Many men worry that losing one testicle will affect their ability to have sexual intercourse or make them sterile. But a man with one healthy testicle can still have a normal erection and produce sperm. Therefore, an operation to remove just one testicle does not make a patient impotent and seldom interferes with fertility. Men can also have an artificial testicle, called a prosthesis, placed in the scrotum. The implant has the weight and feel of a normal testicle.

Surgery to remove the lymph nodes does not change a man's ability to have an erection or an orgasm, but the operation can cause sterility because it interferes with ejaculation. Some men recover the ability to ejaculate without treatment; others may be helped by medication. Patients should talk with the doctor about the possibility of removing the lymph nodes using a special surgical technique that may protect the ability to ejaculate.

Radiation therapy affects both normal and cancerous cells, but normal cells are able to recover. Having treatments 5 days a week for several weeks spreads out the total dose of radiation and gives the patient weekend rest breaks. Nevertheless, the body must work very hard during radiation therapy to repair the tissues injured by the treatment. Patients may feel unusually tired, and they should try to rest as much as possible. Radiation therapy does not change the ability to have sex. Radiation therapy does, however, interfere with sperm production. Usually the effect is temporary, and most patients regain their fertility within a matter of months.

Other unpleasant effects of radiation therapy include diarrhea, nausea, and vomiting. These problems can usually be controlled with medication. Also, there may be skin reactions in the area being treated, and it is important to treat the skin gently. Lotions and creams should not be used on these areas without the doctor's advice.

Chemotherapy causes side effects because it damages not only cancer cells, but other rapidly growing cells as well. Often anticancer drugs are given in cycles; treatment periods alternate with rest periods. The side effects of chemotherapy depend on the specific drugs that are given and the response of the individual patient. These drugs commonly affect hair cells, blood-forming cells, and cells that line the digestive tract. As a result, they may cause various problems, including hair loss, lowered resistance to infection, loss of appetite, nausea and vomiting, and mouth sores. Most men who receive chemotherapy for testicular cancer can continue to function sexually, although some anticancer drugs interfere with sperm production. Although this effect is permanent for some patients, many recover their fertility later on.

Loss of appetite can be a serious problem for patients receiving radiation therapy or chemotherapy. Researchers are learning that patients who eat well are better able to withstand the side effects of their treatment. Therefore, good nutrition is important. Eating well means getting enough calories to prevent weight loss and having enough protein to build and repair skin, hair, muscles, and organs. Many patients find that having several small meals and snacks throughout the day is easier than trying to eat three large meals.

The side effects of cancer therapy vary from person to person and may even be different from one treatment to the next. Patients may find that they are less interested in sexual activity if they are tired or feel ill. Doctors try to plan treatment to keep problems to a minimum, and fortunately, most side effects are temporary. Doctors, nurses, and dietitians can explain the side effects of cancer treatment and suggest ways to deal with them. Helpful information about cancer treatment and coping with side effects is given in the NCI publications Radiation Therapy and You, Chemotherapy and You, and Eating Hints for Cancer Patients.

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