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A special section of the TCRC dedicated to guys who have lost both testicles.

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Treatment the Second Time Around

Treatments?? Why is there a treatments page here? Aren't all the treatments covered on the main section of the TCRC?

Yes, the treatments are covered on the TCRC, however, life becomes more complicated when both testicles are removed. The treatments themselves are the same, however the options and concerns are different. As I see it, there are three distinctly different types of folks who might be reading this:

  1. Guys who, for one reason or another have only one testicle, and it has cancer.
  2. Guys who had TC a while ago, and now have it in the remaining testicle.
  3. Guys who have been told that BOTH testicles have cancer at the same time.

All these guys have two thing in common. First of all, they all need to be concerned with their testosterone level, and they should be particularly motivated to get a baseline testosterone level (and LH level) established before letting a surgeon loose on the cancer. It is important to get this info because it will make life much easier down the road. Second, they all need to bank sperm if they want kids in the future. Testicular cancer is very treatable, and it is not unreasonable to delay treatment to deal with this issue. If you want kids down the road, tell the doctor to let you be for a week or two while you bank sperm.

The guys in the first group are no different than the majority of testicular cancer patients. Everyone ought to worry about testosterone and sperm banking. With these guys it is just a little more of an obvious problem.

The guys in the second group, however, have some bigger concerns. These guys have already been treated for testicular cancer. Unless they chose surveillance the first time around, they have had radiation or chemo and/or an RPLND. An RPLND can be repeated, if necessary, but neither radiation nor chemo can be repeated. If either is needed the second time around, then something different must be used. If you had radiation before, then you might need surveillance or chemo now. If you had chemo, then you might need radiation or a different chemo protocol. However, be aware that just because you had testicular cancer twice does not make your case more severe. Surveillance is still an option and the cancer is still very treatable.

The guys in the third group have a different concern. They haven't had any treatment before, so all treatments are available. However, simultaneous bilateral testicular cancer is really rare. It definitely can happen, but it is rare enough that they probably should ask for a second opinion on the ultrasound before letting the doctor do any cutting.

Few doctors will have seen any of these types of guys before. They may overreact and prescribe a strange treatment, or they might ignore fertility or hormone replacement concerns. For this reason, I strongly recommend that you either find an experienced doctor or have your doctor contact one of the doctors on the experts list to get advice on which treatment is appropriate.

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This page was last updated on Mar 29, 2018
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