Dr. Travis Q&A

Feb. 18, 2026

In a study of nearly 800 testicular cancer survivors, researchers identified long-term health effects of chemotherapy used to treat testicular cancer, including differences in renal function, cardiovascular risk, and chronic health conditions.

Lois B. Travis, MD, and colleagues at IU and elsewhere published these findings in the prestigious Journal of the National Comprehensive Cancer Network (JNCCN). The findings will be used to inform national follow-up guidelines for cisplatin-treated testicular cancer survivors in the future.

Read the news release

Dr. Travis, the Lawrence H. Einhorn Professor of Cancer Research at the IU Simon Comprehensive Cancer Center, is the senior author of the study. The other IU authors include Lawrence Einhorn, MD (the physician who developed the cure for testicular cancer); Paul Dinh Jr., PhD; and Patrick Monahan, PhD.

Travis answers questions about the findings and her testicular cancer survivorship research.

Q: What should the public know about this study?

First, testicular cancer is the number one cancer in young men between the ages of 18 and 39 but remains under-studied. At Indiana University, we are grateful for the ongoing support from the National Cancer Institute to study the survivorship experience of these young men, with their overall 95% 10-year relative survival rate. In this study, our unique multi-center investigation showed that the contemporary, highly effective cisplatin-based regimens, which cure the majority of patients, are associated with measurable long-term health effects — notably reductions in kidney function, hearing loss, neuropathy, and an increased burden of chronic conditions — that differ modestly by regimen. Overall, the cumulative burden of morbidity after either three cycles of cisplatin, bleomycin, and etoposide (BEPX3) or four cycles of etoposide and cisplatin (EPx4) was similar, though specific toxicities varied.

Q: This study notes the differences in renal function and cardiovascular risk and other chronic health conditions for testicular cancer survivors. What does that look like for these patients?

In practical terms, about 41% of survivors had some degree of reduced renal function (estimated glomerular filtration rate, or eGFR), nearly half reported hearing loss or tinnitus, and more than half reported neuropathy. The risk of renal dysfunction was strongly related to the total dose of cisplatin. Importantly, even mild eGFR reductions were linked to higher subsequent risks of hypertension. Moderate-to-severe eGFR reductions were also associated with significantly increased risks of later developing excessively high levels of lipids, and/or cardiovascular disease. These are all clinically relevant problems that can affect long-term, health-related quality of life.

Q: Your work focuses on lessening “the cost of the cure.” How do these findings build on what is already known about long-term efforts of treatment for testicular cancer survivors?

These results confirm prior signals that, despite its effectiveness, cisplatin-based chemotherapy carries lasting toxicities and add new, robust real-world evidence that cisplatin dose-dependent declines in renal function translate into substantially higher cardiovascular risk. The study, therefore, sharpens our understanding of which late effects to monitor and reinforce efforts to reduce avoidable toxicity while preserving excellent cure rates. It is also important to remember that the platinum-based drugs are among the most widely used cancer therapies worldwide, with an estimated 10.5 million patients each year receiving them as first-line treatment. Thus, the long-term toxicity data generated in The Platinum Study can inform survivorship care for many other cancer patients as well.

Q: How will these results impact ongoing care for testicular cancer survivors?

The findings support integrating lifelong renal and cardiovascular surveillance into survivorship care and will help inform risk-stratified follow-up and guideline development, including input to the National Comprehensive Cancer Network. Thus, clinicians can detect and manage hypertension, abnormal levels of lipids, and other conditions earlier to reduce long-term harm.  I also point out that another of our papers published on Feb. 12 with  Sarah Kerns, PhD, MPH, of the Medical College of Wisconsin in the Journal of the National Cancer Institute demonstrated for the first time that the American Heart Association’s 2024 Predicting Risk of Cardiovascular Disease Events (PREVENT) equations can identify those testicular cancer survivors at heightened risk for future cardiovascular events.

Q: Should testicular cancer survivors use this information to self-advocate for any additional screenings or interventions?

Yes. Survivors may discuss renal function and cardiovascular risk with their clinicians and ask for routine checks (blood pressure, lipids, basic renal labs and hearing assessment as appropriate) and lifestyle interventions such as physical activity and smoking cessation. These conversations should be individualized and guided by clinicians familiar with survivorship care.