Testicular cancer survivors can face an increased risk of long-term illness, not because of the malignancy, but the highly effective treatment they receive, according to a study in the urology journal BJUI .
Researchers from the Norwegian Radium Hospital at the University of Oslo found that the number of problems faced by survivors are higher than generally thought, because clinicians only report those that are life-threatening or require medical intervention. Awareness of this discrepancy has led to a greater focus on patient-reported outcomes.
The research review, part of a November BJUI special issue on testicular cancer, shows that as many as a quarter of survivors develop long-term neurological, hearing and circulation problems and they are twice as likely to develop a secondary cancer. On a more positive note, up to 80 per cent who attempt to become fathers after treatment are successful.
"Patients can suffer considerable mental distress after having one testicle removed due to cancer, but this gradually decreases with treatment" says lead author Professor Sophie D Fossa.
"Gastrointestinal side-effects are common during both chemotherapy and radiotherapy and chemotherapy carries added risks like infections and blood clots. Long-term problems include secondary cancers, heart problems, and conditions related to lower hormone levels.
"We believe that the best way to reduce the short and long-term health of survivors is to reduce the risk, by smoking cessation, physical activity and weight reduction, and to provide adequate follow-up for patients who could develop life-threatening toxicity."
Key findings from the review, which covered 40 studies published between 1990 and 2008, included:
"Current patients with testicular cancer should be informed about the risk of short-term and particularly long-term side-effects of their highly effective treatment" concludes Professor Fossa.
"It is important to focus on reducing risks through healthy lifestyle choices and consider important issues like preserving future fertility.
"We would also like to see screening guidelines developed to ensure that the long-term side-effects are diagnosed and treated as early as possible."
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Notes to editors
Short and long-term morbidity after treatment for testicular cancer. Fossa S D, Oldenburg J and Dahl AA. BJUI . 104, 1418-1422. (November 2009). doi:10.1111/j.1464-410X.2009.08869.x
Established in 1929, BJUI is published 23 times a year by Wiley-Blackwell and edited by Professor John Fitzpatrick from Mater Misericordiae University Hospital and University College Dublin, Ireland. It provides its international readership with invaluable practical information on all aspects of urology, including original and investigative articles and illustrated surgery. www.bjui.org
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