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Exercise, diet and psychological support for patients with testicular cancer

Nature Reviews Urology (2025)Cite this article

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Abstract

Prehabilitative and rehabilitative exercise, psychological support and nutrition interventions have proven beneficial in many cancer populations. Testicular cancer survivors have high rates of metabolic syndrome, cardiovascular disease, hypogonadism and psychosocial issues, and might yield greater benefit from such interventions than the average cancer survivor population. Results from the few studies available in this field suggest that exercise can improve fatigue, metabolic syndrome, cardiovascular risk profile and physical performance measures (such as VO2 max), whereas psychological support programmes have been shown to improve fatigue and mental health. However, a paucity of data exists on best practices for provision of nutrition, exercise and psychological support within the testicular cancer space, patients and caregivers, highlighting the urgent need for additional work in this field. Overall, prehabilitation and rehabilitation interventions for testicular cancer are safe and efficacious, and should be implemented by clinicians at diagnosis and throughout survivorship.

Key points

  • A paucity of data exists on prehabilitation or rehabilitation interventions for testicular cancer survivors, and further investigation is needed to define optimal peri-treatment supportive care interventions.

  • In the majority of available randomized clinical trials, efficacy of the prehabilitation measures was shown for ≥ 1 outcomes of interest.

  • Exercise is associated with improvements in fatigue, metabolic syndrome, cardiovascular risk profile and physical performance measures (such as VO2 max or muscle strength).

  • Psychological support programmes are successful in improving fatigue and mental health.

  • Clinicians should consider implementing prehabilitation and rehabilitation interventions for individuals with testicular cancer at diagnosis and throughout survivorship to improve outcomes.

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Author information

Authors and Affiliations

  1. Department of Urology, Mayo Clinic AZ, Phoenix, AZ, USA

    Logan G. Briggs, Adri M. Durant, Haidar Abdul-Muhsin & Mark D. Tyson

  2. Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA

    Logan G. Briggs, Matthew J. Van Ligten, Debarshi Sinha, Vikram S. Gill, Haidar Abdul-Muhsin & Mark D. Tyson

  3. Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Logan G. Briggs, Khalid Y. Alkhatib & Quoc-Dien Trinh

  4. Department of Urology, University of Washington Medical Center, Seattle, WA, USA

    Sarah P. Psutka

  5. Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA

    Kelsey L. Beck

  6. Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Khalid Y. Alkhatib & Phillip M. Pierorazio

  7. Countway Library, Harvard Medical School, Boston, MA, USA

    Paul A. Bain

  8. Department of Statistics, Mayo Clinic, Phoenix, AZ, USA

    Jaxon Quillen & Christopher Dodoo

  9. Division of Urology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Quoc-Dien Trinh

  10. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Phoenix, AZ, USA

    Sara C. Parke

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Contributions

L.G.B., M.J.V.L., K.L.B., D.S. and V.S.G., researched data for the article. S.C.P., L.G.B., S.P.P., P.A.B. and P.M.P. contributed substantially to discussion of the content. L.G.B., D.S., A.M.D. wrote the article. S.C.P., L.G.B., S.P.P., M.J.V.L., K.L.B., V.S.G., K.Y.A., A.M.D., P.A.B., J.Q., C.D., P.M.P., H.A.M., M.D.T. and Q.D.T. reviewed and/or edited the manuscript before submission.

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Correspondence to Sara C. Parke.

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Competing interests

L.G.B. reports consulting fees from Delfina Inc and Tolmar outside of the submitted work and research funding from the Office of Scholarly Engagement at Harvard Medical School. S.P.P. serves on the advisory board for Immunity Bio Merck and Pfizer, receives research funding from Bladder Cancer Advocacy Network and the National Institute on Aging, consulting fees from CG Oncology and Janssen, serves on the editorial boards for European Urology and Bladder Cancer, and serves on guidelines committees for AUA Upper Tract Urothelial Carcinoma and AUA Practice Guidelines Committee. K.Y.A. serves on the Board of Directors for the Testicular Cancer Awareness Foundation (uncompensated position). P.M.P. serves on the Board of Directors for the Testicular Cancer Awareness Foundation (uncompensated position) and on Testicular Cancer guidelines committees for the AUA and NCCN. Q.D.T. reports consulting fees from Astellas, Bayer, Intuitive Surgical, Janssen, Novartis and Pfizer, and research funding from the American Cancer Society, Pfizer Global Medical Grants (Prostate Cancer Disparities no. 63354905) and a Health Disparity Research Award from the Department of Defense Congressionally Directed Medical Research Program (no. PC220551). All other authors declare no competing interests.

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Briggs, L.G., Psutka, S.P., Van Ligten, M.J. et al. Exercise, diet and psychological support for patients with testicular cancer. Nat Rev Urol (2025). https://doi.org/10.1038/s41585-025-01089-5

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