Testicular cancer has an excellent 5-year survival rate of over 95%. But, according to new research, the platinum-based treatment that cures it is also making patients ill—sometimes very ill—for decades to come.
There’s no better alternative to the platinum treatment for most patients who need more than surgery alone. But there could be things you can do to spare yourself some of the longterm side effects.
A CURE THAT LINGERS
The problem is that platinum stays in the body for a very long time, and it’s toxic. The level of platinum in cancer survivors can be up to 1,000 times above normal for 20 years after treatment. Knowing what its side effects are will help you get the continuing care you need as a cancer survivor.
The study. Researchers from 11 major cancer centers around the world surveyed more than 1,200 testicular cancer survivors who had been treated with the platinum-based chemotherapy drug cisplatin, asking about health problems they’ve been experiencing. The participants ranged in age from 18 to 74, with 37 being the median age. The median time since treatment was just over 4 years. The most commonly reported problems were:
- Sensory nerve damage causing tingling, numbness, and/or pain in the hands and feet
- Ringing in the ears
- Hearing loss
- Raynaud phenomenon, which causes decreased blood flow to the fingers and toes leading to numbness and feeling cold
- Erectile dysfunction
- Low testosterone
- High blood pressure
- High cholesterol
Platinum therapy was already known to have the long-term side effects of blood vessel damage and sensory nerve damage, with consequent effects on, for example, high blood pressure and cardiovascular disease. This study raises the possibility that cisplatin might contribute to all the commonly reported problems and characterizes the overall burden of multiple conditions, each with differing severities.
The researchers created a scoring system to measure the number and severity of adverse outcomes and measured how this score correlated with the men’s quality of life. Close to 20% had high-to-severe scores, and 30% had medium-range scores. Only 5.4 % had a score of zero. Importantly, a worse score correlated very strongly with worse self-reported health, indicating that the score reflects a health status perceptible to survivors. Note: Cisplatin is given along with other chemo drugs, and these findings held true regardless of which of the two most commonly given combinations was used for treatment.
A promising finding: One individual factor was linked to having a lower score, meaning not a lot of negative impact on quality of life: engaging in vigorous exercise. This is promising because unlike certain factors such as one’s age, exercise is something most people have a lot of control over. The type of exercise that seemed to help the most was vigorous, high-calorie-burning activity such as running, cycling and aerobics.
YOUR CONTINUING POST-CANCER CARE
Because testicular cancer tends to occur in younger men—18 to 39 is the typical age range—and because of the lingering effects of platinum treatment, survivors are at risk for adverse treatment effects for a much longer time than those who get cancer later in life. But at any age, if you’ve been treated with platinum-based chemo, taking a more rigorous approach to your health can limit its impact, says Sarah Kerns, PhD, MPH, one of the study’s lead investigators. To improve your quality of life, Dr. Kerns suggests…
- Let all your health care providers know you are a cancer survivor who was treated with cisplatin.
- Watch your weight, blood pressure and cholesterol, and take corrective actions if any of these gets out of a healthy range.
- Stay active with at least 75 minutes of vigorous activity each week as recommended by the CDC
- If you smoke, quit—in the study, smokers suffered a greater decline in quality of life than nonsmokers.
Note: If you were treated with cisplatin for another cancer, including bladder, ovarian, oral, skin, brain or a metastatic cancer, you may also have some of these long-term side effects, and these care steps may help you as well.