Fertility Gonadal and Sexual Function in Survivors of Testicular Cancer

Huddart, Robert; Norman, A.; Moynihan, Clare; Horwich, A.; Parkar, C.; Nicholls, E.; Dearnaley, D.P.

doi:10.1016/s0022-5347(05)00624-5

Cited by 41 publications

(67 citation statements)

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“…In comparing treatment types, those who received orchiectomy alone, without chemotherapy or radiation therapy, reported better sexual function, although all groups treated had changes in gonadal function. 33,34 After non-Hodgkin lymphoma, fatigue is 1 of the most prevalent long-term functional complications, and this may in part result from not returning to prediagnosis levels of physical activity despite overall good health. 35 Among longterm cervical cancer survivors, sexual function has been the primary problem evaluated.…”

Section: Studies Within Specific Diseasesmentioning

confidence: 99%

Physical and psychological long-term and late effects of cancer

Stein

Syrjala

Andrykowski

2008

Cancer

591

415

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The number of long-term cancer survivors (5 years after diagnosis) in the U.S.continues to rise, with more than 10 million Americans now living with a history of cancer. Along with such growth has come increasing attention to the continued health problems and needs of this population. Many cancer survivors return to normal functioning after the completion of treatment and are able to live relatively symptom-free lives. However, cancer and its treatment can also result in a wide range of physical and psychological problems that do not recede with time.Some of these problems emerge during or after cancer treatment and persist in a chronic, long-term manner. Other problems may not appear until months or even years later. Regardless of when they present, long-term and late effects of cancer can have a negative effect on cancer survivors' quality of life. This article describes the physical and psychological long-term and late effects among adult survivors of pediatric and adult cancers. The focus is on the prevalence and correlates of long-term and late effects as well as the associated deficits in physical and emotional functioning. In addition, the emergence of public health initiatives and large-scale research activities that address the issues of long-term cancer survivorship are discussed. Although additional research is needed to fully understand and document the long-term and late effects of cancer, important lessons can be learned from existing knowledge. Increased awareness of these issues is a key component in the development of follow-up care plans that may allow for adequate surveillance, prevention, and the management of long-term and late effects of cancer. T he number of long-term cancer survivors (5 years after diagnosis) in the U.S. is increasing because of advances in cancer screening, early detection, treatment strategies, and management of acute treatment toxicities. Indeed, the 5-year survival rate for all cancers combined has risen to 66%, up from approximately 50% in the 1970s, 1 and it is estimated that there are now more than 10 million Americans living with a history of cancer.2 Furthermore, based partly on the overall growth and increasing average age of the U.S. population, researchers are predicting that the number of persons over the age of 65 years diagnosed with cancer each year will double by the year 2050, and will quadruple among those aged 85 years in the same time frame.3 Considered together, these factors suggest that the number of cancer survivors in this country will continue to grow and that their long-term heath problems and resulting needs will demand increasing attention.

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Section: Studies Within Specific Diseasesmentioning

confidence: 99%

Physical and psychological long-term and late effects of cancer

Stein

Syrjala

Andrykowski

2008

Cancer

591

415

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“…In a 10-year follow-up study, Nord et al found that men treated for TGCC had a three-to fourfold risk to develop hypogonadism and that the risk increased with age and treatment intensity (11,12). Another study reported increased risk of gonadal dysfunction in long-term survivors of testicular cancer and there was a dose-response effect following chemotherapy (12).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for post-treatment hypogonadism in testicular cancer patients.

Eberhard

Ståhl

Cwikiel

et al. 2008

European Journal of Endocrinology

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Objectives: Testicular germ-cell cancer (TGCC) patients are at risk of developing hypogonadism but no risk factors have yet been defined. Methods: Blood was collected from 143 TGCC patients (after orchidectomy, prior to further therapy (T0) and 6, 12, 24, 36 and 60 months (T6, T12, T24, T36 and T60) after therapy). Biological hypogonadism (BH) was defined as: serum testosterone below 10 nmol/l and/or LH O10 IU/l; odds ratios (ORs) for BH with BH at T0, age, stage of disease, testicular characteristics, and androgen receptor polymorphism as predictors were calculated as well as the OR for developing BH post-treatment (one to two cycles of adjuvant chemotherapy (ACT) versus three to four cycles of higher dose chemotherapy (HCT) versus adjuvant radiotherapy (RT)). Results: HCT increased the OR for BH at T6 (OR 22, 95% confidence interval (CI) 4.4-118) and T12 (OR 5.8, 95% CI 1.5-22). RT increased the OR at T6 (OR 10, 95% CI 2.1-47) and at T12 (OR 3.9, 95% CI 1.1-14). Microlithiasis predicted BH at T0 (OR 11, 95% CI 1.2-112), T12 (OR 3.9, 95% CI 1.1-13), T24 (OR 3.0, 95% CI 1.0-8.8), T36 (OR 5.4, 95% CI 1.7-17) and T60 (OR 4.4, 95% CI 1.2-16). BH at T0 was a risk for BH at T6 (OR 53,, T12 (OR 125, 95% CI 37-430), T24 (OR 88, 95% CI 26-300) and T36 (OR 121, 95% CI 32-460). Conclusions: It is clinically relevant that BH at T0 and testicular microlithiasis were predictive factors for post-treatment BH. HCT and RT gave temporary BH.

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“…The subset of patients that require chemotherapy and/or radiotherapy may experience side effects, severe psychological stress and reduction of their reproductive potential (Brydoy et al, 2005;Huddart et al, 2005). TGCTs of young adults originate from a common precursor, the carcinoma in situ (CIS) cell (Skakkebaek, 1972), also known as intratubular germ cell neoplasia.…”

Section: Introductionmentioning

confidence: 99%