Age, Treatment Type May Increase Mental and Sexual Side Effects Among Testicular Cancer Survivors

Testicular cancer survivors should talk with their care team if they are experiencing symptoms of anxiety, depression or sexual dysfunction.

Testicular cancer survivors, especially those younger than 40 years old, reported increased symptoms of anxiety, depression and sexual dysfunction, compared to those without a history of cancer, according to recent results.

Across disease stages, testicular cancer has been highly curable for many years, Dr. Aditya Bagrodia, co-author on the study, explained in an interview with CURE®. However, mental and physical side effects can follow patients into survivorship, negatively impacting their quality of life.

“While it is wonderful that we can cure the vast majority of these young men, the impact of the diagnosis and the treatment is profound and can affect nearly all aspects of their life,” noted Bagrodia, who is an associate professor and team lead in genitourinary oncology at the University of California, San Diego.

He and researchers administered 143 surveys to testicular cancer survivors to self-report on sexual function and mood. Results — which were presented at the Society of Urologic Oncology 22nd Annual Meeting — demonstrated that survivors reported increased symptoms of anxiety, depression and sexual dysfunction without reduced sexual interest, compared to those without a history of cancer.

Some may experience these symptoms because they are in, what Bagrodia described as “the prime of their life,” as the most common age to receive a testicular cancer diagnosis is between 20 and 40 years. Many may be starting a career, secondary education or a family — which can all be impacted by a testicular cancer diagnosis.

Of note, younger men (between ages 20 and 39 years) reported higher symptoms of anxiety and depression compared to men older than 40.

“By all means, I think that older men and men with a cancer diagnosis — and women, for that matter — all experience some degree of anxiety, depression (and) sexual side effects,” he added. “But I think that it really is just being in that phase of your life where you're working, or you're just starting to work, you're in school potentially, you just started a family potentially, maybe you're not quite as financially independent or free. That (all) can exacerbate things, (that) would be my sense (of it).”

Additionally, men who underwent retroperitoneal lymph node dissection (a procedure to remove abdominal lymph nodes to treat testicular cancer) reported increased depression symptoms compared to those who did not. And those who received chemotherapy demonstrated worse symptoms of sexual dysfunction and depression versus those who did not undergo chemotherapy.

Bagrodia advised testicular cancer survivors who are experiencing symptoms such as anxiety, depression or sexual dysfunction to let their doctor know.

“If you’re feeling any anxiety, depression or sexual side effects from the diagnosis or treatment of testicular cancer, you’re not alone,” he said. “These are actually generally very manageable situations through both counseling as well as allopathic interventions. (Patients) should notify their providers because we can intervene with mental health support services for some of the causative reasons for anxiety, depression, financial toxicity, low testosterone and potentially help you out a little bit.”

Bagrodia added that patients can ask for help for these symptoms regardless of where they are in their cancer journey.

“Even if you’re far out (from treatment) and cured, it’s worth bringing these up with your cancer care team, as well as your primary medical provider, because you don’t necessarily have to live with these for the rest of your life,” he said.

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