EXPANDING THE ROLE FOR (P)REHABILITATION FOR PATIENTS WITH TESTICULAR CANCER

Introduction

Few data exist on best practices for provision of nutrition, exercise, and psychologic support to testicular cancer (TC) patients and their caregivers. We aim to summarize the extant literature and identify gaps.

Methods

We performed a scoping review including randomized controlled trials (RCTs) including patients with TC or their caregivers in a program with (p)rehabilitation, exercise, psychologic support, or nutrition components. Recorded were statistically significant positive (SS+) and negative (SS-) results and nonsignificant differences (NSD).

Results

The systematic search yielded 10,968 records, and included were 14 unique RCTs, encompassing 1729 unique subjects, 250 of which were TC patients/survivors, and 0 of which were caregivers. Overall, 9/14 RCTs (64%) yielded ≥1 SS+ while four demonstrated NSD, and 2 demonstrated one SS- each. Of 3 RCTs evaluating bimodal exercise and psychologic support, 3 yielded ≥1 SS+, compared with 3/4 providing unimodal psychologic support, 0/1 providing unimodal nutritional support, and 3/6 interventions providing unimodal exercise programs, though two demonstrated negative associations (increased thrombotic events and fatigue). Table 1 demonstrates characteristics of included RCTs, while Figure 2 is an alluvial diagram depicting the types of interventions emplyed by included RCTs along with outcomes affected.

Conclusions

Over half of RCTs on TC (p) rehabilitation demonstrate efficacy for ≥1 outcome of interest. Such interventions are safe, with positive findings outweighing the two RCTs with SS- findings. There is particularly strong evidence to support exercise improving fatigue, cardiovascular risk profile, and physical performance measures including VO2 max, muscle strength, etc. as well as psychologic support programs to improve fatigue and mental health. A paucity of data exists in this space and further work is needed.