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Bleomycin, etoposide and platinum (BEP)

What BEP chemotherapy is, how you have it and other important information.

BEP is commonly used as a treatment for men with testicular cancer. It's a combination of 3 chemotherapy drugs: 

  • bleomycin
  • etoposide
  • platinum (cisplatin)

Doctors may also use BEP to treat a rare type of ovarian cancer called teratoma of the ovary. 

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have BEP

You have these drugs into your bloodstream, usually through a long line: a central line, a PICC line or a portacath.

These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.

When you have it

You usually have BEP as a course of several cycles of treatment. A cycle of treatment is the time between 1 round of treatment and the start of another. Usually each treatment cycle lasts 3 weeks (21 days). The first day of treatment cycle is called day 1. 

You might have between 2 and 4 treatment cycles. The number of cycles you have depends on:

  • whether your cancer has spread
  • how well your cancer responds to BEP

If you have an early testicular cancer, you may have 2 treatment cycles of BEP. This is to stop the cancer from coming back (recurrence). 

If your testicular cancer has spread to another part of your body, you may have 3 or more treatment cycles. 

You can have BEP in different ways. A common way of having BEP is:

Day 1
  • etoposide as an injection into your bloodstream (intravenously)
  • cisplatin as an injection into your bloodstream over 1 to 4 hours
  • bleomycin as an injection into your bloodstream (you might have bleomycin on day 2 instead of day 1)
Day 2
  • etoposide as an injection into your bloodstream
  • cisplatin as an injection into your bloodstream
Day 3
  • etoposide as an injection into your bloodstream
Day 8
  • bleomycin as an injection into your bloodstream
Day 15
  • bleomycin as an injection into your bloodstream

Another way of having BEP chemotherapy is:

Day 1
  • etoposide as an injection into your bloodstream
  • cisplatin as an injection into your bloodstream
  • bleomycin as an injection into your bloodstream (you might have bleomycin on day 2 instead of day 1)
Day 2
  • cisplatin as an injection into your bloodstream
  • etoposide as an injection into your bloodstream
Day 3, 4 and 5
  • etoposide as an injection into your bloodstream
  • cisplatin as an injection into your bloodstream
Day 8
  • bleomycin as an injection into your bloodstream
Day 15
  • bleomycin as an injection into your bloodstream

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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