Long Term Side Effects of Testicular Cancer and Treatment (Observational Study of Mortality and Morbidity in Testicular Cancer Survivors)

Purpose: Testicular cancer (TC) is a rare cancer but due to early age at diagnosis and excellent cure rates, there is a big cohort of survivors. Recent studies have highlighted the late side effects of treatments of TC especially cisplatin based chemotherapy. These complications make the survivorship care challenging with detrimental effects on health and prognosis of TC survivors. In this study we provide a snapshot of common late side effects in TCS and a possible care pathway with nurse-led specialised clinic. Methods: We invited TCS in one of the cancer centre in Ireland for a comprehensive screening using questionnaires, examination and blood tests. Further investigations were performed as indicated. Mortality was assessed through retrospective chart reviews. Results: We recruited 78 TCS to participate in study. 3 patients who had died in survivorship phase were assessed through retrospective chart review. Second malignant neoplasms accounted for all three mortalities. Most common conditions in TCS after 5 years of diagnosis were hypertension (40%), dyslipidaemia (55.6%), hypogonadism (~45%) and high body mass index (52%). Majority of underlying conditions were diagnosed during screening in our clinic including two cases of coronary artery disease and one case of transient ischaemic attacks. Chemotherapy and age more than 30 years at the time of TC diagnosis were associated with a higher incidence of the late side effects. Conclusions: TC is a highly curable cancer but survivorship phase is marred by a range of late side effects. As we lack clear guidelines and care pathways for survivorship, this remains a challenge for patients and healthcare workers. A nurse-led, specialised, screening clinic can improve the care and prognosis of TC survivors.