The quality of life and hormonal disturbances in testicular cancer survivors in Cisplatin era.
OBJECTIVE
To assess the degree of hormonal abnormalities in testicular cancer survivors and the effect of these changes on patients' quality of life.


METHODS
Men with complete remission of testicular cancer for over 2 yr were eligible. Patients completed the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), the International Index of Erectile Function (IIEF), and the Sexual Functioning Questionnaire (SFQ), and rated their physical and psychological well-being, quality of life, and relationship with their partner. Levels of the hormones testosterone, estradiol, thyreotropin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin were determined. Relationships between hormone levels and questionnaire results were assessed.


RESULTS
A total of 326 men were tested, of whom 269 were treated with platinum-based chemotherapy. The most common endocrine abnormalities were above-normal gonadotropin levels (LH, 55%, and FSH, 49% of cases) and lowered testosterone (15%). Twenty-seven percent (STAI) and 28% (HADS) of the patients had abnormal anxiety levels, while the depression rate was 15% (BDI) and 18% (HADS); 40% of patients had erectile dysfunction. Linear regression analysis excluding the influence of age showed higher depression levels in the BDI among patients with elevated LH (p=0.010) or FSH (p=0.017). Patients with above-normal LH showed increased sexual problems in the SFQ (p=0.030). Elevated gonadotropins correlated with deteriorated physical well-being (p=0.028). Men with abnormal estradiol were more prone to erectile dysfunction (p=0.009).


CONCLUSIONS
Hormonal abnormalities have a negative impact on the quality of life of testicular cancer survivors.
Wiechno
Paweł
P
Department of Urology, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland.
Demkow
Tomasz
T
Kubiak
Krzysztof
K
Sadowska
Małgorzata
M
Kamińska
Janina
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000728:Androgens / Q000097:blood*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D020018:Sexual Dysfunctions, Psychological / Q000097:blood / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D013997:Time Factors
D000728:Androgens; D000970:Antineoplastic Agents; D002945:Cisplatin