Cardiovascular Disease as a Long Term Complication of Treatment for Testicular Cancer

2002 ◽  
pp. 211-212 ◽  
Author(s):  
R. A. Huddart ◽  
A. Norman ◽  
M. Shahidi ◽  
A. Horwich ◽  
D. Coward ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Testicular Cancer

scholarly journals Toxicities Associated with Cisplatin-Based Chemotherapy and Radiotherapy in Long-Term Testicular Cancer Survivors

2018 ◽  
Vol 2018 ◽  
pp. 1-20 ◽  
Author(s):  
Chunkit Fung ◽  
Paul Dinh ◽  
Shirin Ardeshir-Rouhani-Fard ◽  
Kerry Schaffer ◽  
Sophie D. Fossa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Testicular Cancer ◽  
Cancer Survivors ◽  
Current Status ◽  
Malignant Neoplasms ◽  
Targeted Prevention ◽  
Care Providers ◽  
National Guidelines ◽  
Testicular Cancer Survivors

Testicular cancer has become the paradigm of adult-onset cancer survivorship, due to the young age at diagnosis and 10-year relative survival of 95%. This clinical review presents the current status of various treatment-related complications experienced by long-term testicular cancer survivors (TCS) free of disease for 5 or more years after primary treatment. Cardiovascular disease and second malignant neoplasms represent the most common potentially life-threatening late effects. Other long-term adverse outcomes include neuro- and ototoxicity, pulmonary complications, nephrotoxicity, hypogonadism, infertility, and avascular necrosis. Future research efforts should focus on delineation of the genetic underpinning of these long-term toxicities to understand their biologic basis and etiopathogenetic pathways, with the goal of developing targeted prevention and intervention strategies to optimize risk-based care and minimize chronic morbidities. In the interim, health care providers should advise TCS to adhere to national guidelines for the management of cardiovascular disease risk factors, as well as to adopt behaviors consistent with a healthy lifestyle, including smoking cessation, a balanced diet, and a moderate to vigorous intensity exercise program. TCS should also follow national guidelines for cancer screening as currently applied to the general population.

Cardiovascular Disease as a Long-Term Complication of Treatment for Testicular Cancer

2003 ◽  
Vol 21 (8) ◽  
pp. 1513-1523 ◽  
Author(s):  
R.A. Huddart ◽  
A. Norman ◽  
M. Shahidi ◽  
A. Horwich ◽  
D. Coward ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Testicular Cancer ◽  
Cardiac Risk ◽  
Mortality Data ◽  
Resident Male ◽  
Cardiac Risk Factors ◽  
Long Term Survivors

Purpose: To assess the risk of cardiovascular morbidity and cardiac risk factors in long-term survivors of testicular cancer according to treatment received. Patients and Methods: All resident male patients registered in the United Kingdom between 1982 and 1992 attending for follow-up were eligible for recruitment. Patients completed a current health questionnaire and underwent clinical review, along with hematologic, biochemical, and hormonal profiles. For patients not under routine review, follow-up information was sought from their general practitioner and mortality data were sought from the Office of National Statistics. Descriptive analysis was performed on all variables and comparisons were made among patients treated by orchidectomy and follow-up only, chemotherapy alone (C), radiotherapy alone (RT), and radiotherapy and chemotherapy (C/RT). Results: Data on cardiovascular events were available on 992 patients. After a median follow-up of 10.2 years, 68 events had been reported, including 18 deaths. After adjusting for age, increased risk for cardiac events was seen after C (relative risk [RR] = 2.59; 95% confidence interval [CI], 1.15 to 5.84; P = .022), RT (RR = 2.40; 95% CI, 1.04 to 5.45; P = .036), and C/RT (RR = 2.78; 95% CI, 1.09 to 7.07; P = .032). There were no significant differences in cardiac risk factors. On multivariate analysis, age, treatment group, free thyroxine, protein, and magnesium levels were associated with cardiovascular disease. Conclusion: In long-term survivors of testicular cancer, we observed a two-fold or greater risk of developing cardiovascular disease. This was not due to increases in cardiac risk factors, which suggests a direct or indirect treatment effect. These data support the continued research into the minimization of treatment in good-prognosis testicular cancer.

Long-Term Risk of Cardiovascular Disease in 5-Year Survivors of Testicular Cancer

2006 ◽  
Vol 24 (3) ◽  
pp. 467-475 ◽  
Author(s):  
Alexandra W. van den Belt-Dusebout ◽  
Janine Nuver ◽  
Ronald de Wit ◽  
Jourik A. Gietema ◽  
Wim W. ten Bokkel Huinink ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Testicular Cancer ◽  
Cox Regression ◽  
Myocardial Infarctions ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
Smoking Intervention ◽  
Cox Analysis

Purpose To evaluate the long-term risk of cardiovascular disease (CVD) in survivors of testicular cancer (TC). Patients and Methods We compared CVD incidence in 2,512 5-year survivors of TC, who were treated between 1965 and 1995, with general population rates. Treatment effects on CVD risk were quantified in multivariate Cox regression analysis. Results After a median follow-up of 18.4 years, 694 cardiovascular events occurred, including 141 acute myocardial infarctions (MIs). The standardized incidence ratio (SIR) for coronary heart disease was 1.17 (95% CI, 1.04 to 1.31), with 14 excess cases per 10,000 person-years. The SIR for MI was significantly increased in nonseminoma survivors with attained ages of less than 45 (SIR = 2.06) and 45 to 54 years (SIR = 1.86) but significantly decreased for survivors with attained ages of 55 years or older (SIR = 0.53). In Cox analysis, mediastinal irradiation was associated with a 3.7-fold (95% CI, 2.2- to 6.2-fold) increased MI risk compared with surgery alone, whereas infradiaphragmatic irradiation was not associated with an increased MI risk. Cisplatin, vinblastine, and bleomycin (PVB) chemotherapy (CT) was associated with a 1.9-fold (95% CI, 1.7- to 2.0-fold) increased MI risk, and bleomycin, etoposide, and cisplatin (BEP) CT was associated with a 1.5-fold (95% CI, 1.0- to 2.2-fold) increased CVD risk and was not associated with increased MI risk (hazard ratio = 1.2; 95% CI, 0.7 to 2.1). Recent smoking was associated with a 2.6-fold (95% CI, 1.8- to 3.9-fold) increased MI risk. Conclusion Nonseminomatous TC survivors experience a moderately increased MI risk at young ages. Physicians should be aware of excess CVD risk associated with mediastinal radiotherapy, PVB CT, and recent smoking. Intervention in modifiable cardiovascular risk factors is especially important in TC survivors. Whether BEP treatment increases CVD risk should be evaluated after more prolonged follow-up.

Impact of long-term serum platinum on neuro- and ototoxicity, cardiovascular disease, and hypogonadism in testicular cancer survivors.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 4518-4518
Author(s):  
Line veronika Hjelle ◽  
Roy M. Bremnes ◽  
per Ole Gundersen ◽  
Mette Sprauten ◽  
Marianne Brydoy ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Testicular Cancer ◽  
Cancer Survivors ◽  
Testicular Cancer Survivors
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