The first thought of any patient with malignant testicular tumour is “this is just a dream and I am going to wake up soon. Losing a testicle is a big shock for any man and sometimes one’s thoughts are that it would be better to die with the testicle intact rather than live without one.
Which brings about three paradoxes: firstly, in many cases it is possible to remove only the tumour and save the testicle, secondly, removing the testicle will not in most cases make the man impotent, and thirdly, the healthy testicle will take over producing the sperm and fertility will not be adversely affected.
All these points are thoroughly discussed with the patient and they are never left alone with their disease.