According to a recent article published in the Journal of Clinical Oncology, men who have survived testicular cancer may be at an increased risk of developing subsequent cardiovascular (heart) disease. These individuals should undergo cardiac monitoring as part of their follow-up medical care.
Cancer of the testicles is the most common cancer in men 15 to 34 years old. The testicles are part of the male reproductive system and are located inside the scrotum (a loose sac of skin that lies directly under the penis). Sperm and male hormones are produced in the testicles.
Testicular cancers were among the first types of cancers to be cured by radiation or chemotherapy. Currently, most patients with testicular cancer are cured. Given the young age at which testicular cancer occurs and the high cure rate, long-term survivorship issues, such as medical issues due to treatment, are important concerns for men who have had the disease.
Researchers from the Netherlands recently conducted a study to evaluate the incidence of cardiovascular disease in men who have survived at least 5 years following a diagnosis of testicular cancer. This study included 2,412 men who were treated between 1965 and 1995. Cardiovascular disease rates were compared with those of the general public and between different treatment regimens.
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- At a median follow-up of over 18 years, survivors of testicular cancer had a modestly improved risk of developing cardiovascular disease.
- Recent smoking increased the risk of a myocardial infarction (heart attack) 2.6-fold.
- Patients who received radiation to the mediastinum (lymph nodes in the center of the chest) had an approximately 3-fold increase in the risk of myocardial infarction and heart failure compared with patients who underwent surgery only.
- Patients treated with the chemotherapy combination referred to as PVB (cisplatin, vinblastine, and bleomycin) had a 1.9-fold increase in their risk of myocardial infarction, while those treated with the chemotherapy combination referred to as BEP (bleomycin, etoposide, and cisplatin) had a 1.5-fold increase in their risk of cardiovascular disease (but not myocardial infarction).
The researchers concluded that patients who are long-term survivors of testicular cancer may be at an increased risk of cardiovascular disease, particularly patients who have recently smoked or who are smokers, patients who received radiation to the mediastinum, or patients treated with chemotherapy combinations known as PVB or BEP. Patients who are survivors of testicular cancer should speak with their physician regarding recommended cardiac monitoring.
Reference: Belt-Dusebout A, Nuver J, de Wit R, et al. Long-Term Risk of Cardiovascular Disease in 5-Year Survivors of Testicular Cancer. Journal of Clinical Oncology. 2006; 24: 467-475.