sodium-ethylxanthate and Testicular-Neoplasms

The results of Southwest Oncology Group Study 8711 (Group 2B) are presented. The objective was to evaluate the natural history of sperm concentration and selected hormonal parameters in patients with testicular cancer treated with orchiectomy and radiotherapy.. Of a total of 207 patients enrolled on SWOG 8711, 53 pure seminoma patients were identified who were treated with orchiectomy and radiotherapy only. Sperm concentration, follicle-stimulating hormone (FSH) levels, and sexual satisfaction scores were the main parameters followed.. A fraction of the patients were infertile prior to receiving radiotherapy. Our analysis indicates that incidental radiation dose to the remaining testicle affects time to recovery of fertility, and at an aggregate level, changes in FSH mirror changes in sperm concentration over time. This phenomenon is the same as that described in patients free from testicular cancer. These men evaluated their sexual activity as good after orchidectomy.. Our data support the use of clamshell-type testicular shields as a means of providing maximum protection to the remaining testicle.

Topics: Adult; Biomarkers; Follicle Stimulating Hormone; Humans; Male; Orchiectomy; Prospective Studies; Reproduction; Seminoma; Sex; Sperm Count; Testicular Neoplasms

This retrospective study evaluates changes in sexual functioning after treatment for testicular cancer and investigates whether there is a relationship with different treatment modalities.. A self-reported questionnaire was sent to 337 men who had been treated for testicular cancer at the University Hospital Groningen between 1977 and 1994. Medical information was obtained from the patient records.. A response was received from 287 men (85%); 264 patients were included in this study (78%). The mean patient age at follow-up was 37.7 years (range, 17-71 years). The mean follow-up period was 6.7 years (range, 0.25-18 years). Decrease in sexual functions was reported by 40% of patients (decrease in libido: 19%; arousal: 12% erection: 12.5%; orgasm: 19%; and ejaculation: 26%). Moreover, 23.5% of patients responding reported decreased sexual activity and 12.5% were dissatisfied with their sexual functioning. Patients with Stage II-IV nonseminoma who had been treated with polychemotherapy (PCT) with or without resection of residual retroperitoneal tumor mass (RRRTM) (PCT +/- RRRTM) reported a significantly sharper decrease in sexual functioning than patients who had been followed with a wait-and-see policy (W & S) (Stage I nonseminoma patients). It was noteworthy that patients treated by PCT alone reported more sharply decreased sexual functioning than patients treated by PCT + RRRTM. Patients treated by radiotherapy (Stage I-IIA seminoma) did not report findings significantly different from the W & S group.. Testicular cancer patients are at risk for reduced sexual functioning, especially when treated by chemotherapy, with or without resection of residual tumor. Although chemotherapy may influence somatic aspects of sexual functioning, it appears that psychologic factors arising from the confrontation with testicular cancer play a strongly mediating (if not determining) role.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Germinoma; Humans; Male; Middle Aged; Orchiectomy; Radiotherapy; Retrospective Studies; Sex; Surveys and Questionnaires; Testicular Neoplasms

Topics: Adolescent; Adult; Body Image; Humans; Libido; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal; Orchiectomy; Sex; Testicular Neoplasms

Between 1978 and 1982 the sexual functions of 54 patients with a nonseminomatous testicular tumor stage II or III were assessed before and after treatment with surgery and combination chemotherapy. Two years after completing therapy 54% of the patients experienced sexual functional disorders. Greatly reduced or absent antegrade ejaculation was reported by 26 patients; 18 of them had been treated with more or less extensive retroperitoneal lymph node dissection, whereas 8 had not. This means that the chemotherapy might be responsible for ejaculatory disorders in 30% of the patients. Only two patients reported a change in the quality of erection; seven patients experienced a decidedly diminished libido, and five patients noticed their orgasm had changed in a negative sense. The appearance of the contralateral testis changed in 21 patients, who showed "atrophy" of this testis. The findings of this study indicate that sexual and ejaculatory disorders in particular are quite common in men treated for a disseminated nonseminomatous testicular tumor. Many of these disorders seem to be owing to causes other than surgical intervention.

Topics: Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Ejaculation; Humans; Male; Sex; Sexual Dysfunction, Physiological; Testicular Neoplasms

With the advent of effective treatment for urologic cancer, the preservation of sexual function and fertility has become an important goal. Some cancer treatments damage the physiological systems involved in reproduction. All have a psychological impact on sexuality. For men with prostate cancer, current issues in sexual rehabilitation include the debate on nerve-sparing radical prostatectomy, the role of vascular damage in causing erectile dysfunction after radiotherapy, and the need for a better understanding of hormonal effects on central and peripheral mechanisms of sexual function. In the treatment of men and women with bladder cancer, the sexual function morbidity of radical cystectomy is described in data from prospective interview studies. Sexual desire and orgasm remain normal after surgery despite disruption of the genital vasocongestion accompanying sexual arousal. Long-term follow-up studies of testicular cancer patients suggest that some increase in sexual dysfunction does occur. Infertility remains a concern for a subgroup of younger, childless men. Attempts to modify or eliminate retroperitoneal lymphadenectomy are discussed, as is recovery of spermatogenesis after chemotherapy and radiotherapy. Sexual function in patients with penile, urethral, or renal cell carcinoma is briefly reviewed.

Topics: Adult; Counseling; Dysgerminoma; Female; Fertility; Genital Neoplasms, Male; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal; Penile Neoplasms; Prostatectomy; Prostatic Neoplasms; Sex; Testicular Neoplasms; Urinary Bladder Neoplasms; Urogenital Neoplasms

Within the United States, cancer is the second leading cause of death by disease among adults and children alike. Although cancer has been characterized as primarily a disease of aging, there is growing awareness that many of the cancer risk factors have their origins earlier in life. In keeping with the current trend of pediatricians assuming the primary care responsibility of adolescents and young adults, this article reviews the current status of primary and secondary cancer prevention as it relates to pediatric practice.

Topics: Adolescent; Alcohol Drinking; Breast Neoplasms; Child; Female; Humans; Lung Neoplasms; Male; Nutritional Requirements; Obesity; Primary Prevention; Risk; Sex; Smoking; Testicular Neoplasms; Uterine Cervical Neoplasms

The effects of therapy on the sexual ability and fertility of sixty-seven patients with nonseminomatous germ cell tumors of the testis were analyzed. Ten of 38 patients had subfertile sperm counts before therapy. Normal ejaculation was preserved in only 7/61 patients who underwent retroperitoneal lymph node dissection. In five of these patients, sperm analysis was done after chemotherapy; all had complete azoospermia. An effort to restore ejaculation with imipramine yielded only minimal response in 4/9 patients who received this drug. No major long-term effects on the libido were observed.

Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Chlorambucil; Cisplatin; Cyclophosphamide; Dactinomycin; Doxorubicin; Ejaculation; Humans; Imipramine; Infertility, Male; Libido; Lymph Node Excision; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal; Oligospermia; Sex; Testicular Neoplasms; Vinblastine

The mechanism of infertility after high retroperitoneal lymphadenectomy was studied in 36 patients. In 35 patients infertility occurred because of unavoidable seminal vesicular and ductus deferential sympathetic denervation, with consequent aspermia. Potency and orgasm were unchanged in all patients and there was no evidence of retrograde ejaculation. The findings suggest that sympatholytic drugs be studied for possible application as reversible male contraceptives.

Topics: Denervation; Ejaculation; Female; Humans; Infertility, Male; Lymph Node Excision; Male; Oligospermia; Pregnancy; Retroperitoneal Space; Seminal Vesicles; Sex; Testicular Neoplasms; Vas Deferens

Topics: Adult; Choriocarcinoma; Gastrointestinal Hemorrhage; Humans; Liver; Male; Microscopy, Electron; Radiography, Thoracic; Radionuclide Imaging; Sex; Stomach; Testicular Neoplasms