This patient is most likely to develop metabolic syndrome. Following treatment of testicular germ cell tumors, men remain at risk for both recurrent cancer and many other long-term medical complications. Although some complications occur during or soon after treatment, others develop years after initial therapy, particularly as many patients are relatively young at the time of diagnosis. The risks for an individual patient are associated with the type of treatment given. Both radiation therapy and chemotherapy are associated with specific risks. Among these is an increased risk for development of metabolic syndrome (insulin resistance, hypertension, dyslipidemia, abdominal obesity). The risk is particularly increased in men treated with combination chemotherapy. Data indicate that the risk for cardiovascular diseases (such as ischemic coronary disease, heart failure, peripheral vascular disease) is also increased in this patient population. Additional risks associated with treatment of testicular cancer that would be relevant to this specific patient include kidney disease, peripheral neuropathy, chronic pulmonary toxicity, secondary malignancy, and sexual dysfunction. Most of these would be evident either during or soon after completion of treatment. Secondary malignancy typically develops years following treatment.

The risk of gastric and duodenal ulcer disease is increased slightly in men treated with radiation therapy, which this patient did not have.

Obstructive uropathy is only rarely associated with treatment of testicular cancer, and that association occurs only in men treated with radiation therapy.

The risk of secondary solid tumors is increased in patients treated for testicular cancer, with the most common sites of involvement being the lung, colon, bladder, pancreas, and stomach. Soft tissue sarcomas are not commonly reported in these patients in the absence of radiotherapy, which is known to increase the risk of soft tissue sarcoma, typically diagnosed many years after treatment. As the patient in this case was not treated with radiation, he would not be expected to have an increased risk of soft tissue sarcoma.