Damage of hormonal function and bone metabolism in long-term survivors of testicular cancer

Improved survival of testicular cancer (TC) patients leads to rising of interest on the disease consequences for the whole organism (impact on hormonal status, bone metabolism). The aim of the study was to present three years experience with hormonal and osteologic examination in long-term survivors of TC. During the period of 11/2005-1/2009 879 patients who were previously treated for TC (823 with unilateral, 56 with bilateral disease) were examined. Each patient underwent hormonal and osteologic examination, results of which were associated with therapy following orchiectomy and with the time interval since the primary therapy. The median follow-up time in patients with unilateral TC was 96 months since the therapy. Mean age at the time of examination was 32 years. Testosterone deficiency was observed in 171 patients (19.5%), increased LH in 168 patients (19.1%), increased S-CTx in 388 patients (44.1%). Bone damage (osteopenia and/or osteoporosis) was observed in 445 patients (50.6%). The median follow-up time in patients with bilateral TC was 175 months. Mean age at the time of examination was 27 years. Testosterone deficiency was observed in 47 patients (83.9%), increased LH in 45 patients (80.4%), increased S-CTx in 31 patients (55.4%). Bone damage was observed in 41 patients (73.2%). Hormonal examination and testosterone substitution may be recommended as an important aspect of patient's follow-up in bilateral TC, moreover in unilateral disease. The important part of standard examination algorithm should be also osteological examination to prevent osteopenia or even osteoporosis development.