Testicular cancer and male infertility.
OBJECTIVE
Testicular cancer and infertility affect a similar age group of patients and have common biologic, epidemiologic, and environmental backgrounds. In this review, we provide current literature on links between infertility and testicular cancer, and new developments in the management of testicular cancer aimed at improving quality of life in men with testicular cancer.


RESULTS
In-utero environmental exposure to endocrine disruptors modulates the genetically determined fate of primitive gonad and results in testicular dysgenesis syndrome, which may result in infertility and testicular cancer. Excellent response of testicular cancer to radiation and chemotherapy results in over 90% of survival and quality of life--fertility and sexual function--is of significant concern to patients and clinicians. The testicular-sparing management of testicular masses emerges as a sound alternative to radical orchiectomy and allows for preservation of spermatogenesis and hormonal function, and at the same time achieving similar survival rates. Secondary malignancies, pulmonary, and cardiovascular complications are recognized as late complications of treatment for testicular cancer.


CONCLUSIONS
Better understanding of common mechanisms involved in infertility and testicular cancer, and scientifically driven evidence-based treatment options should improve quality of life in young men faced with this potentially life-threatening disease.
Paduch
Darius A
DA
Department of Urology, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA. dap2013@med.cornell.edu
D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003131:Combined Modality Therapy; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D008297:Male; D009919:Orchiectomy / Q000379:methods; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012662:Semen Preservation; D013736:Testicular Neoplasms / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome