Young men who survive testicular cancer, a disease most commonly diagnosed between the ages of 18 and 39, may face a range of long-term health risks related to the chemotherapy used to treat the disease, according to a new study published online in the Journal of the National Comprehensive Cancer Network (JNCCN). While modern cisplatin-based chemotherapy boasts a cure rate exceeding 95%, researchers are increasingly focused on the lasting effects of treatment as survivors live for decades after completing therapy.
The study, conducted by a multi-center team evaluating nearly 800 long-term survivors treated at eight major cancer centers in North America, assessed a broad spectrum of adverse health outcomes more than a decade after treatment. Researchers identified differences in renal function, cardiovascular risk and the overall burden of chronic health conditions among survivors, suggesting that the specific chemotherapy regimen used can influence the type and severity of long-term effects.
“Our findings show that while today’s standard chemotherapy regimens are highly effective at curing testicular cancer, they’re associated with meaningful long-term health risks that appear to differ by treatment approach,” said Sarah L. Kerns, PhD, MPH, associate professor of radiation oncology at the Medical College of Wisconsin, and the study’s corresponding author.
Cardiovascular Risks and Chemotherapy Regimens
A related study, published February 12, 2026, in PubMed, specifically examined cardiovascular disease (CVD) risk among testicular cancer survivors. This research utilized the American Heart Association’s (AHA) 2024 PREVENT equation to assess CVD risk and found that survivors experienced an excess incidence and mortality related to CVD. The study indicated that a 5% increase in 10-year PREVENT risk correlated with a nearly threefold increase in the odds of developing CVD.
Notably, the risk appeared particularly elevated among those receiving four cycles of etoposide/cisplatin (EPX4) chemotherapy. Researchers suggest this may be linked to lower estimated glomerular filtration rate (eGFR), a measure of kidney function, and slightly older age at the time of treatment. The study also found that survivors who did not engage in vigorous physical activity at baseline were at a significantly higher risk of CVD.
Renal Function and Chronic Health Conditions
The larger JNCCN study highlighted the importance of monitoring renal function in survivors. Chemotherapy, particularly cisplatin-based regimens, can have toxic effects on the kidneys. The research also pointed to a higher burden of chronic health conditions emphasizing the need for comprehensive long-term follow-up care.
The study represents the most comprehensive real-world evaluation to date of contemporary NCCN-recommended chemotherapy regimens for testicular cancer. Researchers assessed a wide range of adverse health outcomes, including not only renal function and cardiovascular health, but also audiological health, and neuropathy.
Implications for Clinical Guidelines
The findings from these studies are expected to inform national follow-up guidelines for cisplatin-treated testicular cancer survivors. Currently, long-term surveillance typically focuses on detecting recurrence of the cancer. However, these results underscore the importance of proactively monitoring and managing potential long-term side effects of treatment.
The research suggests that a more personalized approach to survivorship care may be warranted, taking into account the specific chemotherapy regimen received, baseline health status, and lifestyle factors such as physical activity. Early intervention and lifestyle modifications, such as regular exercise, may help mitigate some of the long-term health risks.
While cisplatin-based chemotherapy remains a highly effective treatment for testicular cancer, these studies serve as a crucial reminder that curing the cancer is only one part of the equation. Providing comprehensive, long-term care to address the potential late effects of treatment is essential for optimizing the overall health and well-being of survivors.
The researchers emphasize the need for continued research to better understand the long-term health consequences of testicular cancer treatment and to develop strategies for preventing and managing these risks. The use of tools like the AHA’s PREVENT equation may help identify high-risk survivors who could benefit from more intensive monitoring and intervention.
