Removal of testicles can save men with fourth-stage prostate cancer

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By Rupesh Dutta

New Delhi– Initially, 62-year-old Ram Mathur did not feel any symptoms. When he started feeling some difficulty during urination, he chose to ignore it. The problem took an extreme turn when he started noticing swellings in the pelvic region, followed by blood in semen, decreased flow of urine and loss of bladder control. Mathur was shattered to know he had fourth stage prostate cancer.

His urologist told him that he had ignored the symptoms for too long, and his condition was likely to deteriorate as his testicles were secreting testosterone – which fuels growth of the prostate.

According to the Health Ministry, late detection and ignorance about the disease is the sole reason that prostate cancer has affected 1.7 million people around the globe, with 2,88,000 cases in India alone.

Doctors gave Mathur the option of getting his testicles removed through surgery, to permanently stop the prostate from growing further.

The prostate gland — part of the male reproductive system — lies below the urinary bladder and in front of the rectum. The gland surrounds the first part of the urethra that carries urine from the bladder to the penis.

Mathur was initially reluctant to get his testicles removed, feeling it would affect his sex life. But he underwent the surgery, fearing the spreading of the disease. Mathur’s prostate cancer, which had spread to a great extent, is now nil.

“Prostate cancer is hormone dependent and testicles are responsible for secretion of hormones. Therefore, once it is removed the cancer is cured,” S.P. Yadav, Urologist and Managing Director of Gurgaon-based Pushpanjali Hospital, told IANS.

“Prostate cancer forms in the cells of the prostate. It is usually a very slow growing cancer and most patients do not have significant symptoms until the cancer reaches an advanced stage. Most men with prostate cancer die, and many never know that they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it is dangerous,” Yadav said.

Explaining the surgical procedure, Kapil Kumar, head of Surgical Oncology at Delhi-based BLK Cancer Centre, said that an orchiectomy — surgical procedure in which one or both testicles are removed – is done to treat cancer, or for other reasons, to lower the level of testosterone.

“Surgical removal of a testicle is the usual treatment if a tumour is found within the gland itself, but an orchiectomy may also be performed to treat prostate cancer or cancer of the male breast, as testosterone causes these cancers to grow and metastasize (spread to other parts of the body),” Kumar told IANS.

On the precautions to be observed post surgery, Akash Jain, Consultant General Laprascopic Surgery at Delhi-based Saroj Super Speciality Hospital, said that the patient should wear a scrotal support for at least 48 hours, so that it holds the dressing in place and provide support.

“Ice may help with the swelling and bruising post surgery. Patient should not strain when there is bowel movement. More liquids, foods with fibre should be taken,” said Jain told IANS.

Doctors say though such surgeries don’t cost much, they should beAundertaken when there is no other option available.

“The cost of orchiectomy is 40 to 50 thousand rupees but orchiectomy is not required in all the cases; we strongly suggest to take injection instead of surgery,” Vikas Goswami, Senior Consultant Oncologist at city-based Fortis Hospital, told IANS.

According to medical data, the incidence rate of prostate cancer in Delhi is 10.66 per 100,000, which is higher than Southeast Asia (8.3) and north Africa (8.1).

Doctors say late diagnosis is the main culprit for the rising cases of prostate cancer, and recommend going for Digital Rectal Examination (DRE) for detection.

“Prostate-specific antigen, or PSA, is a protein produced by the prostate gland, which can be tested with a simple blood test. Rise in PSA value can be associated with prostate cancer. Early detection of prostate cancer can be done with this test and the state of the prostate glands with Digital Rectal Examination (DRE),” Atul Goswami, Chief of Urology at city-based Action Cancer Hospital, told IANS.



  1. Dr Puneet Chandna: ADT can be done by taking medicines that interfere with androgens or by having surgery to remove the testicles (called an orchiectomy). In many countries, including the United States, the use of medicines is usually preferred over surgery. The medicines used in this context have the same effect as surgery, as they are a form of “chemical castration.”


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