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Raffo M, Di Naro A, Napolitano L, Aveta A, Cilio S, Pandolfo SD, Manfredi C, Lonati C, Suardi NR. Testicular Cancer Treatments and Sexuality: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:586. [PMID: 38674232 PMCID: PMC11051825 DOI: 10.3390/medicina60040586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
The incidence of testicular cancer (TC) has been rapidly increasing over the past years. Diagnosis and early treatment have shown good oncological control, guaranteeing the patient different treatment approaches according to histology and tumor stage. Currently, physicians usually prioritize oncological outcomes over sexual outcomes and quality of life, considering as a first aim the overall survival of the patients; however, differently from other neoplasms, quality of life is still strongly affected among TC patients, and sexual outcomes are frequently compromised after each TC treatment. Several studies have suggested that each treatment approach may be associated with sexual dysfunctions, including erectile dysfunction, ejaculatory disorders, fertility issues, and hormonal changes. Since testicular cancer patients are more frequently young men, the subject of this work is substantial and should be analyzed in detail to help specialists in the management of this disease. The aim of the current narrative review is to generally describe every treatment for TC, including surgery, chemotherapy, radiotherapy, and retroperitoneal lymph node dissection, and to establish which sexual dysfunction may be specifically associated with each therapy.
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Affiliation(s)
- Massimiliano Raffo
- Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy; (C.L.); (N.R.S.)
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Angelo Di Naro
- Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy; (C.L.); (N.R.S.)
| | - Luigi Napolitano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy; (L.N.); (A.A.); (S.C.); (S.D.P.)
| | - Achille Aveta
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy; (L.N.); (A.A.); (S.C.); (S.D.P.)
| | - Simone Cilio
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy; (L.N.); (A.A.); (S.C.); (S.D.P.)
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy; (L.N.); (A.A.); (S.C.); (S.D.P.)
| | - Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University, 80138 Naples, Italy;
| | - Chiara Lonati
- Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy; (C.L.); (N.R.S.)
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Felicetti F, Gatti F, Faraci D, Rosso D, Zavattaro M, Fortunati N, Marinelli L, Leone S, Gill J, Dionisi-Vici M, Dellacasa C, Busca A, Giaccone L, Arvat E, Bruno B, Brignardello E. Impact of allogeneic stem cell transplantation on thyroid function. J Endocrinol Invest 2023:10.1007/s40618-023-02039-x. [PMID: 36884196 DOI: 10.1007/s40618-023-02039-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE Primary hypothyroidism is a main endocrine complication after allogeneic stem cells transplantation (allo-SCT) in children, but in adults data on post-SCT hypothyroidism are limited. The aims of this observational, cross-sectional study were to assess the prevalence of hypothyroidism in adult allo-SCT recipients according to time from transplantation, and to identify risk factors. METHODS One hundred and eighty-six patients (M 104; F 82; median age 53.4 years) who underwent allo-SCT between January 2010 and December 2017 were enrolled and divided into three groups, according to time from allo-SCT (1-3 years; 3-5 years; > 5 years). Pre-transplant TSH and fT4 levels were available for all patients. After transplantation, TSH, fT4 and anti-thyroperoxidase antibodies (TPO-Ab) were evaluated. RESULTS After a follow-up of 3.7 years, 34 (18.3%) patients developed hypothyroidism, with higher prevalence in females (p < 0.001) and in patients who received matched unrelated donor grafts (p < 0.05). No difference in prevalence was found at different time points. Patients who developed hypothyroidism showed higher rate of TPO-Ab positivity (p < 0.05) and higher pre-transplant TSH levels (median 2.34 µU/ml) compared to those with preserved thyroid function (median 1.53 µU/ml; p < 0.001). Multivariable analysis identified higher pre-transplant TSH levels as a positive predictor of hypothyroidism (p < 0.005). The ROC curve analysis identified a pre-SCT TSH cutoff of 1.84 µU/ml, which can predict hypothyroidism with sensitivity 74.1% and specificity 67.2%. CONCLUSIONS About one out of four patients developed hypothyroidism after allo-SCT, with a greater incidence in females. Pre-transplant TSH levels seem to predict the onset of post-SCT hypothyroidism.
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Affiliation(s)
- F Felicetti
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, Corso Bramante 88, 10126, Turin, Italy.
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy.
| | - F Gatti
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, Corso Bramante 88, 10126, Turin, Italy
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - D Faraci
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - D Rosso
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - M Zavattaro
- Division of Endocrinology, Diabetology, and Metabolism, Città della Salute e della Scienza Hospital, Turin, Italy
- Division of Endocrinology, University Hospital "Maggiore della Carità", Novara, Italy
| | - N Fortunati
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, Corso Bramante 88, 10126, Turin, Italy
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - L Marinelli
- Division of Endocrinology, Diabetology, and Metabolism, Città della Salute e della Scienza Hospital, Turin, Italy
| | - S Leone
- Department of Internal Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - J Gill
- Stem Cell Transplant Center, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - M Dionisi-Vici
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, Corso Bramante 88, 10126, Turin, Italy
| | - C Dellacasa
- Stem Cell Transplant Center, Città della Salute e della Scienza Hospital, Turin, Italy
| | - A Busca
- Stem Cell Transplant Center, Città della Salute e della Scienza Hospital, Turin, Italy
| | - L Giaccone
- Stem Cell Transplant Center, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - E Arvat
- Division of Oncological Endocrinology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - B Bruno
- Stem Cell Transplant Center, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - E Brignardello
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, Corso Bramante 88, 10126, Turin, Italy
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Sexual function of adult long-term survivors and their partners after allogeneic hematopoietic cell transplantation in Europe (S-FAST): a study from the Transplant Complications Working Party and Nurses Group of the EBMT. Bone Marrow Transplant 2023; 58:195-202. [PMID: 36376470 DOI: 10.1038/s41409-022-01869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
Sexual dysfunction after allogeneic hematopoietic cell transplantation (allo-HCT) is a common long-term complication. We conducted a European multicenter cross-sectional study of adult allo-HCT recipients who had survived >2 years and their partners to investigate sexual functioning after HCT and to evaluate whether discussion about sexual functioning between the transplant team and the survivor and partner was perceived to have taken place. In total, 136 survivors (77 males, 59 females) and 81 partners (34 males, 47 females) participated. Median age was 56 and 54 years in male and female survivors, respectively. Forty-seven percent of male and 65% of female survivors and 57% of male and 59% of female partners reported clinically relevant sexual problems. Sixty-two percent of survivors and 79% of partners reported that sexual functioning had not been discussed with them during transplant. Standardized sexual functioning scores were correlated with self-reported health status in survivors (rho = 0.24, p = 0.009). The high prevalence of sexual dysfunction warrants additional studies focusing on the impact of changes in sexuality for patients as well as their partners. Future studies should also investigate which methods that are effective in preventing or treating sexual problems after allo-HCT.
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Alsuliman T, Jondreville L, Baylet C, Dann MP, De Bentzmann N, Fontoura ML, Genty C, Huynh A, Ibled D, Yakoub-Agha I, Mercier L, Poirot C, Porcheron S, Tourette-Turgis C, Vernant JP, Vexiau-Robert D, Nguyen S. Sexual and Emotional Health after Allogeneic Hematopoietic Cell Transplantation: A Comprehensive Review and Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC). J Clin Med 2022; 11:jcm11051196. [PMID: 35268291 PMCID: PMC8911485 DOI: 10.3390/jcm11051196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 02/01/2023] Open
Abstract
A person’s sexual and emotional life is greatly impacted after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This topic is not addressed very much by patients and caregivers. Physical, endocrine and genital chronic graft versus host disease (cGVHD)-related disorders are multiple and intertwined with psychological disorders. The Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) has issued recommendations for a better gynecological monitoring of female recipients after allo-HCT. A patient booklet was also offered to patients in the form of questions and answers to facilitate discussions between patients and caregivers and to improve the management of sexual and emotional life after transplant.
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Affiliation(s)
- Tamim Alsuliman
- Service d’Hématologie et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 184 Rue de Faubourg Saint-Antoine, 75012 Paris, France;
| | - Ludovic Jondreville
- Service d’Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 47-83 Boulevard de l’Hôpital, CEDEX 13, 75651 Paris, France; (L.J.); (M.-P.D.); (D.I.); (J.-P.V.)
| | - Caroline Baylet
- Service des Maladies du Sang, CHU Angers, 4 Rue Larrey, 49000 Angers, France;
| | - Marie-Pierre Dann
- Service d’Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 47-83 Boulevard de l’Hôpital, CEDEX 13, 75651 Paris, France; (L.J.); (M.-P.D.); (D.I.); (J.-P.V.)
| | - Natacha De Bentzmann
- Service d’Hématologie Greffe, IUCT-Oncopole, 1 Avenue Irène Joliot Curie, CEDEX 9, 31059 Toulouse, France; (N.D.B.); (A.H.); (L.M.)
| | - Marie-Laure Fontoura
- Unité de Soins Intensifs Hématologie, CLCC Henri Becquerel, 1 Rue d’Amiens, 76038 Rouen, France; (M.-L.F.); (S.P.)
| | - Carole Genty
- Service d’Hématologie et de Thérapie Cellulaire, CHRU Dupuytren, 2 Avenue Martin Luther King, 87042 Limoges, France;
| | - Anne Huynh
- Service d’Hématologie Greffe, IUCT-Oncopole, 1 Avenue Irène Joliot Curie, CEDEX 9, 31059 Toulouse, France; (N.D.B.); (A.H.); (L.M.)
| | - Diane Ibled
- Service d’Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 47-83 Boulevard de l’Hôpital, CEDEX 13, 75651 Paris, France; (L.J.); (M.-P.D.); (D.I.); (J.-P.V.)
| | | | - Lara Mercier
- Service d’Hématologie Greffe, IUCT-Oncopole, 1 Avenue Irène Joliot Curie, CEDEX 9, 31059 Toulouse, France; (N.D.B.); (A.H.); (L.M.)
| | - Catherine Poirot
- Préservation de la Fertilité, Service d’Hématologie, Unité AJA, Hôpital Saint Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France;
- Médecine Sorbonne Université, Site Pitié Salpêtrière, 91 Bd de l’Hôpital, 75013 Paris, France
| | - Sophie Porcheron
- Unité de Soins Intensifs Hématologie, CLCC Henri Becquerel, 1 Rue d’Amiens, 76038 Rouen, France; (M.-L.F.); (S.P.)
| | | | - Jean-Paul Vernant
- Service d’Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 47-83 Boulevard de l’Hôpital, CEDEX 13, 75651 Paris, France; (L.J.); (M.-P.D.); (D.I.); (J.-P.V.)
| | | | - Stéphanie Nguyen
- Service d’Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 47-83 Boulevard de l’Hôpital, CEDEX 13, 75651 Paris, France; (L.J.); (M.-P.D.); (D.I.); (J.-P.V.)
- Correspondence:
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