BODY SIGNAL ALERT TESTICLE, HARD LUMP IN: TREATMENT
Anytime a patient notices a suspicious mass in his testicle, I suggest that he visit a urologist, who will do a sonogram of the mass to determine the exact site and whether the mass is hard or filled with fluid. If the urologist has any doubt, he will perform a biopsy. If the testicle is not cancerous—which is usually the case—it will be left in place.
If you have a cyst on the epididymis, your doctor will probably choose to leave it alone. If it continues to grow, however, it will eventually cause pain. At that point, your doctor will probably want to remove it surgically.
If the lump turns out to be cancerous, your doctor will need to treat it immediately by removing the entire testicle. This procedure is called an orchiectomy and is performed if the cancer has not spread beyond the testicle. Again, since only one testicle is usually affected, the other testicle will be left in place, meaning that your fertility will not be impaired. If your doctor feels that the cancer has spread, however, he will recommend that you also be treated with radiation or chemotherapy; this will result in sterility.
One of my patients is a 37-year-old man whom I diagnosed 10 years ago with testicular cancer; he was unmarried at the time. Before he was treated with surgery and radiation, he decided to have his sperm frozen so he would be able to father a child in the future, since the treatments would render him sterile. He also had a small testicular prosthesis placed into his testicular sac for cosmetic reasons.
Today, he’s been cancer free since the surgery; he needs only an annual blood test and physical exam. He hasn’t yet married, but his semen is intact if he needs it to become a father.
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