Nearly 80 percent of a large group of young men who survived testicular cancer reported having at least one health problem later due to treatment toxicity, says a new Journal of Clinical Oncology study co-authored by Wilmot Cancer Institute scientists.
The result is significant because testicular cancer is curable and is usually diagnosed in men ages 19 to 49. Researchers are concerned about lingering toxicities for young patients as they get older, and are working to characterize and limit the long-term, adverse side effects from modern chemotherapy regimens.
Among 952 men studied, the vast majority reported at least one problem such as hearing impairment, cardiovascular disease, peripheral neuropathy (numbness and tingling in the limbs and feet), obesity, and diabetes—and 35 percent of the survivors said they experienced three or more of these adverse side effects. The outcomes were similar, whether they were treated with etoposide and cisplatin (EP) or bleomycin, etoposide and cisplatin (BEP), the two most common therapies for testicular cancer.
Researchers also discovered that a healthy lifestyle might be the key to better outcomes, said Chunkit Fung, M.D., a study co-author and clinician/researcher at Wilmot who treats people with genitourinary cancers (prostate, bladder, kidney, testicular).
The study found that if a patient’s health was better going into treatment — if the men participated in vigorous physical activity, for example — it was less likely they would experience serious side effects. Factors consistently associated with more toxicity from treatment included older age at diagnosis, smoking cigarettes, lower education, and being single. Weekly exercise was uniformly helpful to survivors, the study said.
“Doctors should promote a healthy lifestyle among testicular cancer survivors,” Fung said. “The next step of our research is to identify patients who are at higher risk of developing life-threatening complications as a result of their treatment. This will allow physicians to follow their patients closely and manage those conditions more effectively.”
The National Cancer Institute supported the study. Fung is part of a collaborative research group from across the U.S., led by Lois Travis, M.D., Sc.D., the Lawrence H. Einhorn Professor of Cancer Research at the Indiana University School of Medicine. Other co-authors from the University of Rochester Medical Center include Annalynn Williams and Sarah Kerns.
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