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Physical long-term side-effects in young adult cancer survivors: germ cell tumors model
Hampig Raphael Kourie1, Jean A Klastersky
1aOncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon bInstitut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium.
Purpose Of Review:
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.
Recent Findings:
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.
Summary:
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.
Insights
Long-term side effects like cardiac toxicity and second cancers are significant concerns for young adult survivors of germ cell tumors (GCTs). Lifestyle interventions may help mitigate these risks.
Area of Science:
- Oncology
- Survivorship Care
- Public Health
Background:
- Advances in germ cell tumor (GCT) treatment yield high cure rates.
- Long-term physical side effects are a major cause of mortality in young adult GCT survivors.
- Effective monitoring and prevention strategies for these side effects are crucial.
Purpose of the Study:
- To review the significant long-term physical side effects in GCT survivors.
- To highlight the importance of monitoring and prevention of these late effects.
- To inform better management strategies for GCT survivors.
Main Methods:
- Literature review of studies on GCT survivorship.
- Analysis of reported long-term toxicities and their causes.
- Evaluation of current monitoring and prevention recommendations.
Main Results:
- Major side effects include impaired fertility, second cancers, cardiac, pulmonary, renal, and neural toxicity, and sensory impairments.
- Cardiac toxicity and secondary malignancies are life-threatening.
- Nephrotoxicity is linked to cisplatin-based chemotherapy and radiation; pulmonary toxicity to bleomycin.
Conclusions:
- Comprehensive data on monitoring and prevention of long-term side effects in testicular cancer survivors are lacking.
- Physical activity and lifestyle modifications targeting cardiovascular risk factors may reduce long-term side effect incidence.
- Further research is needed to establish clear guidelines for GCT survivor care.
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