Cured but What's Next? Rethinking Survivorship Care for Adolescent and Young Adult Testicular Cancer Survivors.
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The excellent cure rates achieved in testicular cancer represent one of oncology's major success stories. Decades of research have optimized survival, leading to cure for nearly all patients with localized disease and most with metastatic disease. As a result, attention is increasingly shifting from survival alone to reducing treatment burden and long-term toxicity while improving quality of life in this predominantly young population with decades-long life expectancy. However, many adolescent and young adult survivors experience persistent physical, psychological, and social consequences that are insufficiently addressed by conventional follow-up care. Current survivorship models remain largely centered on relapse surveillance and provide limited education or support for understanding late effects, managing uncertainty, or developing long-term self-management skills. Limited empowerment may undermine sustained engagement with follow-up care and long-term well-being. This article makes the case for a shift from hospital-centered information delivery models toward more engaging, experiential, patient-centered survivorship frameworks. We propose extended reality-based immersive and interactive digital technologies as enabling tools within a broader survivorship framework designed to support understanding, early symptom recognition, engagement, and shared decision-making beyond scheduled hospital visits. Using the TRANSCEND-XR consortium as an illustrative example, we discuss how co-designed digital interventions may help bridge the gap between cure and long-term quality of life while addressing key clinical, ethical, and implementation challenges relevant to scalability. PATIENT SUMMARY: Many young people cured of testicular cancer experience long-term physical and emotional challenges that are not fully addressed by routine follow-up care. We describe a new approach using extended reality technologies to help survivors better understand late effects, recognize symptoms early, and take a more active role in their care. Such approaches aim to improve quality of life, support long-term well-being, and facilitate a successful transition from cancer treatment to life beyond cancer. Clinical trial identification: n°IDRCB: 2026-A00740-51. ClinicalTrials.gov ID: NCT07571499. Sponsor legal entity: Gustave Roussy Institute, France.