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Effect of Cancer Treatments on Testicular Function

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Endocrinology of the Testis and Male Reproduction

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

An increasing proportion of young male cancer patients are cured, why the issue of quality of life (QoL) of survivors plays an important role. Several studies have shown that, among young subjects treated for malignant disease, well preserved reproductive function represents one of the most important aspects of the QoL. In this chapter, the current evidence as well as gabs of knowledge regarding the impact of cancer and cancer treatment on testicular function – including fertility, androgen production and health of the offspring – are summarized. Also recommendations for preservation of fertility prior to cancer therapy as well as clinical management of reproductive issues in male cancer survivors, are given.

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References

  • Auger J, Sermondade N, Eustache F. Semen quality of 4480 young cancer and systemic disease patients: baseline data and clinical considerations. Basic Clin Androl. 2016;26:3.

    PubMed  PubMed Central  Google Scholar 

  • Bandak M, Aksglaede L, Juul A, Rorth M, Daugaard G. The pituitary-Leydig cell axis before and after orchiectomy in patients with stage I testicular cancer. Eur J Cancer. 2011;47(17):2585–91.

    Article  CAS  PubMed  Google Scholar 

  • Berthelsen JG, Skakkebaek NE. Gonadal function in men with testis cancer. Fertil Steril. 1983;39(1):68–75.

    Article  CAS  PubMed  Google Scholar 

  • Bramswig JH, Heimes U, Heiermann E, Schlegel W, Nieschlag E, Schellong G. The effects of different cumulative doses of chemotherapy on testicular function. Results in 75 patients treated for Hodgkin’s disease during childhood or adolescence. Cancer. 1990;65(6):1298–302.

    Article  CAS  PubMed  Google Scholar 

  • Brannigan RE. Fertility preservation in adult male cancer patients. Cancer Treat Res. 2007;138:28–49.

    Article  PubMed  Google Scholar 

  • Buchli C, Martling A, Arver S, Holm T. Testicular function after radiotherapy for rectal cancer – a review. J Sex Med. 2011;8(11):3220–6.

    Article  PubMed  Google Scholar 

  • Buchli C, Tapper J, Bottai M, Holm T, Arver S, Blomqvist L, et al. Testosterone and body composition in men after treatment for rectal cancer. J Sex Med. 2015;12(3):774–82.

    Article  CAS  PubMed  Google Scholar 

  • Caponecchia L, Cimino G, Sacchetto R, Fiori C, Sebastianelli A, Salacone P, et al. Do malignant diseases affect semen quality? Sperm parameters of men with cancers. Andrologia. 2016;48(3):333–40.

    Article  CAS  PubMed  Google Scholar 

  • Coogan CL, Hejase MJ, Wahle GR, Foster RS, Rowland RG, Bihrle R, et al. Nerve sparing post-chemotherapy retroperitoneal lymph node dissection for advanced testicular cancer. J Urol. 1996;156(5):1656–8.

    Article  CAS  PubMed  Google Scholar 

  • Eberhard J, Stahl O, Giwercman Y, Cwikiel M, Cavallin-Stahl E, Lundin KB, et al. Impact of therapy and androgen receptor polymorphism on sperm concentration in men treated for testicular germ cell cancer: a longitudinal study. Hum Reprod. 2004;19(6):1418–25.

    Article  CAS  PubMed  Google Scholar 

  • Eberhard J, Stahl O, Cwikiel M, Cavallin-Stahl E, Giwercman Y, Salmonson EC, et al. Risk factors for post-treatment hypogonadism in testicular cancer patients. Eur J Endocrinol. 2008;158(4):561–70.

    Article  CAS  PubMed  Google Scholar 

  • Eberhard J, Stahl O, Cohn-Cedermark G, Cavallin-Stahl E, Giwercman Y, Rylander L, et al. Sexual function in men treated for testicular cancer. J Sex Med. 2009;6(7):1979–89.

    Article  PubMed  Google Scholar 

  • Fung C, Fossa SD, Williams A, Travis LB. Long-term morbidity of testicular cancer treatment. Urol Clin North Am. 2015;42(3):393–408.

    Article  PubMed  Google Scholar 

  • Giwercman A, Petersen PM. Cancer and male infertility. Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14(3):453–71.

    Article  CAS  PubMed  Google Scholar 

  • Greenfield DM, Walters SJ, Coleman RE, Hancock BW, Eastell R, Davies HA, et al. Prevalence and consequences of androgen deficiency in young male cancer survivors in a controlled cross-sectional study. J Clin Endocrinol Metab. 2007;92(9):3476–82.

    Article  CAS  PubMed  Google Scholar 

  • Hagenas I, Jorgensen N, Rechnitzer C, Sommer P, Holm M, Schmiegelow K, et al. Clinical and biochemical correlates of successful semen collection for cryopreservation from 12-18-year-old patients: a single-center study of 86 adolescents. Hum Reprod. 2010;25(8):2031–8.

    Article  PubMed  Google Scholar 

  • Hansen PV, Trykker H, Svennekjaer IL, Hvolby J. Long-term recovery of spermatogenesis after radiotherapy in patients with testicular cancer. Radiother Oncol. 1990;18(2):117–25.

    Article  CAS  PubMed  Google Scholar 

  • Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001;86(2):724–31.

    Article  CAS  PubMed  Google Scholar 

  • Haugnes HS, Aass N, Fossa SD, Dahl O, Klepp O, Wist EA, et al. Components of the metabolic syndrome in long-term survivors of testicular cancer. Ann Oncol. 2007;18(2):241–8.

    Article  CAS  PubMed  Google Scholar 

  • Haugnes HS, Aass N, Fossa SD, Dahl O, Klepp O, Wist EA, et al. Predicted cardiovascular mortality and reported cardiovascular morbidity in testicular cancer survivors. J Cancer Surviv. 2008;2(3):128–37.

    Article  CAS  PubMed  Google Scholar 

  • Haugnes HS, Wethal T, Aass N, Dahl O, Klepp O, Langberg CW, et al. Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study. J Clin Oncol. 2010;28(30):4649–57.

    Article  PubMed  Google Scholar 

  • Hoei-Hansen CE, Sommer P, Meyts ER, Skakkebaek NE. A rare diagnosis: testicular dysgenesis with carcinoma in situ detected in a patient with ultrasonic microlithiasis. Asian J Androl. 2005;7(4):445–7.

    Article  PubMed  Google Scholar 

  • Holm M, Hoei-Hansen CE, Rajpert-De Meyts E, Skakkebaek NE. Increased risk of carcinoma in situ in patients with testicular germ cell cancer with ultrasonic microlithiasis in the contralateral testicle. J Urol. 2003;170(4 Pt 1):1163–7.

    Article  PubMed  Google Scholar 

  • Isaksson S, Eberhard J, Stahl O, Cavallin-Stahl E, Cohn-Cedermark G, Arver S, et al. Inhibin B concentration is predictive for long-term azoospermia in men treated for testicular cancer. Andrology. 2014;2(2):252–8.

    Article  CAS  PubMed  Google Scholar 

  • Jahnukainen K, Stukenborg JB. Clinical review: present and future prospects of male fertility preservation for children and adolescents. J Clin Endocrinol Metab. 2012;97(12):4341–51.

    Article  CAS  PubMed  Google Scholar 

  • Kyriacou C, Kottaridis PD, Eliahoo J, McKeag N, Bomford J, McGarrigle HH, et al. Germ cell damage and Leydig cell insufficiency in recipients of nonmyeloablative transplantation for haematological malignancies. Bone Marrow Transplant. 2003;31(1):45–50.

    Article  CAS  PubMed  Google Scholar 

  • Littley MD, Shalet SM, Beardwell CG, Ahmed SR, Applegate G, Sutton ML. Hypopituitarism following external radiotherapy for pituitary tumours in adults. Q J Med. 1989;70(262):145–60.

    CAS  PubMed  Google Scholar 

  • Meistrich ML. Potential genetic risks of using semen collected during chemotherapy. Hum Reprod. 1993;8(1):8–10.

    Article  CAS  PubMed  Google Scholar 

  • Meistrich ML. Effects of chemotherapy and radiotherapy on spermatogenesis in humans. Fertil Steril. 2013;100(5):1180–6.

    Article  CAS  PubMed  Google Scholar 

  • Nord C, Bjoro T, Ellingsen D, Mykletun A, Dahl O, Klepp O, et al. Gonadal hormones in long-term survivors 10 years after treatment for unilateral testicular cancer. Eur Urol. 2003;44(3):322–8.

    Article  PubMed  Google Scholar 

  • Oldenburg J. Hypogonadism and fertility issues following primary treatment for testicular cancer. Urol Oncol. 2015;33(9):407–12.

    Article  CAS  PubMed  Google Scholar 

  • Paoli D, Rizzo F, Fiore G, Pallotti F, Pulsoni A, Annechini G, et al. Spermatogenesis in Hodgkin’s lymphoma patients: a retrospective study of semen quality before and after different chemotherapy regimens. Hum Reprod. 2016;31(2):263–72.

    CAS  PubMed  Google Scholar 

  • Petersen PM, Hansen SW, Giwercman A, Rorth M, Skakkebaek NE. Dose-dependent impairment of testicular function in patients treated with cisplatin-based chemotherapy for germ cell cancer. Ann Oncol. 1994;5(4):355–8.

    Article  CAS  PubMed  Google Scholar 

  • Petersen PM, Giwercman A, Skakkebaek NE, Rorth M. Gonadal function in men with testicular cancer. Semin Oncol. 1998;25(2):224–33.

    CAS  PubMed  Google Scholar 

  • Petersen PM, Skakkebaek NE, Vistisen K, Rorth M, Giwercman A. Semen quality and reproductive hormones before orchiectomy in men with testicular cancer. J Clin Oncol. 1999a;17(3):941–7.

    Article  CAS  PubMed  Google Scholar 

  • Petersen PM, Skakkebaek NE, Rorth M, Giwercman A. Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer. J Urol. 1999b;161(3):822–6.

    Article  CAS  PubMed  Google Scholar 

  • Puscheck E, Philip PA, Jeyendran RS. Male fertility preservation and cancer treatment. Cancer Treat Rev. 2004;30(2):173–80.

    Article  PubMed  Google Scholar 

  • Romerius P, Stahl O, Moell C, Relander T, Cavallin-Stahl E, Wiebe T, et al. Hypogonadism risk in men treated for childhood cancer. J Clin Endocrinol Metab. 2009;94(11):4180–6.

    Article  CAS  PubMed  Google Scholar 

  • Romerius P, Stahl O, Moell C, Relander T, Cavallin-Stahl E, Gustafsson H, et al. Sperm DNA integrity in men treated for childhood cancer. Clin Cancer Res. 2010;16(15):3843–50.

    Article  PubMed  Google Scholar 

  • Romerius P, Stahl O, Moell C, Relander T, Cavallin-Stahl E, Wiebe T, et al. High risk of azoospermia in men treated for childhood cancer. Int J Androl. 2011;34(1):69–76.

    Article  CAS  PubMed  Google Scholar 

  • Rowley MJ, Leach DR, Warner GA, Heller CG. Effect of graded doses of ionizing radiation on the human testis. Radiat Res. 1974;59(3):665–78.

    Article  CAS  PubMed  Google Scholar 

  • Sharpe RM, Skakkebaek NE. Testicular dysgenesis syndrome: mechanistic insights and potential new downstream effects. Fertil Steril. 2008;89(Suppl 2):e33–8.

    Article  PubMed  Google Scholar 

  • Shoshany O, Shtabholtz Y, Schreter E, Yakimov M, Pinkas H, Stein A, et al. Predictors of spermatogenesis in radical orchiectomy specimen and potential implications for patients with testicular cancer. Fertil Steril. 2016;106:70–4.

    Article  PubMed  Google Scholar 

  • Skakkebaek NE, Rajpert-De Meyts E, Main KM. Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects. Hum Reprod. 2001;16(5):972–8.

    Article  CAS  PubMed  Google Scholar 

  • Stahl O, Eberhard J, Jepson K, Spano M, Cwikiel M, Cavallin-Stahl E, et al. Sperm DNA integrity in testicular cancer patients. Hum Reprod. 2006;21(12):3199–205.

    Article  CAS  PubMed  Google Scholar 

  • Stahl O, Boyd HA, Giwercman A, Lindholm M, Jensen A, Kjaer SK, et al. Risk of birth abnormalities in the offspring of men with a history of cancer: a cohort study using Danish and Swedish national registries. J Natl Cancer Inst. 2011;103(5):398–406.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tajar A, Forti G, O’Neill TW, Lee DM, Silman AJ, Finn JD, et al. Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European Male Ageing Study. J Clin Endocrinol Metab. 2010;95(4):1810–8.

    Article  CAS  PubMed  Google Scholar 

  • Tran S, Boissier R, Perrin J, Karsenty G, Lechevallier E. Review of the different treatments and management for prostate cancer and fertility. Urology. 2015;86(5):936–41.

    Article  PubMed  Google Scholar 

  • van Casteren NJ, Boellaard WP, Romijn JC, Dohle GR. Gonadal dysfunction in male cancer patients before cytotoxic treatment. Int J Androl. 2010;33(1):73–9.

    Article  PubMed  Google Scholar 

  • Viviani S, Santoro A, Ragni G, Bonfante V, Bestetti O, Bonadonna G. Gonadal toxicity after combination chemotherapy for Hodgkin’s disease. Comparative results of MOPP vs ABVD. Eur J Cancer Clin Oncol. 1985;21(5):601–5.

    Article  CAS  PubMed  Google Scholar 

  • Willemse PH, Sleijfer DT, Sluiter WJ, Schraffordt Koops H, Doorenbos H. Altered Leydig cell function in patients with testicular cancer: evidence for bilateral testicular defect. Acta Endocrinol. 1983;102(4):616–24.

    CAS  PubMed  Google Scholar 

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Correspondence to Aleksander Giwercman .

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Giwercman, A. (2017). Effect of Cancer Treatments on Testicular Function. In: Simoni, M., Huhtaniemi, I. (eds) Endocrinology of the Testis and Male Reproduction. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-44441-3_29

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  • DOI: https://doi.org/10.1007/978-3-319-44441-3_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44440-6

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