Testicular Cancer
Side effects of surgery (orchidectomy)
An orchidectomy (removal of a testicle) is usually quite straightforward. It may be done as a day case, but men usually stay in hospital overnight. Some of the men interviewed here experienced relatively little discomfort after their operation, though others had pain or discomfort for a few weeks (see also 'Orchidectomy').
A few of the men had minor complications after surgery. One man was playing around with his children on a bouncy castle, just two days after the operation, and as the result of this activity one end of his scar opened up a little.
Some men reported that the scar in their groin area had been tender for a while after surgery. One man said that his scar was still tender 6 months after his operation.
Explains that his scar is still quite tender, six months after surgery.
Explains that his scar is still quite tender, six months after surgery.
Even now [six months after surgery] the scar from the operation, as I said was about five centimetres, well two and a half inches, its actually quite tender. I notice it if we're making love or anything like that. Or if I catch it or if the children are sitting on my lap and they sit on it, a bony bum, or whatever, gets on to that then it feels tender. But it's turned into now just like a red line. They don't use stitching on the outside anymore, they use a glue and that, that in itself is a good thing.
Another man said that his scar had been tender after surgery, but he stressed that the area from the scar to the scrotum, where the doctors had extracted the testicle, had been completely numb for a while.
He said that feeling in that area still hadn't completely returned. Another man said that he was still numb in that area 16 years after the operation, and another wished that he had been warned that this might happen.
Explains that the area below his scar has been slightly numb since the operation.
Explains that the area below his scar has been slightly numb since the operation.
The area, around that area it's not, it's not totally numb. Immediately after the operation it was really weird, it was, it felt slightly swollen if you like er slightly puffy and totally numb, there was absolutely no feeling there at all.
The scar?
This was the scar and everything below the scar, going down into the scrotum. That entire area which is probably, it's probably about a couple of inches sort of long, deep rather, that entire area is still slightly numb to the touch. It's not quite, it's an odd sensation but it's certainly not a problem, there's enough feeling in there to carry on doing anything that I would want to do.
One man said that his scar bled on and off for a couple of weeks, and others said that they had suffered painful wound infections which cleared up with antibiotics. One man recalled that he had a stitch abscess, and another said that he had a stitch that didn't dissolve properly, which caused him some minor irritation.
Explains that he developed a painful wound infection after his operation.
Explains that he developed a painful wound infection after his operation.
Yeah certainly yeah it was, I was back at home and I had a bit of a cough as well and every time I coughed it was extreme pain. I've never known pain like it to be honest with you, it was a very, very, very severe pain. And I coughed once, and my wound opened up, and it started bleeding quite a lot as well. So the district nurse came out that evening, about 1 o clock in the evening, and she said, "Oh the reason it's opened up is because you've caught an infection, who knows where from though," she said, "it could've been from the hospital, it could've been at home." So it was just a question of going on antibiotics again and cleaning the wound up. That was very painful to be honest with you, yeah, and it was quite scary as well seeing, the last thing you want to do is when you come out of the hospital and had an operation is to see all your wound open up and all blood coming out as well yeah, yeah so that was quite scary.
How long did it take to clear up?
What the infection? About 5 or 6 days roughly, yeah.
Explains that he developed a stitch abscess after his operation.
Explains that he developed a stitch abscess after his operation.
One man told us that he had had quite a bit of internal bleeding, and he reported that his scrotum had been very swollen after the operation, and that he was bruised right down to his knee. He mentioned that for a while he had had an area of numbness on the outside of his upper leg. He explained that this was where the doctors had attached some electrodes to try to reduce the amount of blood loss during surgery.
Explains that he had some internal bleeding and that he was bruised and swollen after surgery.
Explains that he had some internal bleeding and that he was bruised and swollen after surgery.
And then I went back to the ward, the consultant came round to see how I was, and the bruising, it looks like bruising because when you have this operation, even though they try and stitch you up, and this is what the consultant said, he tried to stitch me, get rid of as much possible blood loss internally as he could but every now and then you get these drips and they drip and they drip and they drip inside. I mean you, it doesn't mean anything to you, so I was quite swollen down there.
The, the scrotum is very swollen because there's still blood in there as it was dripping in but it also seems to secrete down the skin for some reason so I was actually, it looked like I was bruised to my knee, it was like a, it was almost like a triangular shape going back up to my knee
They say its usually around about three to five weeks you have off depending how much you've bled and unfortunately I was so borderline on how much I'd bled internally so I was very, very swollen. I would say to the size of a grapefruit! Yeah it was a, pretty swollen. It made the wife cry a little bit because she thought, it actually looked like I'd, I suppose the best way of explaining it as I'd been in a car accident and I'd landed on the gear stick, it was along those sort of lines, it looked that bruised, but it wasn't that painful, it wasn't that uncomfortable.
Explains that part of his leg was numb for a while because the doctor attached electrodes to reduce bleeding.
Explains that part of his leg was numb for a while because the doctor attached electrodes to reduce bleeding.
I'd also noticed that, not only had they shaved the area where they lift the testicle out [the groin area], but they'd also shaved the outside of my leg on my quads. And I asked them about that because it was completely numb and it felt very strange, they said, 'Oh, six months it will probably be numb.' What they do is they strap some sort of electrodes on your side of your leg and they send electrical currents through to reduce the amount of blood loss you have while you're having the operation, it's meant to reduce it.
Another man recalled that he had developed a haematoma (a swelling full of blood), and he said that he had to stay in hospital for about 2 weeks, which is much longer than normal.
Recalls that after his orchidectomy he had a haematoma [swelling composed of blood].
Recalls that after his orchidectomy he had a haematoma [swelling composed of blood].
And you say you had, there was a problem after the operation, can you explain what happened?
I think, yeah I developed a haematoma. I think it's a blood clot as a result of that, and I was kept in for you know longer than normal. Literally I think I was there for two weeks.
Where about was the haematoma?
It was in, in the region, it was again, I can't pinpoint it exactly.
Was that very uncomfortable?
I suppose at the time it was yeah, again I can't really remember. I suppose in a way because a lot of that you know, as far as I'm concerned is, I say a bad memory, I've tended to shut a lot of it out of my mind.
The loss of a testicle can affect men's self-image and sense of masculinity, at least for a while (see 'Masculinity and self-image').
Chemotherapy may be given for a short period to prevent cancer coming back, or over many months to cure cancer if it has spread from the testicle to other parts of the body (see 'Chemotherapy'). Many of the men we spoke with had chemotherapy, but they didn't always remember which drugs they had been given.
Chemotherapy affects everybody differently. Men who just had a single dose of chemotherapy to prevent the spread of the cancer had very few side effects. They felt a bit tired, lost their appetite for a day or two, and experienced some nausea and change in taste.
When chemotherapy is given for longer the side effects can be more severe. A common side effect is nausea and vomiting, though anti-sickness drugs can help prevent this.
Many men remembered a horrible metallic taste they had in their mouths, which some said was due to the drug cisplatin. Others described severe nausea or sickness, which often led to weight loss. However, one man said he didn't feel sick at all, even after 3 months of treatment, though his taste had changed, and another man said that he was always hungry.
Recalls that he was constantly sick during the chemotherapy and lost a lot of weight.
Recalls that he was constantly sick during the chemotherapy and lost a lot of weight.
Recalls that he wasn't sick and that he felt better than he expected during the chemotherapy.
Recalls that he wasn't sick and that he felt better than he expected during the chemotherapy.
Once the chemotherapy started it was just a case of lying there and really waiting for the effects to, to take hold. I thought I'd probably feel, start feeling sick pretty quickly but throughout the chemotherapy I can honestly say I didn't feel sick once and I was actually really relieved that everything I'd read probably didn't apply to most people. I think the drugs they use now are obviously better now than they have ever been, they are constantly being developed and obviously the one thing they're looking to do is have as minimal an impact on the body as possible. So I wasn't sick once with chemotherapy. I think the closest I came to being sick was possibly the hospital food! But that wasn't necessarily the food but because my taste buds had gone part way through the treatment. That was probably the closest I came to being sick. So the treatment itself, once I'd decided that, I realised this would probably be fine.
During chemotherapy some men we spoke to temporarily put on weight due to the corticosteroid they were given while having chemotherapy and associated fluid retention.
Another common side effect of chemotherapy is hair loss, which many of the men associated with cancer. After about 3 weeks of chemotherapy, they lost all their body hair, including eyebrows. Some of the men found this quite traumatic. However, some of the men told us that hair loss didn't bother them.
Arthur Frank recalls that losing his hair was one of the most traumatic moments of his illness.
Arthur Frank recalls that losing his hair was one of the most traumatic moments of his illness.
And I remember being, visiting my older daughter and as soon as chemotherapy was over I didn't feel any need to wear hats or anything and some people were kind of, this child I think was asking his mother you know why this guy was virtually bald er and I remember thinking actually I didn't care. To me the problem with hair loss was that it marked me as someone who had cancer and as soon as it no longer was associated with cancer for a man at least it wasn't that much of a problem.
Today it would be even less of a problem because it's stylish to have your head shaved anyway and, and again though there's a big difference between shaving your head because it's stylish and knowing your head is shaved because you've lost your hair, because you're a cancer patient. And it's that visible marker of having cancer that I think is the really difficult thing about hair loss. Plus all of a sudden having these great amounts of your hair fall out is just, it's a horrible thing. I mean there's no getting around it, this is one of the traumatic moments of illness er but as I say fortunately now there are a lot of models who have been stylishly head-shaved and I hope it wouldn't be as much problem for men now as it was for me back in the mid 80s before shaved heads had that kind of niche in fashion.
Explains that he did not mind losing his hair, partly because it convinced others that he was indeed ill.
Explains that he did not mind losing his hair, partly because it convinced others that he was indeed ill.
How did you feel when you lost your hair?
When I lost my hair it was my party trick at first because obviously I wasn't that ill the first few times I went so I was still managing to go out with friends. And sort of like my party trick you could grab hold of it and pull out a load of hair which was quite funny at the time (laughs). But unfortunately I was ill in the winter time during sort of like the October, November, December, January, so I had no hair then. I got very, very cold. But the stigma side of it I didn't, I didn't worry about that at all, didn't worry me at all, you're ill and that's it really. I mean in a way it shows that you are ill and people sort of have a different attitude. Because if you just, if you're ill and something is wrong with you and people can't see there's something wrong with they don't, how can I, not sympathy, you don't want sympathy but it's not the same. If you've got no hair and that lot, people realise that you're ill and not just skiving off work or whatever you know. So I've no worries at all about losing the hair at all.
The men recalled numerous other side effects, including short-term memory loss, fatigue, diarrhoea, mouth ulcers, bleeding gums, skin rashes, and in one case, blood in the sputum. Some said that the drug cisplatin caused tingling in the fingers and toes, and affected balance, and one man said that bleomycin made him have amazing dreams.
Some men reported that they had mood swings, and one man said he had to take anti-depressant drugs. Others said that the chemotherapy made them feel as though they had a hangover, or a bad attack of flu.
Chemotherapy drugs may temporarily reduce the number of normal cells in the patient's blood. Some men who received high doses of chemotherapy for long periods reported they developed infections due to the effects on their immune system, and one described his fatigue and shortness of breath due to anaemia.
Explains that he caught an infection because his immune system was affected by chemotherapy.
Explains that he caught an infection because his immune system was affected by chemotherapy.
Now the one thing that did happen then was I, I did feel very ill for a day or two and I really started to heat up and that was probably the worst experience of the chemotherapy itself. Which was my immune system had apparently dropped so low that I think I'd caught something, a bug or something and my body was actually not, my body was unable to defend itself against this. What actually happened I took myself into hospital, to the local hospital to, to be checked over and they gave me something called, I think it's barrier nursing, which is basically everyone who sees me including the nurses must be completely frocked up and plastic gloves on and masks on because they needed to treat me as soon as they could and as quickly as they could. So I was given treatments over a couple of days with antibiotics. And this is I guess the final effect of the chemotherapy was I, at that stage my white blood cells, I think my immune system had come down very low which was obviously an effect of the chemotherapy.
So although I tried to keep myself away from people when I could because obviously the chances of catching something is out there all the time, I'd obviously caught something from someone, which I've seen, made me go into hospital. And I was there for about two or three days and then the antibiotics worked, I felt better and then I slowly recovered after that.
Sometimes the side effects of chemotherapy are more serious and may be permanent. For example, cisplatin can cause tinnitus (ringing in the ears) and may damage hearing. Two men, who had chemotherapy for 3 months, told us about their partial loss of hearing.
One man said that he had suffered lung damage, which he attributed to bleomycin, and kidney damage from cisplatin. Another man said that carboplatin had damaged his liver, kidneys and pancreas.
Explains that the chemotherapy affected his hearing and gave him tinnitus (ringing in his ears).
Explains that the chemotherapy affected his hearing and gave him tinnitus (ringing in his ears).
Another side-effect was that my hearing went as well for a little while, my hearing wasn't very good. I went for a hearing test and everything, and every single time I went for the chemo it seemed to be getting worse. In the end, well I've still got it now, I've still got tinnitus which is like a ringing in the ears. Every single chemo session I went for, it seemed to be getting worse. Now when I told the doctors and that lot they did change part of the chemotherapy, one of the drugs they give you, and it seemed to stop getting worse then. But I have actually got tinnitus now, which is like I say ringing in the ears, which was from the side effects from the cancer treatment.
Has the hearing improved?
No, not really no, it's about the same level as it was and like I've got this ringing in my head all the time but..
Oh dear that must be annoying?
I've got used to it now, it's like an unnecessary friend really (laughs) is how I can explain it.
But you actually lost some of the hearing?
My hearing wasn't good. I actually lost, because I went for a hearing test and they put you in a booth with this machine put your ears on and it's very weird in like a soundproof booth, can't hear a word, a single sound in there and then they start giving you buzzing through a machine and you have to switch it off. And through that I found that my hearing has dropped a few degrees really now.
Explains that chemotherapy damaged his lungs and kidneys.
Explains that chemotherapy damaged his lungs and kidneys.
Another 2 months of it and on top of that they also told me that they did regular scans and regular blood tests and they also do lung function tests and kidney function tests. And one of the worst things, as you asked me before, one of the worst things was the lung function, my lungs were damaged by the drugs. I'm not sure, I think it was the bleomycin that damaged my lungs. I was left afterwards with a lot of scarring in my lungs so they stopped me on the bleomycin. And the cisplatin was causing me kidney damage so I had to go onto a drug called carboplatin which was slightly less effective but instead of being on the three drugs I was on two drugs, one of which was changed. So me being the inquisitive person I was wanted to know what does this mean for me? And it meant that the treatment might be slightly less effective but they couldn't at that time afford to continue with it because I was just getting so much lung damage and kidney damage as well.
Has that left you with long-term lung and kidney damage?
Initially I had lung scarring for, oh at least a good 12 months there was lung scarring and I was out of breath. If I walked up a flight of stairs I was out of breath. And they also gave me steroids for my breathing because my breathing was bad, they gave me steroids to help with the breathing. And in fact one of the things that came out of that was the determination to do the Great North Run, which I did. And as far as the kidneys are concerned I was left with kidney impairment.
Copyright © 2024 University of Oxford. All rights reserved.