Long-term adverse effects of cancer treatment are of increasing importance, as the number of cancer survivors is growing rapidly. The number of cancer diagnoses increases due to screening and ageing of the population, and cure rates improve due to new treatment strategies.
Survivorship care is important, as it is known that late adverse treatment effects decrease life span and influence the quality of life. This thesis of Sjoukje Lubberts investigates survivorship from testicular cancer, a model for a curable form of cancer, and describes a phenomenon of early ageing. Early ageing is observed after testicular cancer treatment, especially with platinum-based chemotherapy, including development of second primary malignancies and cardiovascular disease at younger ages than expected. Risk factors for cardiovascular disease after testicular cancer treatment are cisplatin-based chemotherapy, obesity and smoking behaviour at diagnosis, and development of Raynaud’s phenomena as a subclinical marker of endothelial dysfunction.
A shared-care survivorship program was investigated in which patients visit both the oncologist and their primary care physician, as the primary care physician has an important role in cardiovascular risk management. The shared-care program was both safe and feasible. A healthy life style should be promoted among testicular cancer survivors, already at start of treatment, and when needed, professional help has to be offered.
