Survivors cope with life after testicular cancer

Testicular cancer survivors (TCSs) demonstrate similar health-related quality of life (HRQoL) to that of the general population at a median of 28 years since treatment initiation, reports a study.

“This similarity held true even though adverse health outcomes (AHOs), especially after platinum-based chemotherapy (PBCT)-high, were becoming more prevalent among TCSs,” the researchers said.

The evaluation included 427 TCSs, of whom 155 were in the surgery-only group, 222 in the PBCT-standard group with ≤850 mg cisplatin, and 50 in the PBCT-high group with >850 mg cisplatin. HRQoL of these participants were compared to that of men from the general population who served as controls.

Compared with men who underwent surgery alone, more TCSs who underwent PBCT reported having typical AHOs, particularly among those who received PBCT-high therapy. During 16 years of observation, the number of TCSs reporting typical AHOs, except Raynaud’s phenomenon, increased.

In the last survey wave, TCSs reported a median of four AHOs (any type) following PBCT-high therapy compared with a median of two AHOs after surgery only or PBCT-standard. In addition, PBCT-high, but not PBCT-standard therapy, resulted in decreasing physical HRQoL (A2 Regression coefficient, ‒4.3; p=0.008) with surgery only as reference.

In comparisons between all TCSs and controls, no clinically important difference was noted in physical and mental HRQoL at either survey wave. In the last survey wave, however, TCSs after PBCT-high therapy exhibited clinically important impairment of HRQoL. Only peripheral sensory neuropathy reduced HRQoL among all typical AHOs.

Additional covariates included chronic fatigue, pain, anxiety/depression, sexual dysfunction, unemployment, being single, and low education.

“The study revealed that individuals with a history of PBCT-high are at a high risk of experiencing a significantly increased prevalence of long-term AHOs, which subsequently leads to diminished HrQoL,” the researchers said. “It is crucial to recognize and provide specialized attention to these TCSs during lifelong follow-up care.”