Physical Functioning

Most research efforts to date have concentrated on describing the short- and long-term toxicities of tes-ticular cancer treatment. Several clear and consistent trends have been described. For example, chemother apy is associated with nephrotoxicity, cardiovascular toxicity, neurotoxicity, and pulmonary toxicity whereas radiation therapy is associated with gastrointestinal and cardiopulmonary toxicity.30 The effects that these side effects and testicular cancer itself have on QOL and other psychosocial outcomes have not been as frequently studied. Moreover, there are relatively few published reports in which physical functioning is compared between treatment groups.31 However, evidence does suggest that men receiving chemotherapy and/or radiation therapy report more long-term physical side effects than do men who are treated only with surgery32 and that patients receiving only chemotherapy report more physical problems than do men who receive only radiation therapy.2433

Long-term follow-up studies indicate that more than one-half (54%) of men treated for testicular cancer report poorer physical condition (eg, more fatigue and decreased muscle strength) 5 or more years after treatment, compared to before treat-ment.34 However, findings from other studies indicate that the incidence of physical problems is low and that most men consider themselves to be in good or excellent physical health following treat-ment.21'28,35 Future research efforts using a validated measure of physical functioning are needed to more definitively assess the physical functioning outcomes of testicular cancer patients and to track these outcomes as time since treatment increases.

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