Late treatment effects, health behavior, and quality of life (QOL) in testicular cancer (TC) survivors

Abstract

8012 Background: TC is the most common solid tumor diagnosed among men aged 15 to 34 with almost 7000 new cases/year in the United States. Most of these patients will be cured and become long-term survivors. Although physiological late consequences of treatment are well articulated, the impact of late treatment effects and health behavior on QOL is not known. Methods: The Living Well After Cancer (LWAC) Survivorship Program at Penn monitors TC survivors ≥ 2 years since diagnosis and disease-free. To date, 55 subjects have been recruited from LWAC for this ongoing study. Treatment variables, subjective and objective measures of late effects, health behaviors, and the City of Hope QOL measure were examined. Results: Subjects were young (\(\underline{\mathrm{M}}\)=39 yrs) and 63% received cisplatin-based chemotherapy (CBCT). Physical (\(\underline{\mathrm{M}}\)=8.0) and Social well-being (\(\underline{\mathrm{M}}\)=7.0) were high; Psychological (\(\underline{\mathrm{M}}\)=4.6) and Spiritual well-being (\(\underline{\mathrm{M}}\)=5.0) moderate. Physical, Social, and Psychological well-being were positively related (all \(\underline{\mathrm{p}}\) < .03); Spiritual well-being was independent of other QOL indices. Time since diagnosis and receipt of CBCT were not related to QOL (\(\underline{\mathrm{p}}\) > .12). Total cholesterol was elevated in 43% and LDL in 32% of the survivors. Health behaviors were examined; 42% of subjects reported a smoking history. Smoking was a marker for decreased Social well-being; increased fatigue; anxiety; depression; uncertainty about the future; concern about second cancers, recurrences, or metastases; and interference from illness with home and financial responsibilities (all \(\underline{\mathrm{p}}\) < .05). Objective measures of late treatment effects including lipid levels were not related to cisplatin status, smoking history, or QOL (\(\underline{\mathrm{p}}\) > .23). Conclusions: These data suggest: 1) TC survivors report high physical and social well-being, but lower psychological and spiritual well-being; 2) Smoking may be a marker for overall social concerns and a number of specific QOL deficits in this group. Smoking cessation interventions may not only impact physiologic health, but psychosocial status. No significant financial relationships to disclose.