How Testicular Cancer Affects Sexual Health

Inger Rosner, MD, is a board-certified urologic oncologist at Inova Scar Cancer Institute’s Genitourinary Cancer Program. Dr. Rosner has published dozens of papers based on her research in the field of urologic oncology. She answers common questions about testicular cancer and sexual health, and provides hope for those with this diagnosis.

Finding out you have cancer is stressful. And when that cancer involves an intimate place like the testicles, it can feel isolating. You may not want to talk about it with others. You may have lots of questions for your healthcare provider but feel hesitant to ask them.

You’re not alone. Most people with testicular cancer face these same challenges. But your sexual health is an important part of your overall health. You deserve answers and support every step of the way. At Inova, we provide care for all aspects of your health: physical, emotional, social and sexual.

What is testicular cancer?

Testicular cancer is cancer that starts in your testicles. Males are typically born with two testicles, which are part of the male reproductive system. They make sperm and hormones, including testosterone.

This cancer most commonly affects males between the ages of 20 and 45. It may affect one testicle or both. There are several different types of testicular cancer, and each requires a customized treatment plan. Depending on the type and stage of cancer, you may need:

• Surveillance: For small, early-stage cancers, your provider may recommend watchful waiting to make sure the cancer doesn’t grow or spread.
• Chemotherapy: This is a medication that destroys cancer cells.
• Radiation therapy: Providers use powerful high-energy beams to stop cancer from growing or spreading.
• Surgery: Your surgery may involve removing just the cancer or your entire testicle. Some patients also benefit from retroperitoneal lymph node dissection (RPLND), a surgery that removes some of your lymph nodes.

Does testicular cancer treatment affect sexual function?

If you’re going through or finished testicular cancer treatment, it’s normal to notice some changes to your sexual health. But with the right support and care, many people can return to healthy sexual function.

Testicular cancer treatment can affect your sexual health in several ways:

Changes to your appearance

Chemotherapy can cause hair loss, which is emotionally distressing for many people. If you feel less confident about your appearance, it may be harder to find interest in sex.

Having a testicle removed makes many people feel less comfortable with sexual activity. They may not like how it looks or worry that their partner notices the change. But it’s important to note that you can have a satisfying sex life with one testicle.

Erectile dysfunction (ED)

Certain types of radiation therapy and surgery can damage blood vessels and nerves in your genitals. Nerve damage can cause erectile dysfunction (ED), the inability to get or keep an erection.

Fatigue, nausea and mood changes

Chemotherapy and radiation therapy can make you feel tired, unwell or not like yourself. The stress of a cancer diagnosis and treatment can also be emotionally draining. For many people, these side effects make them less interested in sexual activity.

Infertility

Testicular cancer treatments like chemotherapy and radiation can affect sperm production and fertility. If you wish to have a biological child in the future, talk with your cancer care specialists. You may be able to store sperm for later use. You may also benefit from fertility procedures like in vitro fertilization (IVF).

Lower testosterone levels

Chemo can lower your testosterone levels during treatment. Lower testosterone levels can temporarily decrease your libido (sex drive). But testosterone levels usually recover in people who still have one healthy testicle after treatment.

Retrograde ejaculation

RPLND surgery can cause nerve damage that leads to retrograde ejaculation — semen flowing backward to your bladder instead of out of your body. While retrograde ejaculation isn’t otherwise harmful, it affects your fertility and may cause emotional stress.

Advanced testicular cancer treatments at Inova

The specialists at Inova Schar Cancer Institute understand how sexual health plays an important role in your overall health. We help prevent or minimize sexual side effects with:

• Nerve-sparing surgery: This is a type of RPLND that helps avoid damage to the nerves that affect sexual function. In the experienced hands of Inova’s surgeons, this surgery lowers the chances of ED or retrograde ejaculation.
• Sperm banking and fertility care: Inova provides sperm banking before testicular cancer treatment for patients who wish to have biological children in the future. We also provide comprehensive fertility care through our Reproductive Endocrinology and Infertility program.

Comprehensive support for people with testicular cancer

Our Inova Life with Cancer program was developed to support people with cancer and their loved ones. Life with Cancer provides comprehensive care and resources to improve your quality of life as you cope with a cancer diagnosis.

This nationally leading support program is free and open to patients at Inova Schar Cancer Institute and other health care institutions in the area. The Life with Cancer team includes:

• Behavioral health therapists
• Acupuncture and massage
• Nurse navigators
• Oncology-certified dietitians
• Psychiatrist

Together, this team cares for patients, family members and caregivers who are impacted by cancer. Our services include:

• Children’s support: Our pediatric experts provide emotional support for children whose parents have a cancer diagnosis.
• Complementary and alternative medicine: We provide acupuncture and massage therapy to help relieve stress, pain and other cancer treatment side effects.
• Education: We provide resources to help you learn about cancer and empower you to make informed healthcare decisions.
• Exercise programs: We help people with cancer feel better through physical activity and movement, including cardio, weightlifting and yoga classes.
• Mental health care: Our therapists and psychiatrists help you manage anxiety, depression, grief and other mental and emotional health concerns.
• Nurse navigators: Your nurse navigator makes your appointments and coordinates your care, so you don’t have to.
• Support groups: Choose from our wide range of in-person and virtual support groups to connect with others in meaningful ways.

Sexual side effects are hard to talk about, and many patients hesitate to even ask their doctor. Our Life with Cancer program gives you a safe space to talk with others who understand. Men with a cancer diagnosis can discuss sexual health in our dedicated online support group.

Through support groups and community resources, you can connect with people who have similar experiences. And our specialists provide the answers and support you need at every step. Our goal is to help you improve your quality of life — through treatment and for years beyond.

If you’re facing a cancer diagnosis, you deserve leading-edge, compassionate treatment. Learn more about the exceptional care we provide at the Inova Scar Cancer Institute.