Cancer survivor late-effects, chronic health problems after cancer treatment: what’s the evidence from population and registry data and where are the gaps?

Abstract

Purpose of review Improvements in cancer treatment have led to more people living with and beyond a cancer diagnosis but survivors may have increased health problems as they age. The purpose of this review is to critically evaluate population data exploring incidence of late effects for cancer survivors. Recent findings 18 studies were identified between 2013 and 2023 that explored the impact on survivors’ physical and emotional health. Patients who had been treated at least 2 years previously for cancer had significant cardiovascular risk factors compared with age-matched controls. Women with breast cancer were more likely to have cardiovascular disease, including hypertension, arrythmias and congestive heart failure. This was associated with anthracyclines and/or trastuzumab as part of systemic anti-cancer therapy. Survivors of colorectal cancer were three times more likely to have acute kidney injury than age-matched controls. Stress and mood disorders were higher in survivors of testicular cancer and prostate cancer. Summary Population studies are important to identify the ‘real world’ consequences of cancer and its treatment beyond clinical trials. Knowledge is critical for managing an ageing cancer population. Data to personalise cancer survivorship care, not only helps determine potential health risks, but can improve secondary prevention, emotional health, recovery, and long-term outcomes.

Testicular Cancer Treatments and Sexuality: A Narrative Review

“…Of course, primary chemotherapy is not free from disadvantages. In fact, it does not attack retroperitoneal teratomas, and thus, it exposes patients to chemoresistance and relapses; in addition, these patients may suffer from cardiovascular disease and secondary malignant neoplasms [47], although relapses are uncommon with primary chemotherapy. The three chemotherapeutic agents used for this kind of neoplasm are Bleomycin, Etoposide, and Cisplatin (BEP) [48][49][50][51][52][53].…”

“…Sexual desire and male disappointment have been importantly considered as side effects of this kind of treatment option [36,67,68]. Orgasmic dysfunction may depend on several factors such as radiotherapy or chemotherapy; in fact, they provoke neuropathy, lower levels of testosterone related to psychological issues, and the possible use of selective serotonin inhibitors [47]. These treatments do not harm patients in every case; in fact, in the previously cited study, Bandak et al demonstrated that patients treated with BEP for testicular germ cell tumors have a preserved orgasmic phase [68].…”

Current evidence supporting associations of DNA methylation measurements with survivorship burdens in cancer survivors: A scoping review

“…Specific survivorship burdens assessed were broadly categorized into five domains for organizational purposes based on common reported survivorship issues. 33 , 34 , 35 , 36 , 37 , 38 , 39 These included Neurocognition, Psychiatry, General wellness, Chronic conditions, and Treatment specific toxicities. Neurocognitive outcomes are reflected in several different categories including executive function, complex attention, language, learning, memory, and motor function.…”

Inhibiting the Extracellular Signal-regulated Kinase 1/2 (ERK1/2) Cascade in Cancer and the Heart: for Better or Worse, in Sickness and Health?

“…These drugs can have significant effects on the heart (cardiotoxicities) including prolongation of the QT interval in the cardiac cycle which increases the risk of arrhythmia, effects on LVEF, myocardial ischaemia and hypertension [5,6]. Apart from cardiac toxicities during their therapy, as more patients survive their cancer, there is increased risk of cardiovascular problems developing as a consequence of their cancer treatment [7,8]. As with heart failure in general, the underlying mechanisms for each of these toxicities varies, and the field can benefit from stratification of these different effects.…”