Carcinoma of the Kidney and Testis, and Rare Malignancies: Innovations in Management edition:1 pages:319-325
Testicular cancer usually in young men, many of whom have not yet established a family at the time at which the diagnosis of cancer is made. Most of the tumors are germ cell tumors, which are highly curable with surgery, radiotherapy, chemotherapy, or multimodality treatment. The primary goal for urologists, radiotherapists, and medical oncologists is, of course, to cure the patient. Despite the obvious stress to the patient caused by the news of a diagnosis of testicular cancer, one must take time to discuss the fertility issues with the patient. Unlike Hodgkin's disease, which also affects young men of reproductive age and is highly curable, testicular cancer involves an organ intrinsically linked with fertility, sexuality, and self-image (see Chap. 36). RIEKER et al. (1990)showed that there were different fertility-related behaviors in these patients. Young childless patients without a stable relationship were more interested in sperm banking, while men who also lost their ejaculatory function after treatment had the greatest risk of continued distress regarding infertility. RIEKER et al. showed that adjustment to infertility is a complex process that begins at diagnosis and extends long after treatment has been completed.