J Cancer Res Clin Oncol DOI 10.1007/s00432-006-0102-z 123 ORIGINAL PAPER Smoking cessation in long-term survivors of germ cell tumour Marcus Hentrich · Martin J. Fegg · Stephanie Meiler · Christoph Jost · Arthur Gerl Received: 4 November 2005 / Accepted: 18 April 2006  Springer-Verlag 2006 Abstract Purpose Long-term survivors of germ cell tumours (GCT) are at increased risk of cardiovascular morbid- ity. We investigated the use of tobacco in patients after therapy for GCT. Methods Four hundred and seventy-four patients treated between 1979 and 2000 at the University of Munich were asked to complete a self-report question- naire on psychosocial dimensions which included items on tobacco smoking before and after treatment of GCT. Results Three hundred and forty-one patients (72%) returned a completed questionnaire. The median fol- low-up period was 9.6 years. 160 of 341 patients (47%) reported to smoke at the time of GCT diagnosis. Of those, 134 (84%) had changed their smoking behavior with 32 patients (20%) having reduced, 56 (35%) hav- ing intermittently quitted and 46 (29%) having deWni- tively quitted smoking. Patients reduced or stopped smoking irrespective of tumour histology, tumour stage, whether they had received chemotherapy or not, and irrespective of the number of chemotherapy courses applied. Conclusion Most patients changed their habit of tobacco smoking after diagnosis and treatment of GCT but only a minority of patients are sustained quitters. Patients with GCT should be strongly encouraged to stop smok- ing or to participate in smoking cessation programs. Keywords Germ cell tumours · Testis cancer · Smoking cessation · Smoking habits · Long-term survivors Introduction Modern cisplatin based multi-modality therapy of tes- ticular germ cell tumours (GCT) has resulted in cure rates as high as 80–90% (International Germ Cell Can- cer Collaborative Group 1997; Gerl 2000). However, long-term survivors of testicular GCT have been found to be at increased risk of developing cardiovascular morbidity and second cancer (Stoter et al. 1989; Gie- tema et al. 1992; Bokemeyer et al. 1996; Huddart et al. 2003). After chemotherapy for GCT about 15–39% of patients have arterial hypertension (Meinardi et al. 2000; Strumberg et al. 2002). A recent study following almost 1,000 patients with GCT reported an increased risk for cardiac events after chemotherapy (relative risk, 2.6), radiotherapy (relative risk, 2.4) and both, chemotherapy and radiotherapy (relative risk, 2.8) (Huddart et al. 2003). Cigarette smoking is the most signiWcant source of preventable morbidity and premature mortality in developed countries (Newcomb and Carbone 1992; M. Hentrich (&) Interdisciplinary Tumour Center, Harlaching Hospital, Academic Teaching Hospital of the University of Munich, Sanatoriumsplatz 2, 81545 Munich, Germany e-mail: tumortumorzentrum.hentrich@khmh.de M. J. Fegg Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University Munich, Munich, Germany S. Meiler · C. Jost · A. Gerl Department of Internal Medicine III, Ludwig-Maximilians-University Munich, Munich, Germany A. Gerl Oncology Practice, Munich, Germany