In a recent study, published in the “ahead of print” issue Jan 14 in Journal of Clinical Oncology (journal impact factor 18.04), Mette Sprauten at the National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet and colleges explored long-term longitudinal changes in sex hormones in 307 testicular cancer survivors (TCSs).
Due to their young age at diagnosis, and because the majority of patients with testicular cancer are cured and expected to live for decades after treatment, in-depth knowledge regarding long-term toxicities is considered particularly important for this patient group. Hypogonadism is one of these long-term adverse effects, and its degree is related to treatment intensity. It may lead to reduced sexual functioning and well-being, fertility problems, muscle weakness, loss of energy, and depression. Furthermore, hypogonadism increases the risk of osteoporosis and is associated with metabolic syndrome and cardiovascular disease.
In all, 307 TCSs treated from 1980 to 1994 provided blood samples after orchiectomy but before further treatment and median 11 and 19 years after treatment. Compared with a healthy control group and adjusted for age, and categorized after treatment (surgery only, radiotherapy or chemotherapy), the risk of lower testosterone and higher LH and FSH levels was significantly increased for TCSs at all time points after radiotherapy and chemotherapy. When compared to the surgery group, men who had received chemotherapy or radiotherapy had a higher risk of hypogonadism. In total, half the TCSs had at least one of three sex hormone levels outside the reference range median 19 years after treatment. Compared with healthy males, they had an accelerated hormonal ageing. Our findings may pertain to cancer survivors in general, underlining the importance of extended follow-up.
Longitudinal Serum Testosterone, Luteinizing Hormone, and Follicle-Stimulating Hormone Levels in a Population-Based Sample of Long-Term Testicular Cancer Survivors.
Sprauten M, Brydøy M, Haugnes HS, Cvancarova M, Bjøro T, Bjerner J, Fosså SD, Oldenburg J.
J Clin Oncol. 2014 Jan 13.
National Advisory Unit on Late Effects after Cancer Treatment
Section for Clinical Cancer Research and Resource Development