Physical long-term side-effects in young adult cancer survivors: germ cell tumors model

• Published in: Current opinion in oncology Vol. 29; no. 4; p. 229
• Main Authors: Kourie, Hampig Raphael, Klastersky, Jean A
• Format: Journal Article
• Language: English
• Published: United States 01.07.2017
• Subjects: Adult; Hodgkin Disease - mortality; Hodgkin Disease - physiopathology; Humans; Neoplasms, Germ Cell and Embryonal - mortality; Neoplasms, Germ Cell and Embryonal - physiopathology; Neoplasms, Second Primary - physiopathology; Quality of Life; Survivors; Young Adult
• ISSN: 1531-703X
• DOI: 10.1097/CCO.0000000000000375

After the important advances in the treatment of germ cell tumors (GCTs) leading to high cure rates, physical long-term side-effects represent an important cause of death in these young adult survivors. Highlighting these physical long-term side-effects, their monitoring and their prevention modalities is necessary for a better management of these cancer survivors. Impaired fertility, increased risk of developing a second cancer, cardiac, pulmonary, renal and neural toxicity, hearing and vision impairment are the major physical side-effects in young adult cancer survivors. Long-term cardiac toxicity, next to second malignancies, represents life-threatening conditions in testicular cancer survivors. The long-term nephrotoxity in testicular GCTs survivors is most frequently associated to the treatment either in those treated with cisplatin-based chemotherapy, mainly Bleomycine, Etoposide, Cisplatin, or those receiving infradiaphragmatic radiation therapy, whereas pulmonary toxicity is mainly attributed to bleomycin related toxicities. There are no clear and comprehensive data concerning the monitoring and prevention of long-term side-effects in testicular cancer survivors. Physical activity and interventions in modifiable cardiovascular risk factors and lifestyles may reduce the incidence of long-term side-effects in these cancer survivors.