Introduction:

Previous research has utilized non-standardized questionnaires to evaluate patient reported outcomes in urologic oncology patients. However, there exists little data using standardized questionnaires to evaluate for patient reported sexual and mental health outcomes in testicular cancer survivors. The use of standardized questionnaires allows for validated comparison of patient groups to control groups. Here, we describe a study utilizing readily available, standardized questionnaires to evaluate testicular cancer survivor sexual function and mood disturbances.

Methods:

Qualtrics surveys were distributed to 143 testicular cancer survivors from 18 countries through testicular cancer survivor email lists and Twitter. Survey information assessed self-reported demographics, health behaviors, treatments, and mental and sexual health outcomes using the HealthMeasures Patient-Reported Outcomes Measurement Information System (PROMIS) validated surveys. PROMIS surveys assessing depression, anxiety, orgasm pleasure, and sexual activity interest were administered. Survey scores were summed and converted to T-scores through the HealthMeasures Scoring Service. Control groups, comprised of the general US population, had a T-score mean of 50 as per PROMIS standardization. Independent samples two-sided t tests were performed to assess for significant differences between groups based on age at initial evaluation and treatment regimen.

Results:

Statistical analysis demonstrated that testicular cancer survivors experienced increased symptoms of anxiety (p<0.001), depression (p=0.001), and sexual dysfunction (p=0.027) without reduced sexual interest (p=0.945) compared to control. Men evaluated at age 20-29 and 30-39 years of age reported increased anxiety symptoms (p=0.004 and 0.022, respectively) compared to men evaluated at age >40. Men evaluated at age 20-29 years reported increased depression symptoms (p=0.012) compared to men evaluated at age >40. Men who underwent retroperitoneal lymph node dissection (RPLND) experienced increased depression symptoms compared to those who did not undergo RPLND (p=0.044). Respondents who underwent chemotherapy demonstrated worse symptoms of sexual dysfunction (p=0.001) and depression (p=0.009) compared to those that did not undergo chemotherapy.

Conclusion:

Here, we demonstrate that testicular cancer survivors exhibit worse sexual function despite similar sexual interest and worsened symptoms of depression and anxiety compared to controls. Testicular cancer survivors evaluated at younger ages and those that undergo chemotherapy or RPLND tend to report worse mood related outcomes compared to older men and those that undergo alternative treatment options, respectively. Further prospective studies evaluating the effect of survivorship programs at diagnosis and throughout treatment course are warranted to assess efficacy of intervention in these patients.

Funding: N/A