Dr. Timothy Gilligan is a medical oncologist, Vice-Chair for Education, and Associate Professor of Medicine at the Cleveland Clinic Taussig Cancer Institute. He is a graduate of the Stanford University School of Medicine and Columbia University Graduate School of Journalism. Following his studies, he trained in internal medicine and medical oncology at Brigham and Women’s Hospital and the Dana-Farber Cancer Institute in Boston, Massachusetts. In addition, he completed the American Academy on Communication in Healthcare’s three-year facilitator training program and is now a member of their faculty and board of directors and serves as co-director of their faculty training program.

Dr. Gilligan is an internationally recognized expert on testis cancer and has a particular interest in testis cancer survivorship. He has contributed to a range of national and international guidelines on the disease and currently chairs the NCCN Testis Cancer panel. He has also co-authored numerous review articles and book chapters on testis cancer. He has given educational talks on testis cancer at the annual meetings of ASCO and ASTRO as well as at numerous board review courses. In addition, at Cleveland Clinic and other hospitals and at national and international conferences, he teaches communication skills, team-building, and coaching, and trains others to teach communication skills.

Dr. Gilligan works on quality of care and clinical practice guidelines with the American Society of Clinical Oncology (ASCO) and the U.S. National Cancer Institute. He helped develop and serves on the faculty and steering committee of the ASCO Quality Training Program, and co-chaired the ASCO panel that wrote the society’s guideline on patient-clinician communication.

Survivorship Issues in Genitourinary Malignancies
Timothy Gilligan, MD, MS, FASCO
Associate Professor of Medicine and vice-Chair for Education
Cleveland Clinic Taussig Cancer Institute
Cleveland, Ohio, USA

Abstract:
Urological cancers are a diverse group of diseases affecting men at different ages with a variety of different survivorship issues. Testicular germ cell tumors are diagnosed mostly between the ages of 20 and 40 years and is the most common cancer among young adult men. Over 95% of men are cured.

However, treatment has been associated with increased risks of secondary malignancies, cardiovascular disease, hypogonadism and other ailments. Prostate cancer is the most common cancer in men overall and a leading cause of cancer-related death. The incidence peaks between the ages of 65 and 80 years.

Local therapies can result in urinary incontinence and erectile dysfunction, and systemic hormonal therapy is associated with sexual dysfunction, an increased risk of cardiovascular events and a variety of metabolic and body-composition changes.

Survivorship has been less well studied in bladder and kidney cancers and most of the data is from patients who underwent radical cystectomy for bladder cancer.

Sexual dysfunction and issues related to urinary diversions and continence predominate. For both kidney and bladder cancers, however, immunotherapy with immune-checkpoint inhibitors plays a growing role and such treatment is associated with numerous autoimmune complications, including pneumonitis, myocarditis, colitis, dermatitis and hypophysitis.

This presentation will review the issues above and highlight high-priority areas for future research.