Division of Cardiovascular Medicine, Department of Medicine, Indiana University School of Medicine, Indiana University, 1800 N. Capitol Ave., E308, Indianapolis, IN, 46202, USA.
Division of Hematology and Oncology, Department of Medicine, University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Institute, Rochester, NY, USA.
Curr Oncol Rep. 2023 May;25(5):445-454. doi: 10.1007/s11912-023-01375-8. Epub 2023 Mar 3.
Testicular cancer (TC) is the leading cancer in men between 18 and 39 years of age. Current treatment involves tumor resection followed by surveillance and/or one or more lines of cisplatin-based chemotherapy (CBCT) and/or bone marrow transplant (BMT). Ten years after treatment, CBCT has been associated with significant atherosclerotic cardiovascular disease (CVD) including myocardial infarction (MI), stroke, and heightened rates of hypertension, dyslipidemia, diabetes mellitus, and metabolic syndrome (MetS). Additionally, low testosterone levels and hypogonadism contribute to MetS and may further drive CVD.
CVD in TCS has been associated with worse physical functioning accompanied by role limitations, decreased energy, and decreased overall health. Exercise may play a role in ameliorating these effects. Systematic CVD screening practices are needed at TC diagnosis and in survivorship. We encourage a multidisciplinary partnership between primary care physicians, cardiologists, cardio-oncologists, medical oncologists, and survivorship providers to address these needs.
睾丸癌(TC)是 18 至 39 岁男性中最常见的癌症。目前的治疗方法包括肿瘤切除,然后进行监测和/或一线或多线顺铂为基础的化疗(CBCT)和/或骨髓移植(BMT)。治疗 10 年后,CBCT 与显著的动脉粥样硬化性心血管疾病(CVD)相关,包括心肌梗死(MI)、中风,以及高血压、血脂异常、糖尿病和代谢综合征(MetS)发生率升高。此外,低睾酮水平和性腺功能减退症会导致 MetS,并可能进一步导致 CVD。
TC 患者的 CVD 与较差的身体功能有关,伴有角色受限、精力下降和整体健康状况下降。运动可能在改善这些影响方面发挥作用。在 TC 诊断和生存期间需要进行系统的 CVD 筛查。我们鼓励初级保健医生、心脏病专家、心脏肿瘤专家、肿瘤内科医生和生存提供者之间建立多学科合作关系,以满足这些需求。