Romantic and Sexual Relationships, Body Image, and Fertility in Adolescent and Young Adult Testicular Cancer Survivors: A Review of the Literature

Abstract

This review presents a summary of existing knowledge regarding the impact of testicular cancer along four broad domains, including romantic and sexual relationships, body image, and fertility. A total of 37 studies were reviewed. Of note, most research consists of older adult testicular cancer survivors, with very little research attention afforded to adolescent and young adult (AYA) survivorship. Relationship status (i.e., partnered versus unpartnered) appears to play an important role as it relates to adjustment outcomes in testicular cancer survivors. In addition, sexual function (and thereby fertility) and body image are also frequently compromised. Implications regarding a lack of developmentally focused research on AYA testicular cancer survivorship are discussed, along with recommendations for new research.

Talking About Cancer and Meeting Peer Survivors: Social Information Needs of Adolescents and Young Adults Diagnosed with Cancer

“…The lack of psychosocial interventions to assist survivors with communicating with partners is at least in part a result of the paucity of research on the impact of cancer on AYAs' relationships. 35 Although it may seem that only those survivors who report a negative impact on relationships would potentially need support, our findings suggest that even those who report positive impact desire information about TAC. This suggests that many survivors are seeking, and could benefit from, interventions designed to encourage healthy communication about cancer experiences.…”

Barriers and facilitators for oncology nurses discussing sexual issues with men diagnosed with testicular cancer

“…While this concern is understandable given the research which indicates that general medical nurses feel unprepared and lack the competence to support and respond to people's with mental health problems (Reed and Fitzgerald 2005;Ross and Goldner 2009), it is worrying that the patients who may find it more challenging to raise sexual concerns (Higgins, 2008) and who may be at increased risk of a reoccurrence or worsening of their depression or anxiety are the least likely to receive the support and information required. Men who are un-partnered at the time of diagnosis may also be a particular vulnerable group as research indicate that they have significant worry about impact on the cancer on future relationships (Carpentier and Fortenberry, 2010). In addition, in view of Allanne and Russo's (2012) recent American study which suggest that suicide is more common in male patients with testis cancer than in the general population, and our knowledge of the impact of testicular cancer on men's personal sexual landscape, sense of self and psychological wellbeing it is imperative that oncology nurses engage with patients and their partners and discuss issues of sexuality in a more proactive and holistic manner.…”

Current urologic care for testicular germ cell tumors in pediatric and adolescent patients

“…In a recent literature review on QOL, outcomes of TGCT survivors were comparable to those of similar aged males, including sexual function and mental health, with an only slightly higher rate of anxiety in survivors of TGCT [63]. However, lower rates of fertility and sexual function have been documented in those treated during adolescence [64].…”