Physical Activity and Testicular Cancer Survivorship Health-Related Quality of Life: A Scoping Review - Beyond the Abstract

Testicular cancer (TC) is one of the most treatable malignancies, with five-year survival rates exceeding 95% when diagnosed early. However, survival alone is not the endpoint—enhancing health-related quality of life (HRQoL) is essential for long-term well-being. Many TC survivors face persistent challenges, including fatigue, anxiety, sexual dysfunction, and metabolic changes related to treatment. As research increasingly highlights the role of lifestyle factors in survivorship, physical activity (PA) has emerged as a crucial, yet often underutilized, tool for improving overall well-being.

In our recently published scoping review in Therapeutic Advances in Urology, we examined the relationship between PA and HRQoL among TC survivors. Our findings revealed that structured exercise programs, whether resistance training, aerobic activity, or hybrid approaches, consistently improve physical and psychological well-being. Benefits include increased energy levels, improved cardiopulmonary health, reduced depression and anxiety, and enhanced overall life satisfaction.

However, despite the promising benefits of PA for TC survivors, key gaps remain:

  1. Lack of Standardized PA Guidelines – While general exercise recommendations exist for cancer survivors, TC-specific guidance is sparse. Survivors need clear, evidence-based PA prescriptions tailored to their unique treatment experiences and health concerns.
  2. Limited Longitudinal Research – Most studies assess short-term outcomes, making it difficult to determine the long-term impact of sustained PA on HRQoL, recurrence rates, and late treatment effects.
  3. Barriers to Exercise Participation – Many survivors face challenges in adopting and maintaining an active lifestyle due to fatigue, psychological distress, lack of awareness, and insufficient provider guidance.
Actionable Takeaways for Survivors and Healthcare Providers

  1. For Survivors:
    • Engage in light to moderate-intensity aerobic activity (e.g., brisk walking, cycling) at least 3 days a week, complemented by strength training. However, you should consult with your physician before committing. Advocate for personalized PA recommendations during follow-up visits with oncologists or primary care providers.
    • Seek out cancer rehabilitation programs or exercise oncology specialists who understand TC-specific challenges.
    • Use wearable fitness trackers or mobile apps to monitor activity levels and stay accountable.
  2. For Healthcare Providers:
    • Integrate PA discussions into routine survivorship care, emphasizing their role in mitigating treatment-related side effects.
    • Refer survivors to exercise physiologists, physical therapists, or oncology fitness programs to facilitate structured interventions.
    • Support research efforts aimed at developing TC-specific PA guidelines, ensuring recommendations align with survivor needs.
Future Directions

Our review highlights the critical need for more robust, long-term studies on PA and TC survivorship. Moving forward, researchers should:

  • Conduct randomized controlled trials assessing the optimal type, intensity, and duration of PA for TC survivors.
  • Develop intervention strategies that address psychosocial barriers to exercise adherence.
  • Explore digital health tools and telemedicine interventions to make PA support more accessible.
Conclusion

Physical activity is not just an adjunct to TC survivorship care—it is a fundamental pillar for improving HRQoL. By bridging research gaps, empowering survivors with actionable guidance, and integrating PA into routine survivorship plans, we can enhance long-term outcomes and promote a higher quality of life for the growing TC survivor population.

For those interested in furthering this conversation or implementing PA-focused strategies in survivorship care, collaboration between researchers, clinicians, and patient advocates is vital. Together, we can redefine TC survivorship beyond survival—toward thriving.

Written by: Michael J. Rovito,1 Keith Brazendale,2 Samantha Gibson,2 Sydney Martinez,2 Ciaran Fairman,3 Craig Badolato,4 Timothy Lyon,5 Bryce Baird,5 Jaclyn Langan,2 M. K. Leslie,2

  1. University of Central Florida, Orlando, FL, USA.
  2. Department of Health Sciences, University of Central Florida, Orlando, FL, USA.
  3. Department of Exercise Science, University of South Carolina, Columbia, SC, USA.
  4. Cancer Care Centers of Brevard, Melbourne, FL, USA.
  5. The Mayo Clinic, Rochester, MN, USA.
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