| January 20,
2001
PENN RESEARCHERS STUDY LONG-TERM
SURVIVORSHIP ISSUES OF TESTICULAR CANCER PATIENTS
Long-term ramifications of treatment to be studied
in growing survivor population
(Philadelphia, PA)--Researchers
at the University of Pennsylvania Cancer Center are
investigating the long-term physical and emotional effects
of testicular cancer on survivors. Testicular cancer-the
leading solid malignancy cancer among males between
the ages of 15 and 34-now has a survival rate of between
90 and 95 %, which is due largely to improved treatment
options, including highly effective chemotherapy regimens.
According to David J. Vaughn, MD, Associate Professor
of Medicine, (Hematology/Oncology) at the University
of Pennsylvania Cancer Center, the combination of a
relatively young patient population at time of diagnosis
and high cure rates have led to a growing number of
cancer survivors with special needs. "It is the relatively
unexplored area of long-term cancer survivorship issues
that we at the University of Pennsylvania have begun
to actively study," said Vaughn.
Of the almost 7,000 cases of testicular cancer reported
annually in the United States, approximately 6,700 will
be cured. (While the number of cases reported annually
is increasing, the reason or reasons for that increase
remain unclear.) This data reflects a patient group
that is generally diagnosed at a young age and has a
very high survival rate. "This patient group presents
an important opportunity for physician researchers to
examine long-term clinical and quality-of-life issues
affecting these survivors. It is exciting that we have
so many long-term survivors of cancer today. It is a
tribute to the advances in our field. Our challenge
now is to learn about the medical and personal consequences
of long-term survival and to find new clinical programs
to support these special concerns." explained Vaughn.
Some of the issues to be explored by the Penn researchers
will include; the potential late medical consequences
of treatment; the occurrence of cancer in the other
testicle; issues regarding fertility and sexuality,
and the psychosocial impact of the disease. "Unfortunately,
many patients believe that once they have had surgery
and/or chemotherapy, they are "cured" and all immediate
risks have been eliminated. It is critically important
to make the testis cancer patient, as well as all long-term
survivors of cancer, aware of the long term medical
and personal issues that may arise," emphasizes Vaughn.
Dr. Vaughn also notes that there is a general reluctance
among testis cancer survivors to monitor their condition
after treatment. It is believed that the castration
impact and other symbolic effects of a testicle removal
(or "oriechtomy") on the male psyche is significant
but this phenomenon remains relatively undocumented.
Evidence does suggest that there may be a causal connection
between the chemotherapy and increased incidence of
late cardiovascular and renal problems years after treatment.
A potential increased risk of atypical nevi or "moles"
resulting in melanomas and other secondary cancers including
chemotherapy induced leukemia are also suspected--and
are in need of further study as well. A primary concern
to testis cancer patients is their post-treatment ability
to have children. Treatment can induce lower sperm counts
and so affect a patient's reproductive ability --which
then raises the potential for increased psychosocial
distress.
The long-term cancer survivorship initiative builds
upon the University of Pennsylvania Cancer Center's
leadership position in studying and treating testicular
cancer. The ultimate goal of this comprehensive, multi-disciplinary
research program is to provide clinical expertise, information
and support to long-term survivors and families, and
to serve as a model of care and research for other cancers
at the University of Pennsylvania and throughout the
nation. The ultimate goal will be to establish a testicular
cancer survivorship clinic to assist patients and help
monitor all medical and psychosocial developments.
Editor's note: The University of Pennsylvania Cancer
Center will be recruiting testicular cancer patients
who have been cancer/symptom free for at least two years,
to take part in a survivorship clinic to commence in
early 2001.
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