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DG DISPATCH - ASCO: Testicular-Cancer Survivors Face Long-term Effects
By Robert H. Carlson
Special to DG News
NEW ORLEANS, LA -- May 26, 2000 -- Treatment of advanced testicular cancer is one of the success stories in modern oncology.
Before the drug cisplatin was introduced in the 1980s, young men faced a 95-percent mortality rate from the disease. Cisplatin combined with radiation treatment dramatically changed the odds to the 95-percent cure rate which these patients enjoy today.
But apparently not without exposure to other risks.
Studies presented in New Orleans at the 36th annual meeting of the American Society of Clinical Oncology show that men who survive advanced germ cell cancer of the testicle and reach middle age are prone to dangerous metabolic changes, hypertension, coronary artery disease, and development of other cancers.
One study, from the Royal Marsden Hospital in London, U.K., studied the records of 1,603 men treated for testicular cancer between 1982 and 1992. Data available on 946 men showed that those who received chemotherapy, radiotherapy or both after surgery had approximately double the risk of cardiovascular disease and about a 50-percent higher incidence of high blood pressure as do men who were treated with surgery alone.
There was no difference in smoking history or cholesterol levels between treated and non-treated groups to explain the increased risk, reported R.A. Huddart, MD, principal investigator.
The treated men also had detectable biochemical changes in sodium, magnesium, potassium, creatinine, and protein. And the treated men had approximately double the risk of non-testicular cancer in the years following their treatment.
In the same session here, researchers from The Netherlands reported that long-term survivors of testicular cancer treated with chemotherapy and surgery had more signs of vascular damage and more pronounced metabolic, and hormonal imbalance, compared with men who had been treated with surgery alone.
Martin T. Meinardi, MD, University Hospital of Groningen, said the incidence of hypertension was 39 percent in a group of 62 men treated with chemotherapy and surgery, compared with 13 percent among 40 men treated with surgery alone.
Experts here recommended that men in this category should receive close long-term follow-up by oncologists aware of the potential risks.