Mortality and incidence of second cancers following treatment for testicular cancer

Abstract

We studied 5555 seminoma patients and 3733 patients with nonseminomatous testicular cancers diagnosed in Southeast England between 1960 and 2004. For both groups survival improved over time: 10-year relative survival increased from 78% in 1960 -1969 to 99% in 1990 -2004 for seminomas, and from 55 to 95% for nonseminomas. In the early period mortality was still significantly increased more than 15 years after diagnosis in both groups, whereas in more recent periods the excess deaths mainly occurred in the first 5 years after diagnosis. For seminomas, there was a significant excess of cancers of the colon (standardised incidence ratio (SIR) 2.36; 95% confidence interval (CI) 1.13 -4.35), soft tissue (SIR 13.64; CI 1.65 -49.28) and bladder (SIR 4.28; CI 2.28 -7.31) in the long term (20 þ years after diagnosis), of pancreatic cancer in both the medium (10 -19 years) (SIR 2.91; CI 1.26 -5.73) and long term (SIR 5.48; CI 2.37 -10.80), of leukaemia in both the short (0 -9 years) (SIR 3.01; CI 1.44 -5.54) and long term (SIR 4.48; CI 1.64 -9.75), and of testis cancer in both the short (SIR 6.69;) and medium term (SIR 3.96; CI 1.08 -10.14). For nonseminomas, significant excesses were found in the long term for cancers of the stomach (SIR 5.13; CI 1.40 -13.13), rectum (SIR 4.49;) and pancreas , and for testis cancer in the medium term (SIR 5.94;. Leukaemia was significantly increased in the short term (SIR 6.78; CI 2.93 -13.36). The better survival observed is largely attributable to improved treatment, and the trend in reducing the toxicity of therapy should continue to reduce future health risks in testicular cancer survivors.

Testicular germ cell tumours

“…After chemotherapy the risk includes leukaemias, lung cancer, and melanoma. 43 There is also an increased risk of cardiac events. A cohort study of UK survivors found a relative risk of cardiovascular disease of 2.6 after chemotherapy and 2.4 after radiotherapy.…”

Roles of Radiation Dose and Chemotherapy in the Etiology of Stomach Cancer as a Second Malignancy

“…However, survivors of both testicular cancer and Hodgkin lymphoma are at increased risk of second solid malignancies, beginning 10-15 years after diagnosis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Gastrointestinal cancer, especially stomach cancer, accounts for the larger part of second solid malignancies among testicular cancer survivors.…”

Exposure to Bleomycin, Etoposide, and Cis-Platinum Alters Rat Sperm Chromatin Integrity and Sperm Head Protein Profile1

“…Fortunately, the mortality rate has been progressively decreasing over time as a result of early diagnosis and the advancements made in treatment protocols [1,3]. Specifically, the coadministration of bleomycin, etoposide, and cis-platinum (BEP) has improved the 5-yr survival rate of testis cancer patients to over 90%, for all stages of testicular germ cell tumors [4][5][6].…”