Discuss Mental Health in Testicular Cancer Survivorship Plans

Oncology nurses should discuss mental health issues with testicular cancer survivors, as recent data published in the Journal of Clinical Oncology showed that this patient group is more likely to seek mental health services than their cancer-free counterparts.

The researchers analyzed 2,619 Canadian testicular cancer survivors and matched them with 13,095 individuals without a cancer history. At baseline, the 2 groups had the same rate of mental health services used.

However, in the peritreatment time period (1 month before to 1 month after orchiectomy) and the post-treatment period (1 month after treatment to end of follow-up), those with a history of testicular cancer were significantly more likely to seek an outpatient mental health service.

Participants in the study were followed for 12 years, and as time passed, the cancer survivors became even more likely to seek mental health services.

“Such persistence of mental health needs beyond the time of the diagnosis or immediate treatment (i.e. orchiectomy) suggest that the mental health concerns experienced by testicular cancer survivors are not restricted to time-limited mental health disturbances,” the authors wrote. “This also highlights that the long-term and late-effect complications of testicular cancer diagnosis and treatment extend well beyond the 5-year period during which early-stage patients are typically followed by their cancer care providers.”

Testicular cancer survivors are at an increased risk of secondary illnesses, such as cardiovascular disease, pulmonary toxicities, liver issues, neurotoxicity, and decreased fertility. While these outcomes are usually related to cancer and its treatment, the researchers found that the survivors usually sought out advice from their primary care providers, rather than their oncology team.

“The long-term mental health sequelae associated with testicular cancer, together with the fact that most visits for these problems were with family physicians and not oncologists, highlights the importance of open lines of communication between the cancer care team and primary care providers,” the researchers wrote.

Survivors who had baseline mental health treatment and/or sought out additional treatments for their testicular cancer had an increased rate in mental health service use. Since the researchers did not stratify participants by cancer stage, they cannot say if those who had adjuvant treatment for stage 1 disease had less anxiety than those who followed with surveillance.

The number of cancer survivors continues to grow, and as testicular cancer is the most common solid cancer in young adult males and had a high cure rate, understanding the long-term effects of the disease is now more important than ever.

“Accordingly, there has been an increased emphasis on understanding the long-term and late-effect treatment complications affecting testicular cancer survivors,” the researchers wrote.

Oncology nurses should be sure to talk about potential mental health issues that testicular cancer survivors may see down the road, while also maintaining open lines of communication with other members of the individual’s care team.

“Efforts to increase awareness of mental health consequences and ensure that appropriate resources and support are in place beyond the acute phase of diagnosis and treatment to support the long-term mental health of testicular cancer survivors are warranted,” the researchers wrote.