Long-term side effects of testicular cancer and treatment (observational study of mortality and morbidity in testicular cancer survivors).

purposeTesticular cancer (TC) is a rare cancer, but due to early age at diagnosis and excellent cure rates, there is a large cohort of survivors. Recent studies have highlighted the late side effects of treatments of TC, especially cisplatin-based chemotherapy. These complications make the survivorship care challenging with detrimental effects on health and prognosis of TC survivors (TCS). In this study, we provide a snapshot of common late side effects in TCS and a possible care pathway with a nurse-led specialised clinic.

methodsWe invited TCS to participate in the study at one of the cancer centres in Ireland for a comprehensive screening using questionnaires, examination and blood tests. Further investigations were performed as indicated. Mortality was assessed through retrospective chart reviews.

resultsWe recruited 78 TCS to participate in the study with a median of 129 months since diagnosis (range 60 to 304 months) and 3 who died in survivorship. Second malignant neoplasms accounted for all three mortalities. Most common conditions after 5 years of diagnosis were hypertension (40%), dyslipidaemia (55.6%), hypogonadism (~ 45%), and high BMI (52%). The majority of conditions were diagnosed during screening, including two cases of coronary artery disease and one case of transient ischaemic attacks. TCS who received chemotherapy and were aged more than 30 years at the time of diagnosis had a higher prevalence of the late side effects.

conclusionsTC survivorship phase is marred by a range of late side effects. This remains a challenge for patients and healthcare workers as ambiguity surrounds the care pathways in the survivorship setting. We hope this nurse-led, specialised, screening clinic might improve the care and service provision for TC survivors.