FEATURED MEDICAL EDUCATION TOPIC: Testicular Cancer Survivorship: Fertility, Testicular Prosthesis, and Sexual Health

What is the problem?

Testicular cancer is the most common solid tumor in men aged 15 to 40. With cure rates exceeding 95%, most patients live for decades after treatment. This younger population tends to underuse preventive and longitudinal care, and reproductive and sexual concerns carry a stigma that may be heightened by age, culture, and language. Testicular cancer and its treatment can affect fertility, body image, testosterone levels, and sexual function, yet care and counseling remain focused primarily on achieving cure.

Professional Practice Gap:

Current national guidelines recommend that every male patient be offered sperm banking before any cancer treatment begins (Su et al., J Clin Oncol, 2025). In practice, this conversation is often rushed or skipped because surgery and chemotherapy usually follow quickly after diagnosis. Testicular implants show a similar gap. Patients who receive them generally report high satisfaction, yet in an international survey, only about half of urologists (53%) said they always offer one at the time of surgery (Emmanuel et al., BJUI Compass, 2025). After treatment ends, survivors are often not routinely checked for low testosterone or changes in sexual function, even though these effects can appear or persist for years. As a result, many young men live with lasting effects on fertility, sexual health, and self-image that earlier discussion and consistent follow-up could help prevent or address. Clinicians need practical, survivorship-focused strategies to raise these topics before treatment and build them into long-term care.

Proposed Learning Objectives

Upon completion of this activity, participants will be able to:

• Counsel post-pubertal patients with testicular cancer on fertility preservation options and the timing of sperm cryopreservation before orchiectomy and gonadotoxic therapy.
• Integrate testicular prosthesis counseling into the pre-orchiectomy consent process, including candidacy, timing, and realistic expectations for satisfaction and complications.
• Diagnose and manage testosterone deficiency in testicular cancer survivors, including when to screen and the principles of treatment and monitoring.
• Evaluate and manage erectile and ejaculatory dysfunction and body-image concerns in testicular cancer survivors.

If your medical staff needs an update on testicular cancer survivorship, consider contacting our office to book a speaker at 714-505-4777 or info@speakersnetwork.com.

How do we know this is a problem?

• Su HI, Lacchetti C, Letourneau J, et al. Fertility preservation in people with cancer: ASCO guideline update. J Clin Oncol. 2025;43(12):1488–1515. doi:10.1200/JCO-24-02782
• Brannigan RE, Hermanson L, et al. Updates to male infertility: AUA/ASRM guideline (2024). J Urol. 2024.
• Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril. 2019.
• Emmanuel A, Kanthabalan A, Alexander C, et al. Current attitudes to testicular prosthesis insertion during radical orchidectomy: an international perspective. BJUI Compass. 2025;6(1):e465. doi:10.1002/bco2.465
• Fung C, et al. Toxicities associated with cisplatin-based chemotherapy and radiotherapy in long-term testicular cancer survivors. Adv Urol. 2018;2018:8671832.
• Testicular cancer survivorship: looking back to move forward. J Clin Oncol. 2022.
• Incidence of erectile dysfunction and testosterone deficiency in testicular cancer survivors. J Urol. 2024.
• Satisfaction with testicular prosthesis after radical orchiectomy. Urology. 2018.