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January 20, 2001


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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