Indiana University, Indianapolis, IN
Somer Case-Eads , Lois B. Travis , Chunkit Fung , Howard D. Sesso , Darren R. Feldman , David J. Vaughn , Robert James Hamilton , Eileen Johnson , Derick R Peterson , Sophie D. Fossa , Lawrence H. Einhorn , Clair Beard
Background: Testicular cancer (TC) is the most common cancer in men aged 15-40, with survival rates after diagnosis > 95%. Testicular cancer survivors (TCS) are known to be at increased risk for certain acute and chronic medical conditions, but few studies have examined barometers of their psychological health. The objective is to characterize the prevalence of PSM use and associations with demographics, health behaviors, and treatment-associated toxicities among TCS. Methods: TCS aged < 50 years at first-line CHEM completed a questionnaire regarding co-morbidities and prescription drug use, including PSMs. For co-morbidities, peripheral neuropathy (PN) responses of ‘a little’, “quite a bit”, or “very much” were scored ‘yes.’ Fisher’s exact test was used to examine the significance of various associations. Results: Among the first 680 consecutively enrolled TCS, median age at TC diagnosis was 31y (range, 15-49y) and median time since CHEM completion was 52mo (range 12-360mo). 85 TCS (12.5%) reported PSM use, including antidepressants (N = 65 [76.5%]), anxiolytics (N = 23 [27%]), and stimulants (N = 21 [25%]) with 20 TCS on ≥ 2 PSMs (23%). Compared to non-users, more PSM users were unemployed (11.8% vs. 4.4%%; P < .01), self-rated their health as fair/poor (12.2% vs 4%; P < .01), and had gained > 20lb since CHEM (39.8% vs 23.4%;P < .01). PSM users were more likely to have tinnitus (49.4% vs. 36.4%; P < 0.04), both tinnitus and PN (43.5% vs. 27.2%; P < 0.01), cardiovascular disease (26.2% vs. 15.6%; P < .02), and greater use of prescription medications for pain control (20% vs. 4.7%; P < 0.01), hypertension (16.5% vs. 7.1%; P < 0.01), diabetes (8.3% vs. 2.9%; P < 0.02), and testosterone replacement (10.6% vs. 5.0%; P = 0.048). Conclusions: Future studies should aim for identification of high-risk patients in need of intensified preventive and therapeutic interventions.
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