S-58 Testicular cancer (TC) as an illustrative paradigm S.D. Fosså Rikshospitalet - Radiumhospitalet Medical Center, Oslo, Norway With a 35 year median age at diagnosis and a >90% cure rate after multi-modal treatment, TC survivors represent an excellent cohort for the illustration of late effects and survivorship problems experienced not only by themselves, but by cancer survivors in general. The most serious late effect is the steadily increasing relative risk (RR) of a second malignancy (for solid cancer: radiotherapy alone [RR: 2.0]; chemotherapy alone [RR: 1.8]; combination treatment [RR: 2.9]), the youngest patients displaying the highest risk. Typically these second solid malignancies develop after a delay of >10 years, when the patient no longer is regularly seen by the oncologist. During recent years increasing evidence has emerged that modern treatment of TC (cisplatin-based chemotherapy, infradiaphragmatic radiotherapy) implies an increased risk of cardiovascular disorders (CVD), evidenced by biochemical parameters, premature development of myocardial infarction and/or increased mortality due to CVD. Again the youngest patients display the greatest risk. Abdominal radiotherapy also leads to increased mortality due to benign gastrointestinal conditions. Approximately 20% of longterm TC survivors complain about peripheral sensoric neurotoxicity and/or ototoxicity. Germ line GSTP1 polymorphisms seem to be associated with individual sensitivity for cisplatin-induced neuro- and ototoxicity. At least 70% of TC survivors who attempt post-treatment paternity are successful, in dependency from the intensity of treatment, for most patients without the use of cryopreserved semen. Though both libido and ejaculation may be reduced in TC survivors, they are at least similarily satisfied with their sexuality as the general population. TC survivors` post-treatment quality of life (Qol) is comparable to that of the general population, though fatigue (prevalence: 17%) and anxiety (19%) are seen more often than in controls. Conclusion: After 3 decades of large international randomized trials TC patients can now be treated with minimal treatment without reduction of cure and taking into account the individual patient`s preferences. Before treatment TC patients should be informed about the prospective of good Qol in spite of some unavoidable side effects in some of them. Life-style changes and regular life-long controls by the community health care service may be necessary to prevent CVD based on an individual survivor care plan, to be given to the patient when he discontinues oncological care. The increased risk of second cancer should not be overlooked. These conclusions are probably also relevant for other survivors after adult-onset cancer diagnosed at young age. MASCC, 2007 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.