For testicular cancer survivors, remission is a monumental milestone that deserves celebration. However, it rarely means there’s no more worry.
After all, any form of cancer can be a stressful experience. Before remission, survivors often spend months or years, feeling uncertain, worried and hypervigilant about their health. Those feelings and habits don’t go away so easily. And since testicular cancer treatment sometimes leads to other health concerns, follow-up cancer screenings should occur regularly for years after treatment.
Like many other cancers, testicular cancer doesn’t always seem gone, even when it is.
We spoke to Alex Bowman, MD, a medical oncologist at Banner MD Anderson Cancer Center at Banner Gateway Medical Center in Gilbert, AZ, who specializes in cancers of the urinary tract and genitals. He offered helpful advice for life after testicular cancer and all that it entails, from follow-up schedules to coping with side effects and post-remission strategies.
Follow-up schedules
Once you’re in remission, your follow-up schedule depends on various factors such as type of cancer, stage of diagnosis, and treatment methods. Dr. Bowman laid out the schedule an average person in remission could expect:
- Office visit and labs:
- Every two to three months for the first year
- Every three to six months for the second and third year
- Every six months for the fourth and fifth year
- Imaging (CT scans of the abdomen/pelvis): At varying intervals, typically every three to six months for the first several years, then annually.
Dr. Bowman emphasized how crucial this follow-up regimen is. It’s so important, he said, for men to not get “lost” from the medical system during these years. Testicular cancer is quite curable, even when it relapses, but the key is discovering it early.
“Men in their 20s and 30s — the typical patient — are often not the best at keeping up with their doctors,” Dr. Bowman said. Without regular follow-ups, a patient with a possible relapse of cancer may not get the help they need until it has progressed to the point of noticeable physical symptoms.
Possible long-term side effects
Ridding your body of cancer is of the utmost importance and, thanks to advancements in treatment, testicular cancer has a 5-year relative survival rate of 90%. But as with most cancer treatment, side effects can be expected during and after the treatment, some of them long-term, and others that may not develop for months or even years afterward. In fact, studies show that testicular cancer survivors have a 24% higher risk of developing long-term health effects (more than five years after diagnosis) than men who have never had cancer. Obesity before diagnosis is typically the strongest factor associated with these late effects.
The American Society of Clinical Oncology lists the following potential long-term side effects from treatment, often caused by radiation therapy, and chemotherapy drugs such as bleomycin and cisplatin.
- Lung problems
- Kidney damage
- Nerve damage: Feeling of numbness or “pins and needles.”
- Hearing problems: Tinnitus (ringing in the ears), or no longer hearing high-pitched sounds.
- Secondary cancers: Leukemia, which is rare (fewer than 1% of testicular cancer patients treated with chemo), but quite serious when it happens.
- Fertility: Decreased sperm count.
- Low testosterone
- Heart and blood vessel problems: A condition called Raynaud’s phenomenon, where the blood vessels narrow, and skin changes color when exposed to certain triggers such as the cold. Especially common in the hands.
Dr. Bowman also mentioned the increased risk of coronary artery disease, which can lead to strokes and heart attacks at a younger than typical age.
Just as important as the physical side effects is the psychological impact of treatment: Anxiety and depression are common, as patients often spend years worrying about whether their cancer will return. Psychosocial issues can also be common, and may include concerns about sexuality, attractiveness, personal inadequacy, and social rejection.
Creating your path forward
If you’ve experienced cancer, you are acutely aware that not everything is within your control. But you can find some comfort knowing that many things can be. Dr. Bowman said he counsels testicular cancer survivors to prioritize a healthy diet and exercise. That’s important for everyone, but particularly for this group, since it reduces the risk of heart and kidney disease down the line. He also encouraged patients to talk with their primary care provider about their long-term risks, since most of these risks won’t show up until long after the patient has stopped seeing an oncologist.
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