Psychosocial factors, curative therapies, and behavioral outcomes. A comparison of testis cancer survivors and a control group of healthy men

Abstract

In a retrospective study of 223 testis cancer survivors and 120 controls matched sociodemographically, we examined the relative impact of sociodemographic and clinical factors on long-term outcomes in the areas of sexual function, relationships, employment, and mental outlook. For most of the survivors, testis cancer did not lead to unemployment (4.5%), divorce (6.8%), or disabling psychological problems. Multivariate analysis results confirm that cancer survivors report significantly more infertility and sexual performance distress, but not more desire distress, than the control group. Survivors' sexual impairment varied according to treatment received (and therefore histologic factors) and sociodemographic variables. Parental status (not having children) and education (college or less) independently predict infertility distress, whereas education and lower occupational level independently predicted sexual performance distress. Adjusting for socioeconomic status (SES), the men with advanced testis cancer who received chemotherapy and standard retroperitoneal lymph node dissection (RPLND) had significantly more infertility and performance distress than those men who received other treatments. Neither the treatment or SES variables predicted disrupted relationships or a deteriorated mental outlook. However, men with sexual impairment distress were more likely to report strained relationships and a pessimistic mental outlook. These findings have implications for treatment decisions and can be used to identify subgroups of survivors who could benefit from counseling and sexual rehabilitation services.

Gender disparity in the rate of partner abandonment in patients with serious medical illness

“…Prior studies [4][5][6][7][8][9][10][11][12] have suggested that the overall frequency of divorce in cancer patients (range, 5-17%) does not differ from that of well-matched controls in the general population. Our results are consistent with this observation, revealing an overall frequency of divorce (11.6%) in the 3 patient cohorts representing >500 patients diagnosed with serious neurologic and oncologic illnesses.…”

“…Some studies have in fact suggested that men are less able to undertake a caregiving role and assume the burdens of home and family maintenance compared with women. [3][4][5][6][7][8][9][10][11] Thus, a woman becomes willing sooner in the marriage to commit to the burdens of having a sick spouse.…”

“…[4][5][6][7][8][9][10][11][12] In our neuro-oncology practice, however, we were impressed by a striking gender asymmetry in the occurrence of divorce. Divorce appeared to occur almost exclusively when the wife was the disease-afflicted partner.…”

Gender Differences in Marital Disruption among Patients with Cancer: Results from the Korean National Health and Nutrition Examination Survey (KNHANES)

“…A Danish cohort study suggested that cancer patients face the same challenges with regard to divorce as people who have never been confronted with cancer (Carlsen et al, 2007). Moreover, studies suggest that some couples find that cancer strengthens their relationship (Rieker et al, 1989;Schover and von Eschenbach, 1985). Other studies show, however, that some special cancers such as breast cancer and cervix cancer result in marital disruption.…”

Testicular cancer: A narrative review of the role of socioeconomic position from risk to survivorship

“…Lower educational level and occupational status were also associated with higher sexual performance distress [35]. In a study of cancer survivors of many cancer types, Taskila et al reported that male cancer survivors with less than a college degree and lower occupational status had a greater need for support in the workplace and from occupational health personnel [31].…”