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    Hello Everyone,

    My name is Josh, I am 25. About 2 months ago I was in Italy with some friends from work. I asked my buddy (who was my medic) to check out this issue I'm having with my testicles (My veins were think and all tangled up and made me curious if it could be an issue). He recommended that I get it checked out. I return back to Germany where I see my Primary Care Manager who took a look at my testicles and said that its just large veins and shouldn't concern me, but gave me a referral for an ultrasound in a near by German hospital. Once I arrived at the German hospital I got my ultrasound started where they stated my reason for coming in was completely normal but they wanted to look at my testicles for any irregularities. My left was fine but the doctors were speaking German and discussing among themselves which was aggravating because I was the only American there who only spoke English, about 5 minutes after them debating she turns the screen to me and shows me that I had a tumor in my right testicle. It blew my mind because I never felt pain or had any clue. They recommended a CT Scan but it was shot down by the lead Urologist who said I will need immediate surgery. It lead to the removing the tumor and sparing my right testicle, after a week of pain the doctors said that their pathology recommend complete removal of the right testicle. A PET Scan was completed (Which showed a possibly spread to the lungs) I was sent back to the states for further treatment so I can be cared for close to home. Upon arrival I gave my samples that were removed in Germany to the Hematologist/Oncologist here who sent it in for pathology reports. Luckily the lung issue was unrelated and poses no immediate threat. When speaking to Urologist weeks later they stated it was a Teratoma that stayed local in the testicle and said he thinks I should be fine to keep the testicle, however it still causes pain 2 months later and hasn't descended completely. Every doctor and TC survivor said "just lose the nut" because it has a possibility of returning, and could be worse. The Urologist said it is a possibility that it could return but he isn't sure because nothing is 100% (which I understand) he gave me the option to choose what I wanted. Luckily I am in no need for chemo like originally thought or RPLND. So I have scheduled my surgery to remove the right testicle in a week and a half. (Also understand I have not had any other tests on my testicle since Germany besides Tumor Makers which appear okay.

    My questions are:

    -Am I right to go ahead and get the testicle removed?
    (I don't wanna live constantly thinking it may come back and regret not losing it when I had the chance)

    -If it is removed should I get the Testicle Implant?

    -Can I have children with only one Testicle?

    -Should I bank sperm?
    (I am Active Duty and covered by TriCare Prime but they will not provide the cost for banking which is $450 upfront the $150 annually Then retrieval of the sample is $350.)

    -Will my fertility change?
    (I did a lot of research but it always says "should, could, may" not clear answers.

    -Will my testosterone lower?

    -Will my sex drive go down?

  • #2
    I'll chime in with my personal experience and some questions for you to clarify.

    Do I read correctly that they did a partial orchiectomy on just one side? I don't think a partial orchiectomy is common. My understanding is that a hypoechoic ultrasound is typically treated by full (radical) orchiectomy.
    Pathology was 100% teratoma? Was there something unique about the location of your tumor or its size?

    If I were you I would have the full orchiectomy and just lose the nut. I'm down one nut 10 months now it's not really any kind of an issue.

    Regarding implant -- I can just chime in that I didn't and it doesn't bother me to have one nut. I'm married with kid , so things may be different for you. If I was not married I think being symmetrical would be important for my self-confidence.

    One suggestion -- get your testosterone checked BEFORE orchiectomy. That way you have a baseline to afterward. I think most people do eventually reach a normal range of testosterone with only one, but of course "normal range" doesn't necessarily mean that it's optimal/suitable for you.

    I have one nut, went through 1xBEP chemo also which also affects this area. My testosterone is "normal" but on the very low end. I have a normal sex life and libido (as compared to some years ago). I have some difficulty with my physical fitness and building muscle, however. Is physical strength and muscle important for your career?

    Certainly, though, low testosterone can be remedied by hormone replacement.
    Age 31 - Portland, OR
    01NOV16- Pain in right testicle, palpable mass
    13NOV16- R I/O. Markers normal
    27NOV16- Stage Ia non-seminoma, 1.3cm, 100% EC, no LVI
    06DEC16 - CT scan clear
    09DEC16 - Started 1xBEP. Neutropenic at day 15; Worst part for me was bleo (allergic).
    03JAN17- Ended 1xBEP; start surveillance
    18MAR17-2nd pathology report shows 90% EC , 10% seminoma


    • #3
      Hey man, sorry to hear you're in this mess too...

      My doc made it very clear that the testicle needs to go.

      If all goes according to plan, the other one picks up the slack.

      In short, I noticed no change in sex drive, or sex, or testosterone.

      My wife is not bothered by the fact there's one testicle so I'm glad I didn't get an implant but it's just a personal choice...

      Did sperm banking which might be a good idea in case your fertility is affected - could be in case you need chemo...
      July 2016 - Left I/O
      December 2016 - BEPx3
      All clear for 1 year!

      My Testicular Cancer Support Kit
      First Oncologist Visit Checklist
      Simplify Cancer Podcast


      • #4
        Lose the nut, man. It's a bit odd at first but you will get used to it fairly quickly. I have a completely normal sex life, my wife doesn't notice at all the missing testicle, and we are expecting our second child this coming January, which was conceived about 7 months after completing radiation for a relapse.

        No worries this sounds like a quick surgery and then you can move in with your life man


        • #5
          You guys are great! I appreciate the advice. I am pretty confident that I will have the surgery and not get the transplant. I'll probably skip the transplant, if I'm about to get laid and a woman has anything negative to say about having one but then I guess it'll be a long walk home lol. Testosterone is very important because strength and endurance go hand in hand with Military so I'm hoping I have no issues. It was odd that they did a partial because immediately after the german doctors wanted to do a full orchiectomy, it's until now that the doctor is telling me he thinks I'll be fine. I honestly believe he is just being more cautionate with surgery where other doctors were more aggressive which is the way I am. I just feel like it's better than stressing thinking it may come back or worse.


          • #6
            I agree with much of what has been said, but I do have two pieces of information to add. First, I think that testosterone and libido will be very personal. I've experienced almost no changes in sex drive, endurance, muscle mass, etc. If anything, I had more problems during the period when my tumor was growing fast enough to become noticeable.

            As far as fertility, I just so happened to have testing done just before my diagnosis and just recently (exactly 2 years after chemo). I am almost certain that my fertility did take a temporary hit, but as of two years later, everything is almost completely normal. There was a slight decrease in sperm motility, which I doubt would have even been flagged if the doctor did not have a comparison sample.