Follow-up Care in the Adult Survivor SettingDavid Vaughn, M.D.
Abramson Cancer Center, University of Pennsylvania
- Testicular cancer represents a useful model for the development of survivorship care guidelines. Testicular cancer is the most commonly diagnosed solid tumor in men ages 15 to 35 years, and incidence of this cancer is increasing. Most patients are cured and become long-term survivors; however, late effects of treatment and the disease itself have been documented.
- Currently, more than 95 percent of testicular cancer patients experience long-term survival. Advances in chemotherapy largely are responsible for this increase, but new drugs also have had a significant effect on the risk of physiological and psychosocial late effects and second cancers. Testicular cancer survivors face increased mortality, attributed to increased risk of cardiovascular and benign gastrointestinal problems and also second cancers. Mediastinal radiation; cisplatin, vinblastine, and bleomycin (PVB) chemotherapy; and smoking are associated with increased risk of cardiovascular disease in testicular cancer survivors. Chemotherapy for testicular cancer leads to increased risk of certain conditions that can contribute to cardiovascular disease risk, such as hypertension, hypogonadism, obesity, hyperlipidemia, metabolic syndrome, and endothelial dysfunction.
- The University of Pennsylvania Testicular Cancer Program is an integrated treatment and survivorship program with links to clinical and genetic research. The program interacts with the LAF Living Well After Cancer (LWAC) Program. The LWAC LAF Testicular Cancer Team consists of a primary care physician and a core team who will identify issues requiring attention and provide care guidelines to the primary care physician. The core team includes specialists in oncology, nutrition, counseling, and research coordination. Consultants with expertise in psychiatry, urology, endocrinology, cardiology, cancer genetics, and rehabilitation medicine also provide information.
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