title: Emotional disorders in testicular cancer survivors in relation to hypogonadism, androgen receptor polymorphism and treatment modality.
abstract: OBJECTIVE
  It has been documented that testicular germ cell cancer (TGCC) patients may be at increased risk of developing emotional distress (EMD). Hence, the aim of the present study was to investigate whether EMD is related to the presence of hypogonadism, androgen receptor (AR) polymorphism and/or treatment intensity.
  
  
  METHODS
  Three to five years after treatment, testosterone and luteinizing hormone (LH) levels were measured in 165 TGCC patients. These patients also completed a questionnaire concerning mental health. EMD was measured by the Hospital Anxiety and Depression Scale (HADS). The androgen receptor (AR) gene has two polymorphic regions in exon I; glutamine encoding CAG and glycine encoding GGN repeats. Association between emotional disorders and AR polymorphisms as well as type of treatment was assessed.
  
  
  RESULTS
  Neither anxiety (OR 1.0; 95% CI 0.40-2.4) nor depression (OR 1.1; 95% CI 0.20-6.4) were overrepresented in biochemically hypogonadal TGCC patients and no association between AR polymorphisms and EMD was found. Patients treated with >or=5 cycles of cisplatinum based chemotherapy due to refractory or relapsed disease were more prone to experiencing symptoms of anxiety (p=0.006), but not depression (p=0.38).
  
  
  CONCLUSIONS
  Biochemical hypogonadism and AR polymorphism do not seem to be risk factors for EMD in TGCC patients. Patients with refractory or relapsed disease receiving >or=5 cycles of cisplatinum based chemotherapy may, to a higher degree than patients receiving less intense therapy, suffer from anxiety.
authors: Department of Oncology, Lund University Hospital, Lund University, SE 221 85 Lund, Sweden. jakob.eberhard@med.lu.se
authors: Jakob
authors: J
authors: Eberhard
authors: Olof
authors: O
authors: Ståhl
authors: Gabriella
authors: G
authors: Cohn-Cedermark
authors: Eva
authors: E
authors: Cavallin-Ståhl
authors: Yvonne
authors: Y
authors: Giwercman
authors: Hamideh
authors: H
authors: Rastkhani
authors: Lars
authors: L
authors: Rylander
authors: Malin
authors: M
authors: Eberhard-Gran
authors: Ulrik
authors: U
authors: Kvist
authors: Aleksander
authors: A
authors: Giwercman
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001007:Anxiety / Q000209:etiology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003863:Depression / Q000209:etiology; D020022:Genetic Predisposition to Disease; D018237:Germinoma / Q000378:metabolism / Q000523:psychology; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000209:etiology / Q000523:psychology; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D019964:Mood Disorders / Q000209:etiology* / Q000235:genetics / Q000378:metabolism / Q000523:psychology; D009367:Neoplasm Staging; D011110:Polymorphism, Genetic; D011944:Receptors, Androgen / Q000235:genetics*; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D013548:Sweden; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism / Q000523:psychology*; D013739:Testosterone / Q000097:blood; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D011944:Receptors, Androgen; D013739:Testosterone; D007986:Luteinizing Hormone; D002945:Cisplatin