Prostate cancer relies on the male hormone, testosterone, to enable it to grow. One way of controlling the cancer is to starve it of testosterone. This can either be done medically, using drugs, or surgically by performing an orchidectomy (removal of the testicles). Orchidectomy is not used very often these days because there are hormone treatments available that work in the same way.
Some men prefer this operation to taking medication over a long period of time. Either both testicles are removed completely, or the area of each testicle responsible for testosterone production is cut, so that the two non-functional testicles remain within the scrotum. This operation may be done as a day case with local anaesthetic, or as an inpatient with a spinal or general anaesthetic. The side effects of this operation are similar to those experienced by men on medical hormone treatment (see 'Side effects of treatments').
One man described his orchidectomy as a very minor operation, but another man developed complications and was in hospital for five days. This man, who had a very high PSA level, but who had not had cancer confirmed by biopsy, followed his surgeon's advice to have the orchidectomy, as the most suitable form of treatment. This man still wonders whether or not he has cancer, given that the diagnosis was made on the basis of his raised PSA level alone.
- Age at interview:
- Age at diagnosis:
So I thought well I'm getting older so I said I'll [have the operation]. I was castrated.
For other men who might be worrying about making that decision was it done with a local anaesthetic, the castration?
Yeah it's a sort of a nothing job really.
Perhaps you could just tell other men what's it like because they might be worrying about it.
Yeah well I mean there's about three things they give you and you have to make up your mind you know you sort of can't tell anybody else what to do can you but I, you know I thought well I thought if I'd got to go down there every month or something, have injections here and something else I thought if I'm castrated, because if I'd been younger perhaps I wouldn't have done, but it's nothing, it's a nothing job really.
Who does that, do you go to the hospital for that?
They done that at the hospital yeah.
At the hospital
Just with a local anaesthetic?
Yeah, you don't know you're having it done really
Really so it didn't take long?
A couple of minutes.
Is it that quick?
Yeah [laughs] it's, because you can't feel no different, you can't feel no different at all. Of course you don't get an erection or anything after, nothing like that you know but...
Are there any other side-effects?
No, no so whether I made the wrong decision or not I don't know but [laughs].
At least you haven't got to have the injections every month then.
No nothing, that was it, that was a one off. If you was castrated that was it. I don't know what else there was, there was injection in there and there was something else, but it was something you'd got to keep, it was something you'd got to keep having done you know. So I took that.
I made the decision there and then, that's it.
How did your wife feel about that, was that alright for her?
Well as I said we're getting old, we're getting old
So it was alright.
Yeah she, I mean I was over 70 then you know so I thought well
So it was quite an easy decision for you to make
It was quite easy to make yeah.
If I was younger I might have to think about it a little bit but no it was easy decision to make.
- Age at interview:
The surgeon sat me down and he gave me all the various opportunities, one was the radiology and he said that was no good because they didn't know where it was and we then, I agreed with him. I said 'Well what would you have done?'
Well what were the other options?
Well there were only
You mentioned the orchidectomy.
Yes there were only three really, one was radiology and the other was, two operations one that I had was the bilateral orchidectomy, whatever it's called, I can't remember what the third operation was but it was a bigger actually.
And he explained to me everything and I decided, I said 'Well what would you have?' and he said 'Well do this,' and I agreed. And I went in for an operation on 29th November.
So you had the surgery, even though you weren't really sure that you had cancer?
Yes, yes I took that advice.
Mm because your surgeon said he thought you probably did?
Yes he thought I probably did have it and I couldn't argue.
Did you think of getting a second opinion or not?
No he was, he was a well known surgeon and he was doing it privately and he had, he had operated on me once before for a hernia years ago so
Do you mind explaining to other people what happened during the operation in case they want to know, they won't know who you are of course.
It was an unfortunate operation in that they, he, you had a complete anaesthetic and they did the operation on my testicles and the next day he had to do another operation because it had all become very swollen and there was a blood clot inside, so he, in his words he had to open me up again.
Oh dear. What did they actually do the first time?
Well I'm not quite sure what he cut but he cut some part of my testicles.
Did he explain why?
Yes, oh yes he explained why and he explained to me that it would finish any sexual, sex I needed but at the age of 76 or 75 it didn't really matter because my wife is paralysed.
But did he explain the reason behind why they felt it was useful?
Yes he did, he explained what he was doing and he was trying to restrict the flow of something, I can't remember what he said but he said by doing this it will stop the PSA rising.
Okay so you were in hospital for how long?
Well I would've been only in for 3 days but because he had to do another operation I was in for 5 days.
Mm oh dear quite a while.
And how comfortable or uncomfortable was it?
Oh no I was quite comfortable, no problems, I got up the same day kind of thing to wash and things.
So my main problems were really that I'm not sure that although I had a very high PSA I ever had cancer. I had two biopsies and they took probes, four on each one, two from each side, I had two complete bone scans and I only wish that one knew how reliable the PSA was because I have my doubts.