Testicular Cancer Survivorship

Abstract

Testicular cancer (TC) is the most common cancer among men aged 18 to 39 years. It is highly curable, with a 10-year relative survival approaching 95% due to effective cisplatin-based chemotherapy. Given the increasing incidence of TC and improved survival, TC survivors (TCS) now account for approximately 4% of all US male cancer survivors. They have also become a valuable cohort for adult-onset cancer survivorship research, given their prolonged survival. Commensurately, long-term treatment-related complications have emerged as important survivorship issues. These late effects include life-threatening conditions, such as second malignant neoplasms and cardiovascular disease. Moreover, TCS can also experience hearing loss, tinnitus, neurotoxicity, nephrotoxicity, pulmonary toxicity, hypogonadism, infertility, anxiety, depression, cognitive impairment, and chronic cancer-related fatigue. Characterization of the number and severity of long-term adverse health outcomes among TCS remains critical to develop risk-stratified, evidence-based follow-up guidelines and to inform the development of preventive measures and interventions. In addition, an improved understanding of the long-term effects of TC treatment on mortality due to noncancer causes and second malignant neoplasms remains paramount. Future research should focus on the continued development of large, well-characterized clinical cohorts of TCS for lifelong follow-up. These systematic, comprehensive approaches can provide the needed infrastructure for further investigation of long-term latency patterns of various medical and psychosocial morbidities and for more in-depth studies investigating associated etiopathogenetic pathways. Studies examining premature physiologic aging may also serve as new frontiers in TC survivorship research.

The Enigmatic Role of TP53 in Germ Cell Tumours: Are We Missing Something?

“…An increased risk of second malignancies in cancer survivors has been associated with previous exposure to CT and/or RT [61]. In GCT survivors, an increased risk of various second tumours, comprising haematological, gastro-intestinal (GI), and urologic malignancies is already well established [62][63][64][65][66][67][68]. A significant 3-fold risk of leukaemia, after a median latency of 5 years, was reported in an international population-based study of 18,576 TGCTs who underwent pelvic RT [69], and both cisplatin and etoposide have been associated with elevated risks of secondary leukaemia in survivors [69,70].…”

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

“… 18 In contrast, a Serbian study found that 12% of TC survivors experienced mild or moderate depression. 19 The National Comprehensive Cancer Network 20 indicated that there is no sufficient evidence to argue that TC survivors experience higher levels of depression than the general population.…”

Promoter methylation of DNA homologous recombination genes is predictive of the responsiveness to PARP inhibitor treatment in testicular germ cell tumors

“…Testicular germ cell tumors (TGCTs) are among the most frequent solid neoplasms in young‐adult Caucasian men, and incidence is increasing worldwide due to life‐style changes [1]. These patients show an overall good prognosis (especially due to high efficacy of platinum‐based chemotherapy) and often become long‐term cancer survivors [2]. Nonetheless, a substantial number of patients are overtreated, receiving adjuvant treatment although they would never endure disease recurrence.…”