IU study: Many testicular cancer survivors have low testosterone levels; likely to experience other chronic health problems

  • June 2, 2017

INDIANAPOLIS – Indiana University cancer researchers found that many testicular cancer survivors have low testosterone levels and are more likely to have chronic health problems.

In the study, the researchers found that 38 percent of 491 testicular cancer survivors had low testosterone levels, or hypogonadism. Further, compared to survivors with normal testosterone levels, survivors with low testosterone were more likely to report a range of chronic health problems such as high blood pressure, diabetes and erectile dysfunction.

"Because testicular cancer is the most common cancer among young men and is highly curable, many survivors may live more than 40 years after diagnosis," Mohammad Issam Abu Zaid, MBBS, an assistant professor of medicine at IU School of Medicine and lead author, said. "Our findings underscore the need to screen testicular cancer survivors for hypogonadism and treat those who have symptoms."

Dr. Abu Zaid, who completed his hematology-oncology fellowship at the Indiana University Melvin and Bren Simon Cancer Center in 2016, presented the findings at the American Society of Clinical Oncology (ASCO) annual meeting today in Chicago. The findings were part of the ASCO official press program. Less than 1 percent of all abstracts submitted to ASCO are included in the press program. More than 2,150 abstracts were accepted for presentation at the annual meeting, plus more than 2,890 additional abstracts were accepted for online publication, according to ASCO.

Dr. Abu Zaid and colleagues reported that low testosterone can be present at the time of testicular cancer diagnosis or it can develop as a side effect from surgery or chemotherapy. Although it has been known that low testosterone levels can occur in testicular cancer survivors, this is one of the first studies to examine its relationship with long-term health complications among North American patients, according to the researchers.

Compared to survivors with normal testosterone, testicular cancer survivors with low testosterone were more likely to take medications for:

 •    High cholesterol
 •    High blood pressure
 •    Erectile dysfunction
 •    Diabetes
 •    Anxiety or depression

"Testicular cancer survivors are at risk for late complications from their cisplatin-based chemotherapy," Dr. Abu Zaid said. "Recognizing and treating low testosterone in those with symptoms can improve quality of life and lessen adverse health outcomes such as diabetes and early cardiac problems. We recommend that these men exercise, maintain a healthy body weight, and monitor their blood pressure and cholesterol levels."

The researchers studied 491 patients enrolled in the IU-led Platinum Study. The goal of the study is to follow the lifelong health of men who received cisplatin chemotherapy for testicular cancer.

In 1974, Lawrence Einhorn, MD, IU Distinguished Professor, Livestrong Foundation Professor of Oncology, and professor of medicine, tested cisplatin with two additional drugs that were effective in killing testis cancer cells. The combination became the cure for this once deadly disease.

This study was funded by the National Cancer Institute (R01 CA157823).

Other authors from IU included Dr. Einhorn, Lois Travis, MD, ScD, and Patrick Monahan, PhD.

ASCO is the world’s leading professional organization representing physicians who care for people with cancer. The annual meeting attracts more than 30,000 oncology professionals from around the world.

Mohammad Issam Abu Zaid, MBBS

Mohammad Issam Abu Zaid, MBBS, assistant professor of medicine at IU School of Medicine

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Michael Schug