Orchiectomy
Surgical removal of a testicle: the diagnostic and first curative step for testicular cancer, or of both, as a cheap permanent form of hormone therapy in prostate cancer.
Radical inguinal orchiectomy (through the groin, not the scrotum, to avoid seeding) removes the tumour and gives the histology (seminoma vs non-seminoma) that guides surveillance, carboplatin or BEP chemotherapy. Bilateral orchiectomy lowers testosterone to castrate levels within hours and remains the most cost-effective androgen deprivation worldwide, though most men choose GnRH drugs for reversibility. Testosterone falls to castrate levels permanently, so the hot flushes, bone loss and fatigue of androgen deprivation follow.
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