Testicular Cancer Treatments Work But Cause Future Health Problems
When it comes to testicular cancer, you might say the glass is more than half full—but not exactly spilling over. It’s inspiring to witness superstar athletes like Lance Armstrong and Scott Hamilton show that the disease is not only survivable, but that men can thrive after treatment. However, that’s not quite the whole story…as with other forms of cancer, having had testicular cancer has implications for your future health, some from the disease and others that result from its treatment. To better understand the long-term picture, researchers at The Norwegian Radium Hospital at the University of Oslo, Norway, conducted a review of 40 studies published between 1990 and 2008, cataloguing the health challenges many survivors face.
The Oslo researchers concluded that though survival rates are very high (95%), the long-term effects of testicular cancer have been underestimated. Though they’re not typically life-threatening and many don’t even require medical intervention, they can affect the quality of your life. It is helpful to know about the common challenges men with testicular cancer are likely to face in the years ahead so you can do all you can to prevent them.
According to the report, testicular cancer survivors were almost twice as likely as age-matched men in the general population to develop a secondary cancer. To varying degrees, they were also vulnerable to a range of long-term effects from their treatment, including cardiovascular disease…hypogonadism (in which the testes produce little or no sex hormone) and reduced fertility…chronic fatigue…mental distress…and neurological problems such as peripheral neuropathy, impaired hearing and tinnitus. On a more positive note, most of those who’d had a single testicle removed and wanted to were able to conceive children, and reports on frequency and quality of sexual activity found little difference between survivors and men who never had testicular cancer. The study was published in the journal BJU International.
The Dangers of Testicular Cancer Treatments
Testicular cancer is the most common form of cancer in men between ages 15 and 34, though overall it accounts for only 1% of male cancers. Early symptoms include swelling, pain or a lump in a testicle or the scrotum, or back or abdominal pain. Treatment usually involves some combination of surgery, radiation and/or chemotherapy.
J. Stephen Jones, MD, chairman of the Department of Regional Urology at the Cleveland Clinic Glickman Urological and Kidney Institute and professor of urologic surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, had some comments on the Oslo study. He agreed that some testicular cancer treatments (specifically radiation and cisplatin-based chemotherapy) can indeed cause long-term health problems but said that, in his view, it’s worth the tradeoff. Men who have these problems have, in fact, survived a disease that used to be lethal.
Dr. Jones provided insights on the top four health challenges identified by the research…
Men who had cancer in one testicle face an increased likelihood of developing cancer in the other testicle. A history of cancer of any kind raises your risk for other cancers, including recurrence. According to Dr. Jones, testicular cancer patients have genetic traits or have faced environmental factors that put them at higher risk already, as is evidenced by their earlier cancer.
Testicular cancer survivors are nearly twice as likely to develop cancer in another part of the body, especially in the lower body. The radiation and chemo used to treat their testicular cancer are known carcinogens in their own right, increasing the risk that other cancers will develop.
Heart disease risk is increased. Several types of treatment for testicular cancers (and other types as well) have been linked to heart damage—specifically, mediastinal radiation, an out-moded type of treatment involving radiation beamed to the chest (even when the cancer is elsewhere) and cisplatin, a common chemotherapy drug known to harm the coronary arteries.
Peripheral neuropathy affects a high percentage of patients. This painful condition caused by nerve damage, particularly in the hands and feet, is another long-term effect of treatment with radiation and/or cisplatin.
Reason to be Optimistic
These problems can be managed with appropriate medical care, including regular screenings and preventive measures, said Dr. Jones, urging survivors to maintain good communication with their doctors so health issues can be addressed as they emerge. He urges testicular cancer survivors to be very focused on keeping the risk for many of these long-term health problems as low as possible by eating a nutritious diet, getting regular exercise, maintaining a healthy weight—and not smoking.
Furthermore, Dr. Jones points out that monthly testicular self-examination is important to identify any new tumors in the earliest stages for all men—most especially those who have had one testis removed.
In the end, the news continues to get better for men with testicular cancer as more people survive this disease—and, in fact, many other types of cancer, too. Experts are working to find better ways to address the long-term effects as well as to identify early biomarkers that can flag degenerative changes known to be caused by cancer treatments…and it looks like the developments ahead will be “all good.”