Digital Public Defence: Ragnhild Veline Nome

Cand.med. Ragnhild Veline Nome at Institute of Clinical Medicine will be defending the thesis “Biochemical Changes in Testicular Cancer Survivors. –Pituitary, Renal and Thyroid function” for the degree of PhD (Philosophiae Doctor).

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

Click here to participate in the public defence

Download Zoom here

Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

Order a digital copy of the thesis here

Digital Trial Lecture – time and place

See Digital Trial Lecture.

Adjudication committee

  • First opponent: Associate Professor Kristin Moberg Aakre, Haukeland University Hospital
  • Second opponent: Senior Consultant Olof Ståhl, Skåne University Hospital
  • Third member and chair of the evaluation committee: Associate Professor Elisabeth Qvigstad, University of Oslo

Chair of the Defence

Professor Anne Hansen Ree, University of Oslo

Principal Supervisor

Professor Trine Bjøro, University of Oslo

Summary

Norway has one of the world’s highest incidence of testicular cancer and fortunately also high survival rates, leading to high prevalence of testicular cancer survivors (TCSs); >8 000 by 2019. Several Adverse Health Outcomes (AHOs) are reported in TCSs. Regular follow-up is recommended in national guidelines in order to diminish AHOs negative effect on health in TCSs with particular focus on cardiovascular disease and secondary malignancy.

The aims of this thesis were to assess biochemical AHOs in three different organ systems; the pituitary, renal and thyroid function in TCSs with exceptionally long follow-up.

The pituitary function was evaluated with the biochemical marker human Chorionic Gonadotropin (hCG) in TCSs compared to a reference population, in addition to the gonadotropic hormones LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone). The elevated levels of hCG, LH and FSH combined were consistent with a pituitary source of hCG as a physiological response to primary hypogonadism in tumor-free TCSs during follow-up. As hCG also is a tumor marker in testicular cancer, the study can be useful when elevated hCG is encountered during follow-up after treatment for testicular cancer.

The renal function was mildly reduced after chemo-and radio-therapy in TCSs, but end-stage kidney disease was rare. Mildly reduced kidney function is a known risk factor for cardiovascular disease in the general population, even though it has not been thoroughly evaluated in TCSs.

Lastly, the prevalence of thyroid hypofunction was doubled in TCSs compared to the general population, but could not be connected to a specific treatment modality. Thyroid hypofunction has not previously been recognized as an AHO after testicular cancer.

The biochemical markers of kidney and thyroid function could be relevant to include in the national guidelines for follow-up after testicular cancer, especially as if left untreated, both conditions could have negative effect on comorbidity in TCSs.

Additional information

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Published Jan. 14, 2022 1:15 PM - Last modified Jan. 14, 2022 1:20 PM