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Chemotherapy for testicular cancer

When and how you may have chemotherapy for testicular cancer, and the side effects this can have.

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate around your body in the bloodstream. They work by disrupting the growth of cancer cells.

When you have chemotherapy

You might have chemotherapy to:

  • help prevent the cancer coming back after you've had a testicle removed (called adjuvant chemotherapy)
  • treat cancer that has come back after initial treatment
  • treat cancer that has spread outside the testicle

Testicular cancer cells can spread to the lymph glands that run alongside the major blood vessel in the tummy (abdomen) – the aorta. These are called the para aortic lymph glands.

The cancer can also spread to the lungs. More rarely it can spread to organs such as the brain and liver.

Diagram showing the pelvic and para aortic lymph nodes

How you have chemotherapy

You usually have treatment with a combination of chemotherapy drugs. You have the drugs into your bloodstream by injection or through a drip (intravenously).

Cycles

You usually have the drugs over a few days at a cancer day clinic. Then you rest for a couple of weeks before repeating the treatment.

Each round of treatment is called a cycle. The number of cycles you have depends on:

  • whether your cancer has spread
  • how well your cancer responds to the drugs

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through. It’s worked out based on your weight, height and general health.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You’ll sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

After surgery (adjuvant chemotherapy)

You might have chemotherapy after surgery to remove a testicle. This treatment lowers the chance of early stage cancer coming back. It is called adjuvant chemotherapy.

For early stage seminoma you usually have 1 treatment with the drug carboplatin (Paraplatin).

For early stage non seminoma you usually have 2 cycles with a combination of chemotherapy drugs called BEP or PEB. BEP contains the drugs bleomycin, etoposide and cisplatin.

If cancer has spread or come back

You might have chemotherapy with the BEP drug combination if your cancer has spread or comes back during monitoring (surveillance)

You have 3 or 4 treatment cycles. Your doctor might use blood tests to check how well the treatment is working. 

Or you might have treatment with:

  • PEI (cisplatin, etoposide, ifosfamide) – this drug combination is also called VIP
  • TIP (paclitaxel (Taxol), ifosfamide, cisplatin)
  • VeIP (vinblastine, ifosfamide, cisplatin)
  • POMB/ACE (cisplatin, vincristine, methotrexate, bleomycin, actinomycin, cyclophosphamide and etoposide)

These treatments can make you infertile. So your doctor usually offers you the chance to bank sperm before you start the chemotherapy.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
Contact the doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for the few days that you’re having the chemotherapy drugs. The team caring for you can help to reduce your side effects.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you take any supplements or if you’re prescribed them by alternative or complementary therapy practitioners.

It’s uncertain how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful.

When you go home

Chemotherapy for testicular cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Last reviewed: 
23 Jan 2015
  • Testicular seminoma and non seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    J Oldenburg and others
    Annals of Oncology, 2013, 24 (supplement 6 ): vi125-vi132

  • Guidelines on Testicular Cancer
    P Albers (chairman) and others
    European Association of Urology, 2012

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