Psychosocial Issues in Long-Term Survivors of Testicular Cancer

Schepisi, Giuseppe; Padova, Silvia De; Lisi, Delia De; Casadei, Chiara; Meggiolaro, Elena; Ruffilli, Federica; Rosti, Giovanni; Lolli, Cristian; Ravaglia, Giorgia; Conteduca, Vincenza; Farolfi, Alberto; Grassi, Luigi; Giorgi, Ugo De

doi:10.3389/fendo.2019.00113

Cited by 52 publications

(51 citation statements)

References 113 publications

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“…They may also worry about dealing with common life challenges that young and middle-aged men already face (eg, establishing a family and career) in combination with the body image, sexuality and fertility issues that come with TC. [5][6][7] More efforts are needed to determine patient characteristics that increase the risk of higher anxiety scores. One small fair-quality study found anxiety was associated with sexual confidence and functioning, and cognitiveemotional regulation.…”

Section: Discussionmentioning

confidence: 99%

“…1,4 The burden and risk of treatment side effects are generally higher for those who received chemotherapy. 4 TC survivors are often concerned about sexuality, fertility, body image and male identity [5][6][7] which can impact survivor's quality of life. For instance, a recent study found that at least 26% of TC patients experienced sexual dysfunction and 28% had significant reproductive concerns.…”

Section: Introductionmentioning

confidence: 99%

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An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

Rincones¹,

Smith²,

Naher³

et al. 2021

CMAR

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Purpose: A diagnosis of testicular cancer (TC) at a relatively young age can have a dramatic impact on the psychological well-being of those affected. The aim of this review was to synthesize recent evidence to provide an updated account of the prevalence, severity and correlates of anxiety, depression, fear of cancer recurrence (FCR) and distress in TC survivors. Patients and Methods: A systematic literature review was conducted from September 2017 until June 2020 using electronic databases including Embase, MEDLINE, PsycINFO, Scopus and Web of Science. Study eligibility and quality were independently assessed by two reviewers. Narrative synthesis was used to depict the severity (mean/median scores), prevalence (proportions above standard clinical thresholds) and correlates of study outcomes. Results: A total of 988 articles were identified for screening after duplicate removal. Fiftysix full-text articles were screened, and eight articles met the inclusion criteria. The reported prevalence of the outcomes varied across studies (clinical levels of anxiety ranged from 6.9% to 21.1%, depression varied from 4.7% to 7%, distress was found between 25% and 41.4%, prevalence of FCR was not reported). Few studies compared TC survivors with other populations. Correlates of poorer psychological outcomes included younger age, relationship status, employment status, poorer sexual functioning, impaired masculinity and coping strategies. Conclusion: Anxiety seems to be the most common issue for TC survivors. Men who are single or unemployed appear most at risk of poorer psychological outcomes, which seem associated with impaired masculinity and sexual function. More research is needed to identify TC survivors most likely to need one of the increasing number of psychological interventions being developed for TC survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

Rincones¹,

Smith²,

Naher³

et al. 2021

CMAR

View full text Add to dashboard Cite

show abstract

“…In a similar vein, Ryan and Hoyt [13] reported that men's adjustment following treatment for TC proved to be a challenge and therefore they found themselves unable to successfully navigate into adulthood and experienced greater functional challenges in later life. Such problems, including individual health, sexual relationships and work problems, were found by Schepisi et al [14] to affect several important aspects of survival and significantly influence the QoL of long-term survivors. The authors concluded that to better understand the impact of TC on QoL, sociocultural differences in sexuality, masculinity and fertility must be taken into consideration.…”

Section: Introductionmentioning

confidence: 96%

Men’s experiences of surviving testicular cancer: an integrated literature review

2019

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To synthesize literature in order to elucidate the experiences of men who have survived testicular cancer and determine their quality of life following treatment. Methods An integrated review sought appropriate literature by utilising a keyword search across seven databases. Retrieved studies were appraised for quality, with two qualitative, twelve quantitative, and two mixed method studies deemed appropriate for this review. The data were extracted and aggregated into categories by way of a thematic analysis. The themes were: personal challenges and impact on health, psychological and emotive challenges, perception of reproduction and sexual changes, and outlook and support. Results Men experienced physical, emotional, and sexual difficulties. Some men believed they were infertile, despite evidence that fertility is not compromised in the long term. Psychological conditions can be exacerbated by cultural pressures to conceive and cultural expressions about male identity. Men who had undergone orchidectomy reported minimal impact on their mental health than the men who had chemotherapy or radiotherapy as part of their treatment modality. Sexual dysfunction caused by chemotherapy-associated side effects was detrimental to men's quality of life. In addition, men who had a partner, who were employed, and who had children were able to adjust better after treatment than those who did not. Provision of clear and honest information post-treatment helped testicular cancer survivors return to their normal lives. Conclusions The evidence from the review suggests that the burden of disease for testicular cancer survivors is overall low. Men who had surgical intervention and were treated for testicular cancer experienced minimal impact on their mental health status than the men who had chemotherapy or radiotherapy as part of their treatment modality. Implications for Cancer Survivors There is a need to provide appropriate referrals to the relevant services, including psychosocial support, and the development of more adequate communication resources for men following treatment for testicular cancer.

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“…In TC survivors, platinum concentrations correlated with the cisplatin dose used during therapy have been associated with neurotoxicity and other long-term adverse consequences ( 101 – 103 ). Within this context, it is important to underline the importance of the effects of treatment on a physical level ( 104 ), including erectile dysfunction ( 105 ), reduction in sexual activity ( 106 ), and loss of desire ( 107 ). In particular, a correlation between previous chemoradiotherapy and radiotherapy and the risk of erectile dysfunction was recently confirmed by a Danish study on a cohort of 2,260 TC survivors ( 108 ).…”

Section: Stress-induced Immunosenescence In Testicular Cancer Survivomentioning

confidence: 99%

Immunosenescence in Testicular Cancer Survivors: Potential Implications of Cancer Therapies and Psychological Distress

et al. 2021

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Testicular cancer (TC) is the most frequent solid tumor diagnosed in young adult males. Although it is a curable tumor, it is frequently associated with considerable short-term and long-term morbidity. Both biological and psychological stress experienced during cancer therapy may be responsible for stimulating molecular processes that induce premature aging and deterioration of immune system (immunosenescence) in TC survivors, leading to an increased susceptibility to infections, cancer, and autoimmune diseases. Immunosenescence is a remodeling of immune cell populations with inversion of the CD4:CD8 ratio, accumulation of highly differentiated memory cells, shrinkage of telomeres, shift of T-cell response to Th2 type, and release of pro-inflammatory signals. TC survivors exposed to chemotherapy show features of immunological aging, including an increase in memory T-cells (CD4+ and CD8+) and high expression of the senescence biomarker p16INK4a in CD3+ lymphocytes. However, the plethora of factors involved in the premature aging of TC survivors make the situation more complex if we also take into account the psychological stress and hormonal changes experienced by patients, as well as the high-dose chemotherapy and hematopoietic stem cell transplantation that some individuals may be required to undergo. The relatively young age and the long life expectancy of TC patients bear witness to the importance of improving quality of life and of alleviating long-term side-effects of cancer treatments. Within this context, the present review takes an in-depth look at the molecular mechanisms of immunosenescence, describing experimental evidence of cancer survivor aging and highlighting the interconnected relationship between the many factors modulating the aging of the immune system of TC survivors.

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Psychosocial Issues in Long-Term Survivors of Testicular Cancer

Cited by 52 publications

References 113 publications

An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors

Men’s experiences of surviving testicular cancer: an integrated literature review

Immunosenescence in Testicular Cancer Survivors: Potential Implications of Cancer Therapies and Psychological Distress

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