What is orchiectomy and why use it to treat prostate cancer
The orchiectomy procedure involves removing the testicles from the scrotum, this results in a drastic lowering of testosterone levels in the body as 95% of testosterone is produced in the testicles (testosterone is also produced by the adrenal glands). Testosterone is one of the hormones that promotes prostate growth and development, when it is no longer available the prostate cancer cells are unable to grow. Nowadays this procedure is usually only used in patients with advanced prostate cancer.
In orchiectomy only the testicles are removed, the scrotum remains in place, many people think that the whole scrotum is removed in this procedure; this is not the case.
The Orchiectomy procedure
The orchiectomy operation is fairly simple and takes around 30 minutes to perform, the patient can usually go home on the same day and is treated as an out-patient.
The patient is first given a choice of anaesthetic (either a general or local). The surgeon will then make a 3 to 5cm incision at the front of the scrota sac. The testicles are then pulled out and the spermatic cords are then cut. The insertion is then stitched up.
An alternative to the standard orchiectomy procedure is that of subcapsular orchiectomy. In this technique the glands around the testicles that produce testosterone are removed but the testicles remain. Therefore the subcapsular orchiectomy procedure leaves the appearance of a near normal scrotum. This helps to prevent reported psychological effects associated with the removal of the testicles; another way around this is to insert saline implants.
Why have a orchiectomy treatment?
Having an orchiectomy means that one does not need to have repeated injections of hormones to lower testosterone levels. In men with metastatic prostate cancer pain relief can occur very quickly; this normally takes about a month if receiving hormonal LHRH agonists.
Orchiectomy side effects
The removal of testosterone from the body may have many side effects some of which are similar to that seen in menopausal women such as osteoporosis and hot flushes; a loss of sexual desire; decrease in muscle strength; and weight gain.
A major problem with orchiectomy is that it can have many psychological impacts upon a man, this can often be overcome by having implants or by the performance of a subcapsular orchiectomy.
A further problem is that orchiectomy is none reversible so if you do develop any of the side effects mentioned the patient must learn to live with them.
It is hoped that this article has given you insight into orchiectomy for prostate cancer. If you have further questions it is recommended that you consult your doctor who is aware of your particular circumstances and will hope to reassure you of the pros and cons of any therapy that may be required.