NCI Study Supports Screening for Heart Disease in Testicular Cancer Survivors
Results of a large study supported by the National Cancer Institute (NCI) found that patients who survived testicular cancer are at a higher risk of developing heart disease.
The recommendation comes as a result of the largest study to date that examines the rates of metabolic abnormalities among North American survivors of testicular cancer who received prior platinum-based chemotherapy.
The Platinum Study (JNCCN March 2018;16:257-265) showed that many survivors of testicular cancer are at risk for later complications from chemotherapy or other treatments, including high blood pressure, high cholesterol, obesity, and heart disease.
Researchers evaluated 486 survivors of testicular cancer and found that these individuals were more likely to have hypertension than patients without cancer (43.2% vs 30.7%, respectively; P .001). These survivors were also less likely to have lower levels of good cholesterol (23.7% vs 34.8%, respectively; P .001) or abdominal obesity (28.2% vs 40.1%, respectively; P .001).
In regard to other potential heart disease risk factors, survivors of testicular cancer were found to have higher amounts of low-density lipoprotein (17.7% vs 9.3%, respectively; P .001), higher overall cholesterol levels (26.3% vs 11.1%, respectively; P .001), and were more likely to be classified as overweight based on their body mass index (75.1% VS 69.1%, respectively; P = .04).
“For testicular cancer survivors, as with most cancer survivors, the medical concerns don’t end with remission,” said Timothy Gilligan, MD, MS, Cleveland Clinic Taussig Cancer Institute, and chair of the NCCN guidelines panel on testicular cancer, in a press release (March 13, 2018).
“At this time, there are no criteria for determining what exactly causes metabolic syndrome in cancer survivors,” added Mohammad Abu Zaid, MD, assistant professor of medicine, Indiana University. “Developing those criteria requires long- term follow up of cancer survivors, which is something we’ll be doing as part of this ongoing Platinum Study. This will help us understand which risk factors are more likely to lead to heart disease for this particular population.”
Researchers implore providers to actively screen and treat survivors of testicular cancer for hypertension, dyslipidemia, and hypogonadism, and to promote health lifestyle practices. Physicians should discuss the risks and benefits of testosterone replacement therapy with younger survivors of testicular cancer, researchers added.—Zachary Bessette