Having several rounds of chemotherapy or radiotherapy to treat advanced testicular cancer is known to reduce sperm quality, but the effects of less intensive therapy for earlier stage cancers had not previously been researched in detail. The study, published in Annals of Oncology, reported that there was no clinically significant long-term effect on either sperm count or sperm concentration after one round of post-operative chemotherapy or radiotherapy.
'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,' said study author Dr Kristina Weibring, an oncologist at the Karolinska University Hospital in Stockholm, Sweden.
Testicular germ-cell cancer is the most common cancer in men aged 15 to 40, particularly within the white male population in Northern Europe. The first-line treatment for early-stage testicular cancer is a unilateral orchiectomy of the testicle affected, commonly followed by an adjuvant round of chemotherapy or radiotherapy to reduce the risk of relapse.
The study looked at 182 patients aged between 18 and 50, who had had a testicle removed due to early-stage testicular cancer, but who had not yet begun further treatment. Sperm samples were taken before chemotherapy or radiotherapy treatment, and then at 6, 12, 24, 36 and 60 months after therapy completion.
The radiotherapy group had an initial decrease in sperm count and concentration six months after treatment, but this was temporary, with sperm quality increasing over five years. The chemotherapy group did not show the initial dip in sperm quality. Across all treatment groups, by the end of the study there was no clinically significant difference in sperm quality compared with levels before chemotherapy or radiotherapy.
'I am very excited to see these results as I wasn't expecting sperm to recover so well after postoperative treatment,' said Dr Weibring.
Professor Fabrice André, editor-in-chief of Annals of Oncology, said: 'The finding that one course of chemotherapy has minimal impact on sperm count offers hope for thousands of patients worldwide, but we all must keep in mind that these data are preliminary and will require validation before we can use them in clinics. The next step will be to establish how to predict the toxic effects on sperm count of different chemotherapy regimens.'