Key Updates in Testicular Cancer: Optimizing Survivorship and Survival.

Abstract

Testicular cancer is a rare but highly curable malignancy, predominantly affecting young men. Advances in multimodal therapy, including cisplatin-based chemotherapy, radiotherapy, and surgical interventions, have resulted in excellent cancer-specific survival. However, with improved survival rates, long-term health consequences and survivorship issues have emerged as critical concerns. Testicular cancer survivors (TCSs) are at risk of adverse health outcomes, including endocrine dysfunction, cardiovascular disease, secondary malignancies, chemotherapy-induced neuropathy, and psychosocial challenges. Endocrine disturbances such as hypogonadism and infertility require careful monitoring, while cardiovascular risks necessitate long-term preventive strategies. Survivors also face an elevated risk of secondary malignancies, necessitating tailored follow-up. Recent advances in the de-escalation of therapy, particularly for stage II seminoma and metastatic germ cell tumors, aim to balance oncologic efficacy with minimizing toxicity. This review discusses the evolving landscape of testicular cancer survivorship, the impact of treatment-related complications, and contemporary management strategies, emphasizing a multidisciplinary approach to optimize long-term outcomes and quality of life.