Testicular cancer can have long-term effects on a man’s health, including its potential impact on testosterone levels. Understanding this relationship is important. This article explores how testicular cancer and its treatments can influence testosterone production and well-being.
Testicular Cancer’s Link to Low Testosterone
Testicular cancer can lead to lower testosterone levels, a condition called hypogonadism. The testicles are the primary site for testosterone production, a hormone important for male characteristics, muscle mass, bone density, and sexual function. When testicular cancer is present or treated, the testicles’ ability to produce testosterone can be affected. Many testicular cancer survivors, around 38%, may experience low testosterone levels, which can manifest at diagnosis or develop after treatment.
Mechanisms Behind Low Testosterone Development
The development of low testosterone following testicular cancer is primarily due to the impact of treatment on the testicles’ hormone-producing cells. The most direct cause is orchiectomy, the surgical removal of one or both testicles. If only one testicle is removed, the remaining healthy testicle often compensates by producing sufficient testosterone. However, if both testicles are removed, or if the remaining testicle is not fully functional, a significant drop in testosterone levels will occur, necessitating lifelong replacement therapy.
Chemotherapy, especially platinum-based regimens, can damage the Leydig cells within the testicles, which are responsible for testosterone synthesis. While testosterone levels may return to normal after chemotherapy, high cumulative doses can lead to persistent impairment of Leydig cell function, resulting in a temporary or permanent reduction in natural testosterone production.
Radiation therapy directed at the pelvic area can also affect testosterone-producing cells in the testicles. Even scattered radiation from treatments for other cancers can impact testicular function and reduce testosterone levels.
Identifying and Managing Low Testosterone
Recognizing the signs of low testosterone (hypogonadism) is an important step in its management. Common symptoms include persistent fatigue, decreased sex drive, erectile dysfunction, mood changes, decreased muscle mass, difficulty concentrating, or hot flashes. These can significantly affect daily life and overall well-being.
Diagnosis involves blood tests to measure total and free testosterone levels, often performed in the morning when levels are at their peak. Further tests for luteinizing hormone (LH) and follicle-stimulating hormone (FSH) can help determine if the issue stems from the testicles (primary hypogonadism) or from the brain’s signaling (secondary hypogonadism).
The primary treatment for low testosterone is testosterone replacement therapy (TRT). TRT aims to alleviate symptoms and improve quality of life by restoring testosterone to healthy levels. This therapy can be administered through various methods, including injections, gels, or patches. TRT can improve body composition by decreasing fat mass and increasing lean body mass.
Long-Term Outlook and Monitoring
Ongoing medical surveillance is important for testicular cancer survivors. Regular monitoring of testosterone levels is recommended, as hypogonadism can develop years after treatment. Healthcare providers screen for symptoms and measure testosterone levels. Low testosterone does not cause testicular cancer; it is a consequence of the cancer or its treatment. Continued follow-up care supports overall health management for survivors.