History of testicular cancer chemotherapy: maximizing efficacy, minimizing toxicity.

All patients presenting with metastatic testis cancer should be treated with the goal of cure. However, all physicians treating patients with germ cell tumors need to be aware of the toxicities of chemotherapy. Because many patients are cured of their disease, both short-term and long-term toxicities have been identified. The short-term toxicities are myelosuppression, nausea and vomiting, pulmonary toxicity, nephropathy, and neuropathy. The longer term toxicities often discussed are ototoxicity, impairment of fertility, persistent neuropathy or ototoxicity, cardiovascular diseases, and secondary malignancies, which are all described in this review.