Summary

The treatment of testicular cancer has some notable long-term toxicities; however, the curative potential in the face of metastatic disease far outweighs this problem. This issue requires very careful consideration and is an argument against adjuvant chemotherapy for patients with clinical stage I disease, for whom a risk-benefit analysis must govern decisions. What is absolutely clear is that patients who first received curative chemotherapy for advanced testic-ular cancer in the 1970s are just entering their max-

imum-risk period for cardiovascular and oncologic 13 problems as they approach their fifth and sixth decades of life. Accordingly, it is crucially important 14 that such patients be monitored closely during therapy for toxicities and that they continue to be followed closely by clinicians who are aware of the scope and spectrum of potential late toxicities and who are able to identify them, treat them, and report them to the medical community at large. 16.

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