An orchiectomy is not a prostate cancer treatment--it does not cure the cancer. Because removal of the testicles cause a decrease in testosterone, it is considered a form of hormone therapy, and is used to prolong survival by reducing cancer tumor growth (often causing tumor shrinkage), and relieve bone pain caused by bone metastasis. Up until the early 1990s there was no real hormone therapy alternative to orchiectomy. It is a complete and permanent removal of the major manufacturer of testosterone, and thus is still considered the gold standard for comparison with hormone therapy for advanced prostate cancer.
In Stage IV Prostate Cancer, it is often used in conjunction with external beam radiation treatments (EBRT) aimed at the tumors on the bones, and other organs.
What to Expect from the Surgery
An orchiectomy is really quite a simple procedure often done on an outpatient basis. In a radical orchiectomy, the complete testicle is removed. In a subscapular orchiectomy, only the internal parts of the testicle are removed leaving the outer "shell," allowing the man to keep the appearance of having testicles in the scrotum.
During the surgery, there will be two small incisions made (one on each side of the scrotum) in order to extract the testicles.
After an orchiectomy, men need about a week to resume normal activities and full recovery can be expected within a month.
Risks and Side Effects
- Erectile dysfunction
- Breast development (gynecomastia)
- Sterility (sperm are no longer made)
- Weight gain, hot flashes, loss of muscle mass (from loss of testosterone)
- Osteoporosis (from lack of testosterone)
Most of the side effects listed above can be treated as they appear.
Things to Ponder When Considering an Orchiectomy
Removal of the testes during an orchiectomy has the same effects as other forms of hormone therapy. Some men prefer an orchiectomy over chemical hormone treatments because they involve injections and/or a daily regimen of pills. However, unlike pills or injections, once you have an orchiectomy, the results are permanent.
