This page tells you about the chemotherapy drug combination VeIP for testicular cancer and its possible side effects. There is information about
VeIP is the name of a combination of chemotherapy drugs used to treat testicular cancer that has spread or come back. It is made up of the drugs
- Ve – Vinblastine
- I – Ifosfamide
- P – CisPlatin
The chemotherapy drugs in the VeIP combination destroy quickly dividing cells such as cancer cells.
You have the drugs into your bloodstream. You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having cancer drugs.
You usually have VeIP chemotherapy as cycles of treatment. Each cycle lasts 3 weeks (21 days). You have 4 cycles, taking 12 weeks (3 months) in total. You may need to stay in hospital for the first 5 days of each cycle.
- On the 1st and 2nd day of treatment (days 1 and 2) you have vinblastine into a vein over 10 minutes alongside fluids given by drip. You then have cisplatin for 4 hours and then ifosfamide for 2 hours
- On days 3 to 5 you have ifosfamide and cisplatin in the same way as day 1 and 2
- From day 6 to day 21 you have no treatment
- You then start your next cycle of treatment
When you have ifosfamide you also have the drug mesna. Mesna helps to stop ifosfamide from irritating your bladder and making the lining bleed.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.
We've listed the side effects associated with VeIP below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few of the side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drugs you have (the dose)
- Other drugs you are having
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of these effects.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Breathlessness and looking pale due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick is usually well controlled with anti sickness medicines. Let your doctor or nurse know if you feel sick
- Kidney changes – you will have blood tests before your treatment to make sure your kidneys are working well. To help prevent damage it is important to drink plenty of water. You will also have fluids into your vein before and after your treatment
- Some hearing loss happens in about 3 in 10 people (30%). You may not be able to hear high pitched sounds and may also have ringing in the ears (tinnitus). This nearly always gets better on its own once the treatment ends
- Hair loss – most people have complete hair loss but the hair will grow back once the treatment ends
- Diarrhoea or constipation – drink plenty of fluids and let your doctor or nurse know if it continues for more than 3 days
- A sore mouth and tongue swelling
- Loss of fertility – you may not be able to 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. You may be able to store sperm before starting treatment
- Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks and usually goes within a few months of finishing treatment. Some people may have permanent numbness
- Skin and nail changes, including reddening or darkening of your skin
- Loss of taste or a metallic taste
- Loss of appetite
Between 1 and 10 in every 100 people have one or more of these effects.
- Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your chemotherapy nurse straight away
- Irritation of the bladder – drink as much water as possible to flush out the drugs. You may have fluids into your drip before and after your treatment. Make sure that you pass urine often during the day and before you go to sleep
- Liver changes that are very mild and unlikely to cause symptoms. These will almost certainly go back to normal when treatment ends
- About 1 person in 8 has confusion, sleepiness or extreme lack of energy (lethargy) and hallucinations with ifosfamide – if you have any of these, it is important to tell your doctor or nurse straight away
Fewer than 1 in 100 people have these effects.
- A severe allergic reaction while having VeIP treatment, usually at the 1st or 2nd treatment – let your nurse or doctor know straight away if you have a sudden skin rash, itching, breathlessness or swelling of the lips, face or throat
- Abdominal (tummy) pain
- High blood pressure
- Jaw pain
- A faster heart rate
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor, nurse or pharmacist about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
These drugs may have a harmful effect on a baby developing in the womb. It is not advisable to father a child if you are having this treatment or for a few months afterwards. Talk about effective contraception with your doctor or nurse before starting the treatment.
You shouldn't have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page doesn't list all the very rare side effects of this treatment that are very unlikely to affect you. For further information about these drugs look at the Electronic Medicines Compendium website at www.medicines.org.uk. You will need to look at each drug individually.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at yellowcard.mhra.gov.uk.
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