Metabolic Syndrome Plagues Some Who Survive Testicular Cancer

Researcher suggests chemotherapy may contribute to complication

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By
HealthDay Reporter

SATURDAY, May 14, 2005 (HealthDay News) -- In some ways, a measure of success sought by cancer doctors is to see their patients live long enough to develop other health problems.

Long a topic of research in pediatric cancer, where survivors live longer than their adult peers, post-cancer complications have now become relevant to the men and women who beat their malignancies.

Such is the case with testicular cancer, where some survivors face a higher risk of developing metabolic syndrome, the cluster of conditions that predispose a person to heart disease and type 2 diabetes.

Norwegian researchers presented that finding Saturday at the American Society of Clinical Oncology annual meeting in Orlando, Fla.

Metabolic syndrome involves having some or all of these and other risk factors: excess abdominal fat; blood fat disorders; high blood pressure; insulin resistance or glucose intolerance.

The complication is not insignificant: More than 95 percent of all testicular cancer patients are cured and are presumed to have a life span almost comparable to healthy males of the same age. The incidence of the disease, which is the most common malignancy among young men, is also on the rise, making long-term health issues even more salient, experts said.

"We have only had long-term survivors for 15 or 20 years," said Dr. Herman Kattlove, medical editor of the American Cancer Society. "Now that we have survivors, we have new problems."

In this latest study, Norwegian researchers divided 1,135 patients treated for testicular cancer into four groups based on their treatment: surgery, radiation, high-dose chemotherapy with cisplatin and low-dose chemotherapy with cisplatin. These individuals were compared with a control group of healthy males.

Metabolic syndrome was considered to be present if two or more of these conditions were present: high blood pressure, obesity, high cholesterol and diabetes.

After a median follow-up period of about 11 years, the radiation and surgery groups exhibited a similar prevalence of metabolic syndrome. But both chemotherapy groups had significantly increased odds of metabolic syndrome. Males who had had the higher dose of cisplatin had a 2.8-times higher chance of developing metabolic syndrome, the researchers said.

Study author Hege Sagstuen believes that cisplatin is responsible for the higher risk. While the drug is used to treat other cancers (for example, ovarian, lung and head and neck tumors), these cancers tend to have a poor prognosis.

"No other cancer groups that we treat with cisplatin survive as long," she said.

It's not clear why the drug may have this effect, but experts have hypothesized that it is due to damage to the inside of blood vessels.

The good news is that metabolic syndrome is not a disease, but a risk factor for disease, meaning that prevention efforts may help, said Sagstuen, a doctoral candidate at the University of Tromso in Norway.

"It's important that general practitioners know about this," she said.

More information

For more on testicular cancer, visit the National Cancer Institute.

SOURCES: Hege Sagstuen, doctoral candidate, University of Tromso, Tromso, Norway; Herman Kattlove, M.D., medical editor, American Cancer Society, Los Angeles; May 14, 2005, presentation, American Society of Clinical Oncology, Orlando, Fla.

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