Although bleomycin pulmonary toxic effects may occur, it is rarely fatal at total cumulative doses below 400 units. However, because life-threatening pulmonary toxic effects can occur, the drug should be discontinued if early signs of pulmonary toxic effects develop. Although decreases in pulmonary function are frequent, they are rarely symptomatic and are reversible after the completion of chemotherapy. No clear long-term effects on coronary artery disease have been shown. These include cancers of the stomach, bladder, colon, rectum, and possibly the pancreas.
Many patients have oligospermia or sperm abnormalities prior to therapy.
Depending on scatter dose, sperm counts fall after radiation, but may recover over the course of 1 to 2 years. Shielding techniques can be used to decrease the radiation scatter to the remaining normal testicle. Though testicular cancer is highly curable, all newly diagnosed patients are appropriately considered candidates for clinical trials designed to decrease morbidity of treatment while further improving cure rates. Bosl GJ, Bajorin DF, Sheinfeld J, et al. Cancer of the testis.