A Biobehavioral Intervention to Reduce Adverse Outcomes in Young Adult Testicular Cancer Survivors

Project Abstract This application is responsive to the call for “Administrative Supplements on Long-term Cancer Survivorship" and focuses on long-term young adult survivors of testicular cancer. Testicular cancer is the most common malignancy among young adult males. While survival rates exceed 95%, long-term survivors are at risk for persistent psychological distress, occupational disruption, cognitive concerns, and diminished quality of life. These late effects are especially concerning among those diagnosed in young adulthood—a developmental period marked by goal pursuits, identity formation, and career establishment. However, few studies have examined the self-regulatory mechanisms that may sustain resilience or contribute to risk across long-term survivorship. Our team is currently testing Goal-focused Emotion-Regulation Therapy (GET) in recently treated young adult testicular cancer survivors (parent award: R01CA276143). GET targets goal navigation and emotion regulation—two transdiagnostic skills central to adaptation. Preliminary data suggest GET improves psychological outcomes and stress biology in early survivorship. Yet, it remains unknown whether these core mechanisms remain relevant years after diagnosis. The objective of this cross-sectional supplemental study is to evaluate the biopsychosocial and occupational correlates of self-regulation in 100 long-term young adult testicular cancer survivors (≥5 years post-diagnosis, diagnosed at ages 18–39). We will 1) Characterize biopsychosocial and occupational burden (e.g., mood symptoms, cognitive concerns, fatigue, financial toxicity), alongside GET-targeted mechanisms (goal navigation, emotion regulation, personal agency); 2) Test associations between goal navigation and psychosocial, occupational, and biological outcomes. We hypothesize that stronger goal navigation relates to lower distress, better quality of life, and higher agency.; and 3) Examine emotion regulation in relation to these same outcomes. We anticipate that adaptive emotion regulation will be associated with more favorable functioning across all domains. Findings will clarify whether self-regulatory capacities remain operative in long-term survivorship, informing intervention adaptation, survivorship guidelines, and future longitudinal models of resilience in AYA cancer survivors.