A comparative study of psychosexual adjustment in men with testicular cancer and acute leukemia

Twenty-five men with testicular germ cell tumors were compared by developmental history and past and present psychologic adjustment to 25 men with acute leukemia. The mean age was 30 years for the cancer group and 25 years for the leukemia group. Current and Past Psychopathology Scales (18 scales of prior and 8 of present adjustment) were rated during a semistructured interview. The following differences were found in developmental history: Onset of puberty was 12.4 years for leukemics and 15.1 years for the cancer group (P less than 0.001); cryptorchidism was found in 20% of cancer patients and 4% of leukemia; incidence of opiate drug abuse was 36% in cancer patients and 24% in leukemia patients; psychiatric disturbance prior to illness characterized 32% of the cancer group and 12% of the leukemia group. Major psychiatric illness was diagnosed in 20% of the testicular cancer group and 4% of the leukemia group. Findings of delayed puberty and psychiatric disturbance in men with germ cell testicular tumors as compared to leukemics suggest a possible impairment of the hypothalamic-pituitary-gonadal axis. The etiology of this impairment is discussed (genetic factors, prenatal endocrine milieu, abnormal luteinizing hormone (LH) receptors, and abnormal interaction between dopaminergic system, LH, and endorphins).