Care and mobility considerations
Care and Mobility needs during treatment
Disability related to surgery for testicular cancer is likely to be short lived. On the rare occasion when needs are identified because of Radiotherapy and Chemotherapy these treatments, they can be expected to resolve when treatment is complete.
Disabling effects of treatments
Chemotherapy
The majority of men will have early stage disease (stage 1) and are likely to require only one cycle of chemotherapy after surgery, recovery will be complete, typically within two to three months. For those with metastatic disease treatment is likely to be more prolonged e.g. 4 cycles of chemotherapy and extra treatments such as further surgery, chemo or radiotherapy. The minimum time for treatment and recovery for these men is six months but treatment related disability may extend over a period of years.
If there is time men are offered the opportunity to bank sperm before chemotherapy starts because of potential chemotherapy-related infertility.
Those who have high dose chemotherapy and bone marrow transplant are at high risk of developing infection and experience quite severe side effects during treatment. In the long term they may never fully recover physical strength and may have any of the enduring effects of chemotherapy especially fatigue.
Radiotherapy
Treatment for seminoma is given over 10 to 14 days. Specific side effects include diarrhoea and nausea.
Further surgery
Some men may need further surgery either before or after chemotherapy and radiotherapy treatment. This will usually be to remove ‘lumps’ or ‘masses’ of secondary cancer identified on Computerised Tomography (CT) scanning.
These operations and their side effects are:-
- ‘Lymphadenectomy’ - Removal of lymph nodes from the back wall of the abdomen. This may be carried out as an open or laparoscopic operation; the recovery time is 2-6 weeks.
- Lung surgery is major surgery and requires 3-12 weeks for recovery. If a significant amount of lung tissue is removed this may result in reduced exercised tolerance – getting out of breath easily and not being able to exercise as hard as before.
Long term disabling effects of treatment
These are important in testicular cancer because it affects young men, often in their twenties; by the time they are in their forties a significant number may already have developed long term side effects of treatment. Risks include an increased chance of developing leukaemia, melanoma, sarcoma, cancers of stomach, bladder, colon, pancreas, lung, prostate, kidney and thyroid. They are at increased risk of developing coronary heart disease. They may experience any of the enduring side effects of chemotherapy.
Having cancer at a young age is hard to cope with psychologically. They will be coping with potential loss of life, side effects of treatment, loss of a testicle and hair loss. They may have to stop work or change their type of work as a result of their diagnosis. Their worries may include significant financial problems, fears of the future related to their disease and problems with body image, any of which may cause depression.
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Amended April 2008
