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Nuts&Bolts

The tools to tackle testicular cancer

Nuts & Bolts has the tools you need to confidently handle the testicular cancer journey. From diagnosis, to treatment, to life afterwards — we’ve got your back.
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Nuts&Bolts
Nuts&Bolts

At a glance:
the testicular cancer journey

No two nuts are exactly the same. Neither are two experiences with testicular cancer. Still, the journey can have pretty routine stops along the way.Take a look at what's-what, when it comes to your nuts.

Testie-monials

Testicular cancer stories from the community

Hear Ben B.'s story of tackling diagnosis head on

Watch Ben R.'s video about the day of surgery

Follow Adam's story of recovery and community

Hear Ben B.'s story of tackling diagnosis head on

Watch Ben R.'s video about the day of surgery

Follow Adam's story of recovery and community

Top 3: Frequently Asked Questions

How long after testicular cancer treatment can you have sex?

Ben S.Active guy, love the outdoors, riding my motorbike and watching any and all sportsDiagnosis Age – 23Treatment type – Orchiectomy, BEP chemo x 3, RPLND

As soon as you’re up to it, but it’s wise to use a condom for a while after chemo (and during if you have the energy for it then) as your chemo can make your ejaculate toxic. Something to ask your doc about for sure.

Dr. Ben TranMedical Oncologist,MBBS, FRACP

During chemotherapy, you may feel quite tired and might not be up for it, but if you are, it is ok to have sex during treatment. However, make sure you use a condom, as chemotherapy can be present in bodily fluids for up to seven days after each chemotherapy session. This way, you can ensure you protect your partner from any unexpected chemotherapy exposure.

There is not much science to back it up, but generally we think it is ok to have unprotected sex four weeks after completing chemo. However, most of us recommend that you avoid trying to conceive a baby for at least six months after chemotherapy. So it’s best to use some sort of contraception until then.

Dr. Mark LitwinUrologic Oncology MD, MPH Professor and Chair - UCLA Department of Urology

There’s no hard rule on this, but generally after an orchiectomy (surgery) it takes a week or so before you’re back in the mood and feeling up for it.

What are the pros and cons of getting a prosthetic testicle?

BrettHockey Coach, Accountant and Avid GolferTreatment type – Orchiectomy

I weighed the pros and cons and decided not to get one. My doctor told me that over 50% of the people get it and 50% of those people actually get it removed because it doesn’t always feel natural.

I’m married and my wife did not care “how it looked” and I am actually glad I didn’t get one because I don’t even notice I only have one testicle. I would think someone who is in their 20s and single may think people would have a stigma against it but honestly, it’s more important to be healthy than to care about how something looks that nobody can ever see.

Dr. Mark S. LitwinUrologic Oncology MD, MPHProfessor and Chair - UCLA Department of Urology

It’s pretty easy to have a prosthetic placed at the time of orchiectomy. It is made of soft silicone and shaped like a small egg. Usually, it’s included in the cost of the orchiectomy. If implanted later, insurance companies may consider it cosmetic and decline coverage.

Most patients don’t really notice the prosthetic, except that it brings symmetry to the scrotum after a testicle has been removed. Some patients feel heaviness or discomfort around the prosthetic. In rare cases, the prosthetic can become infected or painful and must be removed. Patients can tell the difference between the prosthetic and the normal testicle, but it’s often surprising that intimate partners don’t notice. There’s not much downside to having a prosthetic placed. Serious negative long-term health consequences are rarely reported.

Ben R.Father of a young boy, hit the beach when I can, watch the stars at night and like to eat a little too muchDiagnosis Age – 32Treatment type – Orchiectomy

I have a prosthetic. I chose to get one for aesthetic reasons. I don’t really notice it anymore, but if I had my time again, I wouldn’t get one as having a ‘half sack’ is like wearing a badge of honour for beating cancer.

Ben S. Active guy, love the outdoors, riding my motorbike and watching any and all sportsDiagnosis Age – 23Treatment type – Orchiectomy, BEP chemo x 3, RPLND

Wouldn’t know! I am a uni-baller, I guess symmetry would be a pro?

I personally don’t really care about the aesthetics of my ball (get used to saying ball and not balls) but my surgeon did remark on the fact that if you’re having chemo it’s great to not put anything into your body which is not completely necessary.

What do I need to know about an orchiectomy (surgery)?

Dr. Mark S. LitwinUrologic Oncology MD, MPHProfessor and Chair - UCLA Department of Urology

Radical orchiectomy involves the surgical removal of one testicle and the spermatic cord that connects it to the body. The surgery is done as an outpatient or day-stay.

After induction of general or spinal anesthesia, the urologist makes a small incision in the inguinal (groin) area at about the pubic hairline, then dissects through the layers to the inguinal canal. The testicle and spermatic cord are then moved up into the incision and out of the body. The spermatic cord is secured with a suture and divided, liberating the testicle. The tissue layers and skin are usually closed with dissolvable sutures.

The testicle and spermatic cord undergo testing in the pathology lab to determine the type and extent of tumor. When the hair fills back in and healing is complete, the scar is often invisible. Patients are told to keep the area dry for a couple days and to place cold packs on the incision to prevent swelling. Most patients need only a few days of pain medication.

Depending on the tumor type, tumor markers, results of the CT or MRI scans, and determination of whether the tumor has spread, patients typically then undergo treatment or management of the lymph nodes in the abdomen (and possibly the chest).

BrettHockey Coach, Accountant and Avid GolferTreatment type – Orchiectomy

What you need to know about surgery is that it is simple (surgeons these days are excellent) and you are out for the entire thing.

I remember looking up at the light one minute and waking up in recovery 2 hours later. I was in and out of the hospital on the same day.

The surgery for me wasn’t the issue, it was the waiting game for a week to determine whether I needed chemotherapy or not based on the results. It is best to focus on recovery, pain management, and enjoying life.

Ben S.Active guy, love the outdoors, riding my motorbike and watching any and all sportsDiagnosis Age – 23Treatment type – Orchiectomy, BEP chemo x 3, RPLND

Ask about sperm storage, fertility and what you need to do. Recovery for me was quick and incomparable to the later stage treatment.

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