1.Surgery for testicular cancer The method of removing part of the testicle through the groin is called terminal inguinal orchiectomy. Patients who undergo this treatment may be concerned that having one testicle removed may affect their sexual performance and may cause them to become infertile. However, a man with only one healthy testicle can still have an erection and produce sperm normally. Therefore, surgical removal of one testicle will not render the patient sexually impotent or infertile. Furthermore, the surgeon can place an artificial testicle in the scrotum during the surgery. The artificial testicle weighs and feels just like a normal testicle, and an uninformed person cannot tell the difference between an artificial testicle and a natural testicle by its appearance. Some lymph nodes deep in the abdomen are also removed. Although this procedure does not affect the patient’s normal erection and orgasm, it can cause infertility because it may prevent ejaculation. 2.Radiation therapy for testicular cancer Radiation therapy is a method of using high-energy rays to kill cancer cells so as to make the tumor shrink. Radiation therapy is a localized therapy which only affects cancer cells in the treated area. To treat testicular cancer, doctors use a gas pedal outside the patient’s body to send high-energy rays at the abdominal lymph nodes. Spermatogonia are very sensitive to radiation. Non-seminogenic cells are not sensitive to radiation; therefore, radiation therapy is generally not used for patients with non-seminogenic cancers. Radiation therapy should be used after orchiectomy. Radiation therapy not only affects cancer cells, but also normal cells. The side effects of radiation therapy are usually determined by the dose of treatment. Common side effects include fatigue, skin changes in the treated area, nausea, and diarrhea. Radiation therapy can affect the patient’s sperm production, and most patients will still be fertile for 1 to 2 years. 3.Testicular cancer chemotherapy Chemotherapy is a method to kill cancer cells in the whole body by anti-cancer drugs. Chemotherapy is usually used after surgery to kill the remaining cancer cells after surgery. This method is called adjuvant therapy. Chemotherapy may also be used as an initial treatment if the cancer is advanced. Most anti-cancer drugs are given by injecting the drug directly into a vein. Chemotherapy is a systemic therapy, meaning that the drugs travel around the body in the bloodstream and act on cancer cells and normal cells throughout the body. The side effects of this treatment usually depend on the type and dosage of the drug used. Common side effects include nausea, hair loss, fatigue, diarrhea, vomiting, fever, chills, cough, sore mouth and rash. They also include dizziness, numbness, poor reflexes, and deafness in both ears. Some anti-cancer drugs can prevent sperm production, and in some patients infertility is permanent, while most patients regain fertility soon after. Some patients with advanced testicular cancer or relapsed testicular cancer require bone marrow transplantation, which requires high doses of chemotherapy. These high doses of chemotherapy can damage the bone marrow (which makes and stores blood cells) In a bone marrow transplant, the doctor takes bone marrow or peripheral stem cells from the patient before chemotherapy. These cells are frozen, then thawed and are re-transplanted into the patient’s body.