ASCO: Testicular Cancer and Low Testosterone

James Radke

Testicular cancer is a rare cancer but one with a relatively good prognosis. The overall 5-year survival rate is 95%. However, the cancer and its treatment can impact men in other ways. A new study presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago indicates that many men given cisplatin chemotherapy for their testicular cancer had low testosterone afterwards and those men had much higher incidence of other chronic health problems.
The study, led by Mohammad Issam Abu Zaid, MD, of the University of Indiana School of Medicine, found that 38% of the 491 testicular cancer survivors had hypogonadism and those patients had significantly higher incidence of high cholesterol, high blood pressure, erectile dysfunction, diabetes, and anxiety or depression

The ongoing testicular cancer survivor study, called the “Platinum Study’ has enrolled over 1600 survivors at last count and of those, data from 491 were presented at ASCO.  The goal of the study is to follow the lifelong health of men who received cisplatin chemotherapy for testicular cancer.

Among the 491 survivors, 38% had a low testosterone level or were on testosterone replacement therapy.
Compared to survivors with normal testosterone, testicular cancer survivors with low testosterone were more likely to take medicine for a variety of chronic conditions.
Table: Medications Taken for Chronic Conditions 

  Condition Hypogonadism Normal P-value
  Erectile dysfunction
< .001
P = .01
P = .02
P = .06
P = .07

In addition to taking medication for the above conditions, the study also noted that survivors with hypogonadism were like to have peripheral neuropathy compared to those with normal testosterone levels (31% vs 23%, P = .04).
In a news report, Dr Abu Zaid said, “Because testicular cancer occurs at a young age and is highly curable, many survivors may live upwards of five decades,” adding, “Our findings underscore the need for clinicians to assess testicular cancer survivors for physical signs or symptoms of hypogonadism and to measure testosterone levels in those who do.”


Abu Zaid MI, Menendez AG, Charif OE, et al. Adverse health outcomes in relationship to hypogonadism (HG) after platinum-based chemotherapy: A multicenter study of North American testicular cancer survivors (TCS). J Clin Oncol 2017; 35: (suppl; abstr LBA10012).

Image of Dr Abu Zaid obtained from University of Indiana.


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