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Testosterone deficiency

Some men who've had Testicular cancer can suffer from Testosterone deficiency

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Unfortunately, before they remove the testicle they don't test your hormones to see what your levels are and how your testicle is working and what your body is used to getting level-wise before it goes. We have been trying to change this and have been for a very long time.

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Testicles produce Testosterone and removing one can affect your testosterone levels for the rest of your life and without a full hormone check before they don't know what levels YOU need and what your body was used to. Let's now forget most men who have testicular cancer are young in age and losing a certain amount of natural testosterone within weeks of being diagnosed with testicular cancer can lead to deficiency.

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After cancer for a while especially if you have had the BEP or EP chemo regimen you will feel tired and a bit low and that's normal but some men recover and feel themselves after a period.

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What's important when it comes to testosterone is how you feel. If you feel fine after Testicular cancer then that's great and probably don't need to think about it. Not all survivors need treatment

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It's important to remember that symptoms of low testo CAN be side effects of chemotherapy so if you still feel these symptoms 6 to 12 months after it could be low testosterone

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symptoms are

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Tiredness

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Weight gain

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Low sex drive

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Memory loss 

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Struggle to maintain an erection

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Depression ( the ordeal of cancer can also bring this on)

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If you have these symptoms after you feel you've recovered from chemo/cancer then it's important you ask your Oncologist to include hormones in your check up's or could they send you for evaluation with an endocrinologist?

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Unfortunately, men's hormones after testicular cancer are still very much not followed up BUT we have been pushing since 2004 for more understanding and we do feel it's getting better.

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There is enough research now published from many experts in the field to suggest there could be a problem

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More and more men are getting treated because we've raised awareness in the UK through social media and pushing survivors in our groups to ask for the tests either at GP level or through their oncologist.

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What's needed to improve the chances of men who have testicular being taken seriously after treatment is

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Two full hormone  tests BEFORE removal of the testicle

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monitoring of hormone levels from six months after finishing treatment

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The symptoms of low testosterone (above) to be addressed more with the test results

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Current testing considers that the men are young and a new set of guidelines for the NHS are for Testicular cancer survivors.

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There are independent guidelines below and further reading from BSSM which is run by trained doctors who are trying to answer our call.

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It's important to consider the overall well-being and symptoms experienced by individuals, rather than relying solely on test results. Hypogonadism can occur as a result of testicular cancer treatment, and research indicates that a significant number of men who had testicular cancer may experience this condition. Endocrinologists are increasingly recognizing the importance of assessing a man's symptoms and quality of life when diagnosing and managing hypogonadism. It's always best to consult with a medical professional for a thorough evaluation and personalized advice.

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In a large study, 38 percent of 491 testicular cancer survivors had low testosterone levels, known as hypogonadism. Compared to survivors with normal testosterone levels, survivors with low testosterone were more likely to have a range of chronic health problems, including high blood pressure, diabetes, erectile dysfunction, and anxiety or depression.

The study will be featured in a press briefing today and presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting.

"Because testicular cancer occurs at a young age and is highly curable, many survivors may live upwards of five decades," said lead study author Mohammad Issam Abu Zaid, MBBS, an Assistant Professor of Medicine at the Indiana University School of Medicine in Indianapolis, Indiana. "Our findings underscore the need for clinicians to assess testicular cancer survivors for physical signs or symptoms of hypogonadism and to measure testosterone levels in those who do."

Low testosterone can be present at the time of a testicular cancer diagnosis, or it can develop as a side effect of surgery or chemotherapy. While it has been known that low testosterone occurs in a significant proportion of testicular cancer survivors, this is one of the first studies to examine its relationship with long-term health complications in North American patients.

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About the Study

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This analysis comes from the first 491 patients enrolled in The Platinum Study, which aims to be the largest study of testicular cancer survivors worldwide, with over 1,600 survivors already enrolled and still actively recruiting. All patients received chemotherapy and were younger than 55 when they were diagnosed with cancer. The median age at clinical evaluation was 38 years.

The goal of the Platinum Study is to follow the lifelong health of men who received cisplatin chemotherapy for testicular cancer. Researchers collect health information through comprehensive questionnaires and blood samples, as well as basic measurements like blood pressure and a hearing test. The study also aims to identify genes that may raise the chance of developing long-term health problems, such as nerve damage and hearing loss. The study is funded by the National Cancer Institute, National Institutes of Health.

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Key Findings

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Among the 491 survivors, 38 per cent had a low testosterone level or were on testosterone replacement therapy. Being overweight or obese was associated with a higher chance of having low testosterone, as was older age. The researchers also found a genetic abnormality (in the sex hormone-binding globulin gene) that appears to predispose some men to low testosterone, but this needs to be confirmed in larger studies. Survivors participating in vigorous physical activity appeared to have higher levels of testosterone.

Compared to survivors with normal testosterone, testicular cancer survivors with low testosterone were more likely to take medicine for:

  • High cholesterol (20 percent vs. 6 percent)

  • High blood pressure (19 percent vs. 11 percent)

  • Erectile dysfunction (20 percent vs. 12 percent)

  • Diabetes (6 percent vs. 3 percent)

  • Anxiety or depression (15 percent vs. 10 percent)

"Some of these health problems have been previously linked to low testosterone levels among men in the general population and in a few studies of testicular cancer survivors, but this study is one of the most comprehensive to date – we are looking at 15 different health conditions," 

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It's important you ask your GP and Oncologist to test your male hormones after cancer

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