Chemotherapy May be Associated with Rare, Early Deaths in Testicular Cancer

Aug. 4, 2015

A small number of testicular cancer patients—about 11 in 6,909—died of cardiovascular disease in their first year after diagnosis and treatment with chemotherapy, a statistic that’s noteworthy because the cancer itself is usually curable and tends to afflict young men, according to a Wilmot Cancer Institute sitting in chair getting chemotherapy

Published in the Journal of Clinical Oncology, the study was a population-based analysis of 15,006 patients from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The elevated risk of death from cardiovascular and cerebrovascular disease among the 6,909 patients treated initially with chemotherapy was in stark contrast to no elevated risk of deaths among nearly 8,100 men treated initially with surgery alone.

Researchers Lois B. Travis, M.D., Sc., D., and Chunkit Fung, M.D., M.S., who treats testicular cancer patients at Wilmot, urged caution in the interpretation of the results, given that they do not include details about extent of disease, treatment, and risk factors. Still, since the cure rate for testicular cancer approaches 95 percent, the early development of any potentially fatal treatment-related problem is devastating, they said.

“Although our findings need to be confirmed, it’s important that oncologists recognize any type of increased risk of death, even if it is quite rare, and apply evidence-based clinical practice guidelines for prevention and treatment of complications,” Fung said.

The small increase in absolute risk of death might be due to cisplatin-based chemotherapy, which also has been shown in previous studies to boost cardiovascular complications in long-term survivors of testicular cancer.  Research suggests that cisplatin-based chemotherapy may induce acute blood vessel injury and that testicular cancer itself may be a high-risk condition for blood clots.  However, it’s often appropriate to treat testicular cancer with chemotherapy, and therefore patients should carefully discuss the risks and benefits with their oncologists.

To read the full study, click here.

The research was funded by the James P. Wilmot Foundation Research Fellowship Fund with support from Travis’ National Cancer Institute award. Travis recently left Rochester to join the faculty at the Indiana University School of Medicine as the Lawrence H. Einhorn Professor of Cancer Research.