Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

What are the psychosocial challenges facing testicular cancer survivors and how can technology help to address them?  (#33)

Ben Smith 1
  1. Ingham Institute for Applied Medical Research and University of New South Wales, Liverpool, NSW, Australia

Testicular cancer (TC) is the most common form of cancer in young men (18-39). More than 95% of men survive TC, but psychosocial sequelae are common. Clinically significant anxiety (≈1 in 5) and to a lesser extent distress (≈1 in 7), but not depression, are more prevalent in TC survivors than the general population. Approximately 1 in 3 TC survivors experience elevated fear of cancer recurrence (FCR). Up to two thirds of TC survivors report unmet needs for help adjusting after TC, particularly regarding existential, relationship/sexual, and financial/insurance issues. Poorer outcomes are more common in men who are single, younger, unemployed/low socio‐economic status, suffering from co‐morbidities, experiencing worse symptoms/side effects, and using passive coping strategies. 

Men may be reluctant or unable to seek face-to-face help due to barriers including stigma, distance and cost. Innovative approaches to providing support are needed. TC survivors report positive attitudes towards eHealth and TC survivors with more unmet needs are more likely to engage in online TC communities. TrueNTH TC (Movember; truenth-tc.org) and e-TC 2.0 (PoCoG/ANZUP; e-TC.org) are two online resources designed to support men from testicular cancer diagnosis through to survivorship. TrueNTH TC aims to reduce anxiety and isolation by providing information and connections with TC survivors and clinicians. Testing of TrueNTH TC is ongoing. e-TC 2.0 is an interactive web-based self-management intervention that aims to reduce anxiety, depression and FCR in TC survivors reporting elevated psychological distress. A single arm phase I trial of e- TC 2.0 in 44 TC survivors found high (>8/10) self-reported acceptability of e-TC 2.0 and pre- to post-intervention reductions in borderline/clinical anxiety (79% vs 30%), distress (59% vs 44%) and FCR (39% vs 8%). However, the feasibility of e-TC 2.0 as a scalable tool to reduce psychological distress in TC survivors may be constrained by limited website usage.