Testicular Cancer
Further surgery for testicular cancer
Usually, the only surgery that is needed is an orchidectomy (removal of a testicle) (see 'Orchidectomy'). However, further surgery is sometimes needed to remove cancer cells that have spread to other parts of the body.
If not diagnosed in its early stages, testicular cancer may spread to the lymph glands. Two men we spoke to told us that they had needed a second operation in the groin area, quite soon after the initial orchidectomy, because doctors found that cancer cells had spread to nearby lymph nodes. One said that the cancer had spread up the spermatic cord.
Chemotherapy or radiotherapy is usually used to kill cancerous tumours in the abdomen, but sometimes doctors are not quite sure whether or not these treatments have been successful. In this case the surgeons may decide to remove the remains of a tumour to make sure there are no remaining cancer cells in what appears to be a non-cancerous lump.
Surgery to remove lymph glands in the abdomen may be quite a big operation. Some men were surprised when they heard that they would be in hospital for 8-10 days. One man recalled his recovery on the ward. He remembered his drips, his catheter, and a drain in the side of his stomach, and the morphine pump that was available for pain relief.
Describes his surprise when he was told he would need 8-10 days in hospital for surgery to remove Describes his surprise when he was told he would need 8-10 days in hospital for surgery to remove a tumour in his abdomen.
Describes his surprise when he was told he would need 8-10 days in hospital for surgery to remove Describes his surprise when he was told he would need 8-10 days in hospital for surgery to remove a tumour in his abdomen.
So I saw the urologist and he said "Yes you know we'll take it [the tumour] out, it's," and I think I said "So will I be in and out?" because with the first operation I was in and out within a couple of days, so I said "Oh, will I be in and out within a day then?" And he said "No, probably 8 to 10 days you'll be in hospital for." I thought you're joking. And he said, "You probably won't be able to eat for about 8 days either. And I was like, 'What!', I just couldn't comprehend that they were going to do something that drastic. So I was like, 'Oh great'. By this stage I thought, I didn't think 'Oh God', it wasn't like I was told I've got to have chemotherapy, you know you've got cancer, it was a case of, by that stage it was okay it's [the tumour] probably dead, this is another thing I've got to do, you know hopefully the finally step to make sure I'm clear of it.
And so I went in, it was the same hospital I had the chemotherapy at, and I went in and I was there for I think for a day and then I was put on like a, a bit like the same sort of stuff I take for weight training, it's just like little protein milkshakes to sort of empty your stomach. Because basically what they were going to do was cut me open from sort of here to here, er top to bottom, remove my stomach, remove my bowel, obviously cut out all the tumour because that's where the tumour was all sort of hidden all the way, right at the back, next to the spine on the lymph nodes. Rip all that out, then put everything back in again and that was why I couldn't eat for a couple of days because they say whenever they touch your bowel it affects your, the way everything works and you've got to slowly let that come back sort of come back into use slowly. So I had, I had an operation, my Dad was there, obviously I went and they tried to give me an epidural, which didn't work because the muscles in my back were too thick and they couldn't get the needle through (laughs). But it didn't stop them trying 2 or 3 times so that hurt a little bit. And the next thing I knew I woke up in intensive care which was, is a precaution after having an operation like that, they will automatically put you in intensive care.
Describes his experiences on the ward after a major operation to remove a tumour in his abdomen.
Describes his experiences on the ward after a major operation to remove a tumour in his abdomen.
Yes and when they did start to bring me back onto food it was, I was only allowed like a ration of water, this much at a time, like every hour er and then I might have been allowed some Cornflakes or something like that. But I think I, I snuck a bit too much water and, and I was sick. And as you can imagine I was bent over, you've just had that operation, you know your stomach goes all, oh I was holding myself in going "No," and all that came up was green which you probably didn't really want to know but (laughs). It's funny some of the colours that are inside you and you don't appreciate they're there, they're not particularly nice. But so I slowly, within 4 or 5 days I was back on my feet, walking round the hospital, wondering when can I go home because it was doing my head in being stuck in there for so long.
Another man we interviewed had an operation to remove a tumour, which was lying beside the aorta (blood vessel) in his back. It was a major operation because it was hard to reach the tumour. He described the incision, which was held together with staples, and the fourteen-inch scar.
Describes surgery to remove a para-aortic node and describes the big scar.
Describes surgery to remove a para-aortic node and describes the big scar.
Yes, and that was, that CT scan was, I think it was probably two months after that - I imagine - but in February 2000 I went, they found a um, is it a PND I think is the name, it's a node, para-aortic node and I was in hospital for ten days, they had to remove that and that was towards my back. But to get to it they had to go in from my front so I had another operation which I suppose was a bit more worrying because the reason why they had to take it out was, it turned out to be a benign tumour was, they weren't sure if it was cancerous or not.
It wasn't cancerous?
It wasn't cancer no, but they had to remove it.
How long, how big was the incision?
I think its about fourteen, fourteen inches long the actual, I call it my shark bite! But I had, I was in hospital for I think for nearly ten days, twelve days I was in hospital for and I came out of hospital and I mean again once I had the operation I was, it was uncomfortable. But because, there wasn't any of the drugs you know, it wasn't too bad. And, and they stapled me, I had forty odd metal staples in my stomach when I came out which I thought was quite amusing!
How long did they have to stay in?
They only had to stay in probably for about a week afterwards and then a nurse came to remove them. But that, that, that took time to, to get over because it was a big cut and a big operation I suppose and even now I mean this was what nearly two years ago I had this operation now, um, you know its still, its still taking time to heal. It takes time for the scar tissue to heal as well. Even the first operation you know when I had my testicle removed, I still get aches in that area but you know you speak to doctors, I mean I go back every three months you know to the hospital for my check-ups, they said that's, that's fairly straightforward you know its fairly normal.
Sometimes it is necessary to remove a rib so that surgeons can reach a tumour. Having had such a major operation, a man recalled his time in intensive care, linked up to heart monitors, breathing apparatus and pain management systems.
Describes major surgery to remove the lymph glands along the back of his spine.
Describes major surgery to remove the lymph glands along the back of his spine.
And the consultant or the surgeon that I saw was, was very, very good. I spoke to my other consultant about him and he is world renowned for this particular operation that he's researched and he's developed himself with his team. And he came down and spoke to me and told me what I was going to have done. And it was a bit of a daunting prospect really because it wasn't like the first operation, this was a very major operation. It involved 6 hours of operation under general anaesthetic, it was a very large scar, 18 inches and the removal of a rib and the collapsing of a lung to actually get to the site. Because obviously where the tumour is you can cut straight through, you can go through the front and go through the stomach and everything which causes complications. You can't go through the back because you've got the ribs and the spine in the way so he's found a way of doing it through the side which involves a rather weird shaped scar along my side. But they go in and they collapse the lung, remove the ribs so they can get in there and then remove all the tumour.
Describes his experience of the intensive care unit after major surgery.
Describes his experience of the intensive care unit after major surgery.
I was linked up to heart monitors and various different breathing apparatus and pain management systems. And spent the next 6, 7 hours just lying there not really being able to move much, being in quite a bit of, not pain but discomfort from this large scar that I had on my side. And not allowed to eat or drink anything again which really annoyed me. I was only allowed to, I was allowed to suck on ice cubes and little foam lollies with water in. So my Mum spent the next 6 hours doing that for me. And then that morning they decided I was well enough to move back down to the general ward. So I was taken back down there and given a personal pain relief system which was very, very good. Which involved a needle in my arm and going through to a box containing the drugs and a button that I could press when I was in pain to administer a dose of pain killer, which was very good, it really helped.
The scar took probably 2, may be 3 weeks to completely heal over. I had stitches in that that were removed by my GP. And then after the operation, approximately 6 weeks later I was discharged from the surgeon's care,who decided that everything was going okay.
Explains that he had further surgery to remove a tumour in his neck, found when he went for a check-up.
Explains that he had further surgery to remove a tumour in his neck, found when he went for a check-up.
And I started your normal five years remission and then unfortunately about the second year into my remission I had a reoccurrence in my neck.
Oh dear.
So they, which is you know they're very good, so thorough in the examinations, blood tests and x-rays and scans, they picked it up straight away. I went in for a biopsy at a local hospital and the surgeon removed it all, took it away. I didn't know that at the time, I just thought I was going in for a...
Biopsy?
Yeah but he took it all away. I went back for the results, expected to hear that you know may be it had come back, may be it hadn't and he said no, the surgeons had taken it all away anyway, so nothing to worry about there. And now I think I'm in my fourth year, I've still got one in my stomach but it's not doing anything, it's just there so they just like to keep an eye on it.
Occasionally, surgery is needed for other reasons. For example, one man had a laparoscopy to make sure he didn't have an undescended testicle. During a laparoscopy a scope is put into the abdomen so that the surgeons can see that everything looks normal.
Another man had a bronchoscopy, thoracoscopy and a mediastinoscopy to make sure that the tumours in his chest that were seen on X-Ray weren't cancerous. These are procedures that allow the doctor to look inside the lungs and chest. The thoracoscopy and mediastinoscopy involved an incision in the side of his chest, under anaesthetic. He found the investigations unpleasant, and needed a week in hospital.
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