Testicular Cancer: A Good News/Bad News Story

First, the good news: The survival rate for testicular cancer is 95 percent at 10 years, due to the invention of cisplatin-based chemotherapy in the 1970s. Despite this success, however, survivors have an increasing risk of second malignancies -- and the risk remains elevated for 35 years.

In the Journal of Clinical Oncology, Chunkit Fung, M.D., M.S., an oncologist at the James P. Wilmot Cancer Center at URMC, and colleagues published what is believed to be the first large population analysis on the risks of second cancers among patients treated in the modern era of cisplatin-based chemo. Cisplatin is one of the most widely used and effective drugs for the nearly 6 million people globally who are diagnosed each year with testicular cancer, as well as cancers of the colon, cervix, bladder, stomach, lung and esophagus.

Fung analyzed data of 12,691 patients diagnosed between 1980 and 2008 with testicular cancer. A total of 210 second tumors were observed in this group. The risk of a second cancer was 40 percent higher among those treated with chemotherapy, but negligible when the patient was treated with surgery alone.

Another disturbing trend: An upswing in second cancers after chemotherapy occurred at 15 to 19 years and 20-plus years after the original diagnosis. This defies conventional wisdom, which holds that the risk of complications declines with the passage of time. In particular, kidney, thyroid, and soft-tissue cancers were observed most often.

Testicular cancer is the most common cancer among men ages 19 to 39. Given the long life expectancy of most patients, quantifying the late effects of cancer and chemotherapy is especially important, the study said.

Read more here.