Secondary malignant neoplasms in testicular cancer survivors

Stephanie A Curreri; Chunkit Fung; Clair J Beard

doi:10.1016/j.urolonc.2015.05.002

Secondary malignant neoplasms in testicular cancer survivors

Urol Oncol. 2015 Sep;33(9):392-8. doi: 10.1016/j.urolonc.2015.05.002. Epub 2015 Jun 11.

Authors

Stephanie A Curreri¹, Chunkit Fung², Clair J Beard³

Affiliations

¹ Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: scurreri@lroc.harvard.edu.
² University of Rochester Medical Center, Rochester, NY.
³ Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

PMID: 26072728
DOI: 10.1016/j.urolonc.2015.05.002

Abstract

Background: Testicular cancer is the most common cancer among men aged 15 to 40 years, and the incidence of testicular cancer is steadily increasing. Despite successful treatment outcomes and the rate of survival at 5 to 10 years being 95%, survivors can experience late effects of both their cancer and the treatment they received, including secondary malignant neoplasms (SMNs). We discuss the development of non-germ cell SMNs that develop after diagnosis and treatment of testicular cancer and their effect on mortality.

Results: Patients diagnosed with testicular cancer frequently choose postoperative surveillance if they are diagnosed with clinical stage I disease. These patients may experience an increased risk for developing SMNs following radiation exposure from diagnostic imaging. Similarly, radiotherapy for testicular cancer is associated with increased risks of developing both solid tumors and leukemia. Studies have reported that patients exposed to higher doses of radiation have an increased risk of developing SMNs when compared with patients who received lower doses of radiation. Patients treated with chemotherapy also experience an increased risk of developing SMNs following testicular cancer, though the risk following chemotherapy and radiation therapy combined is not well described. A large population-based study concluded that the rate ratios for both cancer-specific and all-cause mortality for SMNs among testicular cancer survivors were not significantly different from those of matched first cancers.

Conclusions: Although it is known that patients who receive adjuvant chemotherapy or radiotherapy or who undergo routine diagnostic or follow-up imaging for a primary testicular cancer are at an increased risk for developing SMNs, the extent of this risk is largely unknown. It is critically important that research be conducted to determine this risk and its contributing factors as accurately as possible.

Keywords: Chemotherapy; Diagnostic imaging; Radiation therapy; Second cancer; Testicular cancer.

Publication types

Review

MeSH terms

Antineoplastic Agents / adverse effects
Humans
Male
Neoplasms, Germ Cell and Embryonal* / therapy
Neoplasms, Second Primary / epidemiology*
Radiotherapy / adverse effects
Risk Factors
Survivors
Testicular Neoplasms* / therapy

Substances

Antineoplastic Agents

Supplementary concepts

Testicular Germ Cell Tumor