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Sex After Testicular Cancer

Sex After Testicular Cancer | Jo Divine

Testicular cancer is unusual compared to other cancers because it mainly occurs in younger men. It accounts for just 1% of all cancers that occur in men but is the most common type of cancer in men aged 15-49 years. Prevalence of the disease is five times higher in white men than in black men but the reason for this unknown.

Compared to other cancers, death from testicular cancer is rare. It is one of the most treatable forms of cancer with more than 96% of men with early stage testicular cancer being completely cured. Even in more advanced cases where the cancer has spread to nearby tissue, there is an 80% chance of being cured.

Treatment for testicular cancer includes surgical removal of the affected testicle and chemotherapy. Both treatments have side effects which can affect sexual function, but there are ways in which sexual problems can be overcome should they occur.

A Clic Sargent online survey of 125 young people diagnosed with cancer asked about the impact of the illness on their personal and sexual relationships.

The results showed that young people are more than 50% likely to have questions about relationships and sex after they are diagnosed with cancer, suggesting that many questions go unanswered. Young people are struggling to find the information they need after a cancer diagnosis, compared to finding answers to their questions when they were well.

As a result Clic Sargent have a sex and relationship Agony Uncle Matt Whyman who offers advice to the questions TYA may ask about sex and cancer.

Surgical intervention

Removing the affected testicle should not impact upon your sexual performance or ability to have children. The remaining testicle produces more testosterone and sperm to compensate for the testicle that has been removed.

Surgical intervention which involves removing the retro peritoneal lymph nodes, a primary landing site during the spread of the disease, may cause nerve damage which can cause retrograde ejaculation, whereby the sperm goes backwards into the bladder instead of out of the penis. This does not prevent getting an erection but your orgasm can feel different because it is dry. Your consultant may recommend you store sperm to use to conceive a child but many of the new surgical techniques avoid this problem from occurring.

Chemotherapy

Not all men become infertile after receiving chemotherapy – the effects of chemotherapy on sperm production can be temporary and sperm count can return to normal levels. It is advisable that you do not try to father a child during treatment and for about one year afterwards because the sperm can be malformed due to the effects of chemotherapy drugs, which may affect the formation of the foetus or having a full term pregnancy. It is recommended that you and your partner use effective contraception during this time. It is advisable to wear a condom during sex as some of the chemotherapy drugs may pass out into the semen and may cause irritation to your partner.

Sperm banking

Chemotherapy can often cause infertility, so prior to beginning treatment, your doctor will discuss the option of sperm banking. Even if you are young and not considering a family, it is essential to discuss all fertility options with your doctor. Sperm banking is where 2-3 samples of your sperm are frozen so it can be used at a later date to impregnate your partner during artificial insemination. Sperm samples can be kept frozen until you are 55.

Side effects of chemotherapy

Chemotherapy drugs are designed to destroy cancer cells but can also attack healthy cells too. This results in a range of side effects, some of which can be debilitating, including:

  • Vomiting
  • Nausea
  • Hair loss
  • Sore mouth
  • Loss of appetite
  • Breathlessness
  • Infertility (usually temporary)
  • Tinnitus (ringing in the ears)
  • Skin that bruises or bleeds easily
  • Increased risk to infection
  • Numbness and pins and needles in hands and feet
  • Sensitivity to heat/cold

Many of these side effects are temporary and disappear when you have completed your treatment. Your specialist cancer nurse will advise about ways in which to combat these side effects and how to alleviate them during treatment.

Radiotherapy

Radiotherapy has few side effects and does not cause infertility, but you may be advised to sperm bank your semen. It can make the skin feel very sore and you will be given creams to apply to the affected area. It can also be very tiring.

Interestingly, new research from Cancer Research UK published in the British Journal of Cancer (2018) has found that high-intensity interval training reduces tiredness and improves self-esteem for testicular cancer survivors. Although a small sample group, it is easy to replicate according to Professor Kerry S Courneya who says,

“What’s so exciting is that this programme would be easy to introduce to patients as it’s as simple as jogging for two minutes and walking for two minutes. It can also be specifically targeted at men who aren’t fit and suffer with tiredness.”

Sexual problems

Like any form of cancer, testicular cancer can raise lots of different emotions, but issues related to sexual health and pleasure are more prevalent because many men feel that it has affected their feelings of masculinity due to the cancer being present in their testicles, which are designed for sex. This is similar to the way women feel when they have breast, ovarian or cervical cancers, as these areas of the body are linked to their sexuality.

Often, men find that they have a decreased libido as a result of the way they now view their sexuality and how they think their partner sees them. The stress of coping with a diagnosis of cancer will affect your sex drive, and communication between you and your partner will really help to enable you both to understand what is happening, why it is happening and how to get through this period. Cancer treatments can be very debilitating, so feeling tired or being sick will reduce your libido too.

Many men think that their partner will no longer find them attractive but with good communication you can be reassured by them that this is not the case. Many partners are just worried about hurting the affected person during sexual intimacy and may shy away from making love or even cuddling.

Even though you may not be able to have penetrative sex, there are so many other great things you can do to enjoy sexual pleasure and intimacy. Incorporating the use of sex toys into your sex play can be fun and pleasurable too.

Talk to your cancer nurse, specialist or doctor who will be able to guide you through this time and offer reassurance that the feeling of low libido will not continue once your treatment has been completed.

Erectile Dysfunction

Some men may develop temporary erectile dysfunction following surgery and medical treatment, either as a direct result of surgical intervention or as a result of anxiety, stress and performance issues. Using male sex toys, such as a cock ring, male masturbators or vibrators can help overcome these problems.

The Pulse by Hot Octopuss is ideal as you do not need an erect penis before use. The Pulse III SOLO firmly holds the penis within its wings, the oscillating plates massage the frenulum for amazing sexual sensations.

Penis pumps, such as Bathmate Hydromax are effective in helping the majority of men get an erection suitable for sex. Often, a full erection is not required to achieve sexual intercourse.The actual sight of getting an erection when you have not been able to do so under your own steam can help to unlock whatever emotional or mental problem was preventing you from getting an erection.

Testosterone replacement therapy

Having one testicle removed does not usually affect testosterone levels because the remaining testicle begins to produce more testosterone. Sometimes the remaining testicle is unable to produce enough testosterone or a man may have both testicles removed. Low testosterone levels affect your sex drive and ability to to get an erection. It can also cause tiredness, low mood, and osteoporosis (thinning of the bones).

You must inform your doctor if you experience any of these symptoms and he will be able to measure your testosterone levels by a blood test and prescribe testosterone replacement therapy if it is low. It can be given in the form of a gel, as an injection or as a skin patch. Eating foods that boost your testosterone can help too.

Following treatment. you will have regular check ups to ensure that the cancer has not returned. Around 25-30% of men experience a return of the cancer, usually within the first two years of completing their treatment, which is why it is important to do regular testicular self examination and be aware of any warning signs you may be having. Once treated, sexual function returns to normal and many men are able to father a child successfully.

Useful websites

Clic Sargent : www.clicsargent.org.uk
Trekstock : www.trekstock.com
Shine Cancer Support : www.shinecancersupport.orgCLIC Sargent :
Testicular Cancer UK : @testicularcanceruk
Orchid Cancer UK : www.orchid-cancer.org.uk/
Baggy Trousers : www.baggytrousersuk.org
Macmillan Cancer:www.macmillan.org.uk
Cancer Research UK:www.cancerresearchuk.org
The Royal Marsden:www.royalmarsden.nhs.uk
The Christie Hospital:www.christie.nhs.uk
College of Sex and Relationship Therapists : www.cosrt.org.uk
Testicular Cancer Awareness Foundation : www.testicularcancerawarenessfoundation.org