Hormonal status and the quality of life of testicular cancer survivors

Abstract

4548 Background: Testicular cancer is a highly curable neoplasm and treated patients may potentially survive many decades. The aim of the study was to assess the rate of hormonal abnormalities among testicular cancer survivors and the effect of these changes on patients’ quality of life. Methods: Men with complete remission of testicular cancer lasting over 2 years were eligible. Patients completed State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS), Beck’s Depression Inventory (BDI), International Index of Erectile Dysfunction (IIEF), Sexual Functioning Questionnaire (SFQ) and rated their physical and psychological well-being, quality of life and relationship with partners. Levels of the following hormons were determined: testosterone, estradiol, thyreotropin, folicule stimulating hormone (FSH), luteinizing hormone (LH) and prolactin. Relations between hormone levels and questionaires results were analysed. Results: A total of 326 men were tested from November 2004 till December 2005. Median age was 37 years (range: 18–72). Median disease free survival was 59 months (range: 19–291). Only 24% of patients had all tested hormones within normal ranges. The most common of endocrine abnormalities were gonadotropins over normal (LH - 55% and FSH - 49% of cases) and lowered testosterone (15%). Percentage of patients with abnormal anxiety levels was 27% (STAI) and 28% (HADS), depression rate was 15% (BDI) and 18% (HADS), 40% of patients had erectile disfunction. Hormone levels and scores of the used scales corelated strongly with patients’ age, then a linear regression analysis was performed to exclude the influence of age factor. It was shown that higher depression levels in BDI are found amongst patients with elevated LH (p = 0.010) or FSH (p = 0.017). Men with higher than normal FSH were more anxious in STAI (p = 0.026). Patients with overnormal LH shown more sexual problems in SFQ (p = 0.030). Abnormal gonadotropins levels corelated with a deteriorated physical well-being (p = 0.028). Men with abnormal estradiol were more prone to erectile disfunction (p = 0.009). Conclusions: Hormonal abnormalities are frequent among testicular cancer survivors and have negative impact on the patients’ physical and psychological well-being as well as on their sexual functioning. No significant financial relationships to disclose.