Today we cure about 95% of all testicular cancer patients, that’s thanks to cisplatin based chemotherapy that was discovered forty years ago and now today we would expect a survivor to live for over forty years once they are cured from their disease. That being said, they are at risk for long-term complications from chemotherapy and one of those complications is hypogonadism or low testosterone levels. So the PLATINUM study is a National Cancer Institute funded study; it’s a multi-institution study of cancer centres in North America and Canada. What it’s doing is trying to understand why these complications happen, how prevalent are they and how to mitigate some of these problems.

In this study we enrolled over 1,600 patients so far. The data that we are presenting today is from the first 491 survivors and of those survivors 38% had low testosterone levels. What we found actually is those survivors with low testosterone levels were almost three times more likely to have high blood pressure and twice more likely to have high cholesterol, high diabetes and erectile dysfunction. They were also more likely to take medications for depression and anxiety.

What we would recommend is that healthcare providers that see these survivors screen for hypogonadism, ask them about symptoms for hypogonadism and if they do have those systems then measure their testosterone levels and replace them with testosterone therapy if they are low.

What kind of predisposing factors might there be for developing hypogonadism?

What we found in this study is that as these survivors age then their risk of hypogonadism increases and the more obese they are they are also more likely to have low testosterone levels.

Going forwards, lifestyle management, looking at diet and exercise, would be a possible course?

Absolutely, we always recommend that our survivors maintain a healthy weight and exercise and watch their diet.

In the near or distant future, looking at new therapies, different therapies for treating testicular cancer if cisplatin is the main source of this hypogonadism would alternative therapies be a way of mitigating that risk as well?

I really doubt so. We’ve been looking for forty years now for another therapy and those 5% of survivors who don’t respond to cisplatin, really there is not much out there that can help them. It’s not impossible but I think we’re stuck with cisplatin for a long time. It’s a very good drug, it treats 95% of them.