How should a man with testicular cancer be counseled and what information is available to him?

The peak incidence of testicular cancer occurs in early adulthood (between the ages 19 to 34) when men are physically robust and actively formulating social and sexual identities. This is also a time when they are pursuing career and family goals. The disease not only interrupts these pursuits but its very location threatens the integrity of the body and an organ that is associated with self-esteem, sexuality, fertility, and masculinity-psychosocial issues of importance to both ill and healthy men alike. This paper discusses approaches to counseling these men. Effective counseling depends on understanding the illness itself and four psychosocial domains: the context of patients' lives, the assault on the sense of self, the impact on intimate relationships, and treatment options and psychosexual effects.