Treating Prostate Cancer With Surgical Castration


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An orchiectomy, or surgical castration, is a type of surgery for prostate cancer, but it’s also a hormone therapy because the end goal is to manipulate a man’s hormones in order to stop the spread of cancer.

What is orchiectomy?

An orchiectomy is the surgical removal of the testicles. Typically, for prostate cancer, both of the testicles are removed. This is called a bilateral orchiectomy.

The reason it is done is because most of the testosterone in a man’s body is produced in the testicles (the rest is produced in the adrenal glands). Testosterone fuels the growth of cancer cells. Reducing or eliminating a man’s testosterone levels is intended to slow or stop the spread of cancer.

Considerations

Many men are uncomfortable with the idea of surgical castration. They worry about how the physical alteration will look. Castration may affect a man’s self-esteem, and it’s important to remember that this is a permanent, nonreversible surgery. Many men opt for chemical castration instead, which is the use of hormone therapy drugs to temporarily reduce testosterone levels. Other men prefer an orchiectomy for prostate cancer because it is a simple, one-step procedure, whereas hormone therapy drugs must be taken, injected, or implanted regularly.

If you’re considering this surgery for prostate cancer, however, talk to your doctor about testicular prosthesis. Your surgeon can insert artificial testicles inside the scrotum.

Preparation for surgical castration

Expect to undergo a series of medical tests before the orchiectomy. Your doctor may order blood and urine tests, an ultrasound, or a magnetic resonance imaging (MRI) test. Disclose your full medical history to your doctor, including any other medical conditions you have and drugs or supplements you take. You may need to discontinue certain medications for a period of time, such as blood thinners. As well, tell your doctor if you have recently developed a cold or other infection. Your doctor may prescribe an anti-hormone drug or other medications to take prior to the surgery.

This surgery for prostate cancer will prevent you from fathering children, since your body will no longer be able to make sperm. Consider storing your sperm in a sperm bank.

Arrange to have someone else drive you home from the hospital. It’s also a good idea to have someone stay with you for a few days following the procedure. The night before the orchiectomy, follow your doctor’s instructions regarding food and drink.

What is the surgical castration procedure

The procedure itself is relatively simple, and may be performed on an outpatient basis. Some patients may need a brief hospital stay, however. You will be given fluids intravenously, and the anesthesiologist will administer the anesthesia.

The surgeon will make a small incision in the scrotum. He will then remove your testicles. If you have decided to have artificial testicles, the surgeon will insert them before closing the incision.

Read more in our Prostate Cancer Health Center.