Abstract
With the incidence of testicular cancer (TC) rising, understanding implications for long-term survivorship is essential. Advances in surgery, radiotherapy, and chemotherapy have turned this once deadly disease into a highly curable one. Advanced practice providers (APPs) must be well versed in the evaluation and management of long-term health consequences from multimodal therapy. This article provides an overview of TC, available treatments, and the role APPs play in the evaluation and management of late and long-term health consequences of the disease.
References
American Society of Clinical Oncology. (n.d.). Survivorship Care Guidelines, Care Plans & Resources. https://www.asco.org/news-initiatives/current-initiatives/cancer-care-initiatives/prevention-survivorship/survivorship-compendium/care
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Jr., Virani, S. S., Williams, K. A., Sr., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140(11), e596–e646. https://doi.org/10.1161/CIR.0000000000000678
Bagrodia, A., Haugnes, H. S., Hellesnes, R., Dabbas, M., Millard, F., Nappi, L., Daneshmand, S., Kollmannsberger, C., & Einhorn, L. H. (2025). Key updates in testicular cancer: Optimizing survivorship and survival. American Society of Clinical Oncology Educational Book, 45(3), e472654. https://doi.org/10.1200/EDBK-25-472654
Centers for Disease Control and Prevention. (2026). Signs of noise-induced hearing loss: Loud noises can cause hearing loss. https://www.cdc.gov/nceh/hearing_loss/signs.html
Cohen, J. B., Brown, N. J., Brown, S. A., Dent, S., van Dorst, D. C. H., Herrmann, S. M., Lang, N. N., Oudit, G. Y., & Touyz, R. M.; American Heart Association Council on Hypertension; Council on Arteriosclerosis, Thrombosis and Vascular Biology; & Council on the Kidney in Cardiovascular Disease. (2023). Cancer therapy–related hypertension: A scientific statement from the American Heart Association. Hypertension, 80(3), e46–e57. https://doi.org/10.1161/HYP.0000000000000224
Eichwald, J., Themann, C. L., & Scinicariello, F. (2023). Safe listening at venues and events with amplified music — United States, 2022. MMWR. Morbidity and Mortality Weekly Report, 72(13), 338–341. https://doi.org/10.15585/mmwr.mm7213a3
Gallegos, J. L. (2024). Testosterone replacement therapy for hypogonadism: A primer for primary care. The Nurse Practitioner, 49(8), 21–27. https://doi.org/10.1097/01.NPR.0000000000000210
Global Initiative for Chronic Obstructive Lung Disease. (2025). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2026 report. https://goldcopd.org/2026-gold-report-and-pocket-guide/
Groot, H. J., Lubberts, S., de Wit, R., Witjes, J. A., Kerst, J. M., de Jong, I. J., Groenewegen, G., van den Eertwegh, A. J., Poortmans, P. M., Klümpen, H., van den Berg, H. A., Smilde, T. J., Vanneste, B. G., Aarts, M. J., Incrocci, L., van den Bergh, A. C., Jóźwiak, K., van den Belt-Dusebout, A. W., Horenblas, S.,…Schaapveld, M. (2018). Risk of solid cancer after treatment for testicular cancer: A population-based study. Journal of Clinical Oncology, 36(24), 2504–2513. https://doi.org/10.1200/JCO.2017.77.4174
He, C., Levis, B., Riehm, K. E., Saadat, N., Levis, A. W., Azar, M., Rice, D. B., Krishnan, A., Wu, Y., Sun, Y., Imran, M., Boruff, J., Cuijpers, P., Gilbody, S., Ioannidis, J. P. A., Kloda, L. A., McMillan, D., Patten, S. B., Shrier, I.,…Benedetti, A. (2020). The accuracy of the Patient Health Questionnaire-9 (PHQ-9) algorithm for screening to detect major depression: An individual participant data meta-analysis. Psychotherapy and Psychosomatics, 89(1), 25–37. https://doi.org/10.1159/000502294
Hellesnes, R., Myklebust, T. Å., Fosså, S. D., Bremnes, R. M., Karlsdottir, Á., Kvammen, Ø., Tandstad, T., Wilsgaard, T., Negaard, H. F. S., & Haugnes, H. S. (2021). Testicular cancer in the cisplatin era: Causes of death and mortality rates in a population-based cohort. Journal of Clinical Oncology, 39(32), 3561–3573. https://doi.org/10.1200/JCO.21.00637
Jayakrishnan, B., Kausalya, R., Al-Rashdi, H. A., Davis, K., Ali, J., Al-Harthy, M., & Bennji, S. M. (2023). Bleomycin and perioperative care: A case report. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 40(3), e2023030. https://doi.org/10.36141/svdld.v40i3.14385
Jones, D. W., Ferdinand, K. C., Taler, S. J., Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bansal, N., Bello, N. A., Bress, A. P., Carter, J., Cohen, J. B., Collins, K. J., Commodore-Mensah, Y., Davis, L. L., Egan, B., Khan, S. S., Lloyd-Jones, D. M., Melnyk, B. M.,…Williamson, J. D. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. Advance online publication. https://doi.org/10.1016/j.jacc.2025.05.007
Kerns, S. L., Fung, C., Monahan, P. O., Ardeshir-Rouhani-Fard, S., Abu Zaid, M. I., Williams, A. M., Stump, T. E., Sesso, H. D., Feldman, D. R., Hamilton, R. J., Vaughn, D. J., Beard, C., Huddart, R. A., Kim, J., Kollmannsberger, C., Sahasrabudhe, D. M., Cook, R., Fosså, S. D., Einhorn, L. H., & Travis, L. B. (2018). Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy: A multi-institutional study. Journal of Clinical Oncology, 36(15), 1505–1512. https://doi.org/10.1200/JCO.2017.77.0735
Khan, M. R., Sheehan, P. K., Bazin, A., Leonard, C., Aleem, U., Corrigan, L., & McDermott, R. (2024). Late side effects of testicular cancer and treatment: A comprehensive review. Discover Oncology, 15(1), 646. https://doi.org/10.1007/s12672-024-01549-1
Li, W., Wang, Z., Jiang, C., Hua, C., Tang, Y., Zhang, H., Liu, X., Zheng, S., Wang, Y., Gao, M., Lv, Q., Dong, J., Ma, C., & Du, X. (2024). Effect of intensive blood pressure control on cardiovascular outcomes in cancer survivors. Hypertension, 81(3), 620–628. https://doi.org/10.1161/HYPERTENSIONAHA.123.22194
Loriot, Y., Texier, M., Culine, S., Fléchon, A., Thiery-Vuillemin, A., Gravis, G., Geoffrois, L., Chevreau, C., Gross-Goupil, M., Barthélemy, P., Bompas, E., Mahammedi, H., Laguerre, B., Abadie Lacourtoisie, S., Helissey, C., Ladoire, S., Abraham, C., Massard, C., Grimaldi, S., & Fizazi, K. (2022). The GETUG SEMITEP trial: De-escalating chemotherapy in good-prognosis seminoma based on fluorodeoxyglucose positron emission tomography/computed tomography. European Urology, 82(2), 172–179. https://doi.org/10.1016/j.eururo.2022.04.031
Lubberts, S., Groot, H. J., de Wit, R., Mulder, S., Witjes, J. A., Kerst, J. M., Groenewegen, G., Lefrandt, J. D., van Leeuwen, F. E., Nuver, J., Schaapveld, M., & Gietema, J. A. (2023). Cardiovascular disease in testicular cancer survivors: Identification of risk factors and impact on quality of life. Journal of Clinical Oncology, 41(19), 3512–3522. https://doi.org/10.1200/JCO.22.01016
Michos, E. D., McEvoy, J. W., & Blumenthal, R. S. (2019). Lipid management for the prevention of atherosclerotic cardiovascular disease. The New England Journal of Medicine, 381(16), 1557–1567. https://doi.org/10.1056/NEJMra1806939
National Comprehensive Cancer Network. (2025a). NCCN Clinical Practice Guidelines in Oncology: Adolescent and young adult oncology (Version 1.2026). https://www.nccn.org/professionals/physician_gls/pdf/aya/pdf
National Comprehensive Cancer Network. (2025b). NCCN Clinical Practice Guidelines in Oncology: Adult cancer pain. (Version 1.2026). https://www.nccn.org/professionals/physician_gls/pdf.pain.pdf
National Comprehensive Cancer Network. (2025c). NCCN Clinical Practice Guidelines in Oncology: Colorectal cancer screening (Version 2.2025). https://www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf
National Comprehensive Cancer Network. (2025d). NCCN Clinical Practice Guidelines in Oncology: Survivorship (Version 2.2025). https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf
National Comprehensive Cancer Network. (2025e). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Testicular Cancer, Version 2.2025. https://www.nccn.org.
O’Connor, E. A., Henninger, M. L., Perdue, L. A., Coppola, E. L., Thomas, R. G., & Gaynes, B. N. (2023). Anxiety screening: Evidence report and systematic review for the US Preventive Services Task Force. JAMA, 329(24), 2171–2184. https://doi.org/10.1001/jama.2023.6369
Parekh, N. V., Lundy, S. D., & Vij, S. C. (2020). Fertility considerations in men with testicular cancer. Translational Andrology and Urology, 9(Suppl 1), S14–S23. https://doi.org/10.21037/tau.2019.08.08
Raggi, D., Chakrabarti, D., Cazzaniga, W., Aslam, R., Miletic, M., Gilson, C., Holwell, R., Champion, P., King, A., Mayer, E., Nicol, D., Reid, A., & Huddart, R. A. (2025). Management of testicular cancer. JCO Oncology Practice. Advance online publication. https://doi.org/10.1200/OP-25-00211
Smith, A. B., Rutherford, C., Butow, P., Olver, I., Luckett, T., Grimison, P., Toner, G., Stockler, M., & King, M. (2018). A systematic review of quantitative observational studies investigating psychological distress in testicular cancer survivors. Psycho-Oncology, 27(4), 1129–1137. https://doi.org/10.1002/pon.4596
Wallis, C. J. D. (2020). GSRGT 2020: The International Germ Cell Cancer Collaborative Group (IGCCCG) update. UroToday. https://www.urotoday.com/conference-highlights/gsrgt-2020/testicular-cancer/126571-gsrgt-2020-clinical-trials-corner-the-international-germ-cell-cancer-collaborative-group-igcccg-update.html
Walsh, J. S., Marshall, H., Smith, I. L., Greenfield, D. M., Swain, J., Best, E., Ashton, J., Brown, J. M., Huddart, R., Coleman, R. E., Snowden, J. A., & Ross, R. J. (2019). Testosterone replacement in young male cancer survivors: A 6-month double-blind randomised placebo-controlled trial. PLOS Medicine, 16(11), e1002960. https://doi.org/10.1371/journal.pmed.1002960
Yazici, S., Del Biondo, D., Napodano, G., Grillo, M., Calace, F. P., Prezioso, D., Crocetto, F., & Barone, B. (2023). Risk factors for testicular cancer: Environment, genes and infections—Is it all? Medicina, 59(4), 724. https://doi.org/10.3390/medicina59040724
Yumura, Y., Takeshima, T., Komeya, M., Karibe, J., Kuroda, S., & Saito, T. (2023). Long-term fertility function sequelae in young male cancer survivors. World Journal of Men’s Health, 41(2), 255–271.https://doi.org/10.5534/wjmh.220102
