Sperm quality unaffected by one course of chemotherapy for early testicular cancer

A new study now finds that men with early stage testicular cancer can safely receive one course of chemotherapy or radiotherapy after surgery without it having long-term effect on their sperm count. The study was published in the cancer journal Annals of Oncology.

While it is known that several rounds of chemotherapy or high doses of radiotherapy given to men with more advanced testicular cancer can reduce sperm count and concentration, it has been unclear, until now, whether a single cycle of chemotherapy or radiotherapy would have a similar effect in men with stage I disease.

Speaking about it, lead author Dr Kristina Weibring said, "We wanted to examine in more detail if postoperative treatment, given to decrease the risk of recurrence after the removal of the tumorous testicle, would affect the sperm count and sperm concentration long term in testicular cancer patients with no spread of the disease. To our knowledge, no such study has been done before."

Weibring added, "This is important to find out, since treatment with one course of postoperative chemotherapy has been shown to decrease the risk of relapse substantially, thereby reducing the number of patients having to be treated with several courses of chemotherapy."

Notably, testicular cancer is the most common cancer in young men between the ages of 15 and 40. When it is diagnosed, all patients have the testicle containing the tumour removed, a surgical procedure called orchiectomy.

The study saw 182 men aged between 18 and 50, diagnosed with stage I testicular cancer and who had had an orchiectomy within the past five years, taking part in the study between 2001 and 2006.

Study authors said they found no clinically significant detrimental long-term effect in either total sperm number or sperm concentration, irrespective of the type of postoperative treatment received.

Dr Weibring added, "Among men who received radiotherapy, there was a distinct decrease in average sperm number and concentration six months after treatment, though not in those who received chemotherapy. However, sperm number and concentration recovered in the radiotherapy group after six months, and continued to increase in all groups up to five years after treatment."

Dr Weibring added that with the results of the study, they can give the patients more adequate information on potential side effects from postoperative treatment.

"Testicular cancer patients are often young men wanting to father children at some point, and we find, in many cases, that the patients are afraid of the potential risk of infertility caused by chemotherapeutic treatment. These findings should provide some reassurance to them," Dr Weibring added.

Notably, a well-known problem for men diagnosed with testicular cancer is an impaired ability to create sperm. A condition called testicular dysgenesis syndrome, characterised by poor semen quality among other things, may play a role in this and is also associated with a higher risk of developing testicular cancer.

Dr Weibring concluded, "Our results are promising but more studies are needed, and we still recommend sperm banking before orchiectomy as a number of patients may have low sperm counts at the time of diagnosis that persists after postoperative treatment. In addition, the type of testicular cancer and whether or not it will need further treatments are unknown factors before the orchiectomy. Assisted reproductive measures may be necessary for these patients regardless of any treatment given.