If you still have enlarged lymph nodes in your chest or abdomen after your radiotherapy or chemotherapy, you may have an operation to have them removed. After this operation you may be in hospital for 7 to 10 days and it may take up to 6 weeks to recover fully.

Removing lung tumours

Sometimes specialists will suggest surgery to remove testicular cancer that has spread to the lungs.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating testicular cancer section.

 

 

Removing a testicle

Most men have the whole testicle removed in order to diagnose the cancer. This operation is called an orchidectomy or orchiectomy. Your surgeon can replace the testicle with a false one, called a prosthesis. This will mean that your scrotum appears normal after your operation. In some men with very small tumours the surgeon removes only part of the testicle (partial orchidectomy), but this is very rare. 

You may have the operation under a general anaesthetic or a spinal anaesthetic (where you are awake but can't feel anything from the waist down). The surgeon makes a cut in the groin and removes the testicle. The operation normally takes about 30 minutes.

The diagrams below show how the surgeon removes the testicle and the position of the scar line and prosthesis after surgery.

Diagram showing the testicle being removed (orchidectomy)

Diagram showing the scar line and prosthesis after an orchidectomy

Afterwards you can eat, drink, and move around when you have recovered from the anaesthetic. You usually have this operation as a day case. Occasionally you may need to stay in hospital overnight. Your groin and scrotum may be uncomfortable for a week or so and you may need to take mild painkillers. You have your stitches taken out after about a week. Most men can go back to normal activities, including work, after 2 weeks. But you may need to avoid heavy lifting and strenuous exercise for a month.

Your ability to have an erection and father a child will not be affected as long as only one testicle is removed. Having cancer in both testicles is very rare. If you do have both testicles removed, you will no longer be able to father children. You will also need to take male hormone replacement treatment (testosterone). There is information about this in the surgery side effects section.

 

Surgery to remove lymph nodes

If you have non seminoma cancer and still have enlarged lymph nodes in your chest or abdomen after your radiotherapy or chemotherapy, you may have an operation to remove them. Taking out abdominal lymph nodes is called retroperitoneal lymph node dissection. It is rare to have surgery to remove lymph nodes in your chest (para aortic lymph node dissection).

lymph_testicular_ca

You have surgery to remove lymph nodes under general anaesthetic. It can take between 3 to 7 hours. Beforehand you may need to stop eating and drinking for a few hours and you may have a drip. Afterwards you may be in a high dependency unit (HDU) or intensive care unit (ICU), where your nurses will be able to monitor you closely. This is usually only for one night before you move back to the ward. You may have a drain from your wound. In some cases, you may also have a tube going down your nose and into your stomach to drain fluid and stop you feeling sick. 

Your wound will be sore or painful at first but your nurse will give you painkillers. After a couple of days you can usually start to move around. You will be able to go home after about 7 to 10 days. It can take a few weeks for the wound to fully heal. And you will need to avoid strenuous exercise and heavy lifting for at least 6 weeks.

Removing the lymph glands from the abdomen can make some men unable to father children (infertile). It is sometimes possible to do an operation called a nerve sparing lymph node dissection to try to stop this happening. This is a highly specialised operation and you may need to travel to a specialist hospital to have it. It is not always possible to do if there is cancer close to the nerve pathways. Leaving the nerves behind could increase the risk of the cancer coming back. There is information about this in the surgery side effects section.

 

Surgery to remove secondary cancer in the lungs

Sometimes specialists will suggest surgery to remove secondary testicular cancer that is growing in the lungs. Your specialist may suggest this because

  • There is still a sign of cancer after chemotherapy has finished
  • The cancer is thought to be resistant to chemotherapy

Sometimes, if the cancer cannot be cured any other way, surgery is done more than once if the tumours grow back again. This will depend on how fit you are. It will also depend on how much treatment you want to have.

This is major surgery done under general anaesthetic. Most of the information in the section about having your operation will apply. As well as a drip into your vein and tubes coming out from your wound, you will have a tube into your chest for a few days. The tube connects to a suction bottle. It is there to help your lung expand (inflate) again. Surgery to the chest always makes the lung collapse but it can be expanded (reinflated) over a couple of days. You will have painkillers for some days after the operation. The surgery may involve cutting through a couple of ribs and this can be painful while it heals.

 

More information about surgery

If you would like more information about surgery for testicular cancer you can phone the Cancer research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. Our testicular cancer organisations page gives details of other people who can also give information. Some organisations can put you in touch with a cancer support group

Our testicular cancer reading list has information about books and leaflets on treatments. If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or you can go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.

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Updated: 11 September 2014