About testicular cancer chemotherapy
This page tells you about chemotherapy for testicular cancer. There is information about
About chemotherapy for testicular cancer
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You may have chemotherapy to help prevent testicular cancer coming back after removal of the testicle. Or you may have it to treat cancer that has spread into lymph nodes or other parts of the body.
How you have chemotherapy
You usually have treatment with several different drugs as an outpatient. You normally have the drugs by injection into a vein, or through a drip, over a few days. Then you rest for a couple of weeks before the treatment is repeated. Each round of treatment is called a cycle.
For early testicular cancer, you may have only one or two cycles. The most commonly used treatment is a combination called BEP (or PEB), which is bleomycin, etoposide and cisplatin. If your cancer has spread, you may need 3 or 4 cycles or more. If the treatment does not completely get rid of the cancer your doctor can use other combinations of drugs.
High dose chemotherapy
You may be offered high dose chemotherapy treatment but this is not common. This means that very high doses of chemotherapy are used and they damage the bone marrow cells. To correct this, you have your own blood stem cells back through a drip after your chemotherapy. This type of treatment is sometimes called stem cell rescue or stem cell transplant. It is an intensive treatment and only used in clinical trials.
You can view and print the quick guides for all the pages in the Treating testicular cancer section.
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. The drugs circulate in the bloodstream around the body.
You may have chemotherapy for testicular cancer to
- Help prevent the cancer coming back after removal of the testicle (orchidectomy)
- Treat any cancer that has spread outside the testicle or has come back after removal of the testicle
- Treat testicular cancer that has come back after initial chemotherapy.
Testicular cancer cells can spread to the lymph glands that run alongside the major blood vessel in the abdomen – the aorta. These are called the para aortic lymph glands. The cancer can also spread to the lungs, and more rarely to other organs such as the brain and liver. If your doctor suspects this may have happened in your case, they may recommend that you have chemotherapy.
You usually have treatment with several different drugs. You normally have them by injection into a vein, or through a drip (intravenously). You usually have the drugs over a few days as an outpatient. 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
View a transcript of this video here. (Opens in a new window)
You may have chemotherapy to lower the chance of early stage cancer coming back after removal of a testicle. This is called adjuvant chemotherapy. For early stage seminoma you usually have 1 treatment with the drug carboplatin (Paraplatin).
If you have chemotherapy after surgery 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. Each treatment cycle takes 3 weeks. There is more information on our page about BEP. You may stay in hospital for a few days for chemotherapy in the first week, although some people have it as an outpatient. In the second and third week you have a weekly injection as an outpatient.
If you have treatment for cancer that has already spread or that came back during monitoring (surveillance) you usually have 3 or 4 cycles of BEP.
If you have raised markers in your blood, your doctor will use blood tests to check the markers and monitor how well the treatment is working. If the marker levels stay high you may need more cycles of chemotherapy.
Bleomycin can cause breathing problems in people who have lung conditions so then your doctor may recommend that you have 4 cycles of EP chemotherapy (etoposide and cisplatin) instead of BEP. Or the doctor may change the dose of bleomycin if you are at risk of breathing problems.
If BEP does not completely get rid of the testicular cancer or if it comes back again your doctor will recommend a different chemotherapy combination. They may suggest one of the following
- 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)
- High dose chemotherapy with etoposide and cisplatin as part of a clinical trial
You may be offered high dose treatment with carboplatin and etoposide. High dose treatment means that very high doses of chemotherapy are used that damage your bone marrow cells. To correct this, you have your own blood stem cells back through a drip after your chemotherapy.
Your blood stem cells are collected by machine before you have the chemotherapy and kept frozen in storage until you need them. This type of treatment is sometimes called stem cell rescue or stem cell transplant. It is intensive treatment and causes severe side effects. It is a very specialised type of treatment, and you may be referred to a different hospital to have it. At the moment it is only used as part of clinical trials. There is information about stem cell transplants in the cancer treatment section.
We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed therapies by alternative or complementary therapy practitioners.
Talk to your specialist about any other tablets or medicines you take while you are having cancer treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.
Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking, or thinking of taking, these supplements talk to your doctor to find out whether they could react with your treatment.
You can look at our main chemotherapy section. It explains the treatment in detail including
- What chemotherapy treatment involves
- How your doctor plans your chemotherapy
- How you have your treatment
- General side effects
- Side effects of particular chemotherapy drugs and drug combinations
- Living with chemotherapy
If you would like more information about anything to do with chemotherapy, you can contact our cancer information nurses. They would be happy to help. You can also contact one of the organisations on our testicular cancer information organisations page. They often have free factsheets and booklets that they can send to you. Some organisations can put you in touch with a cancer support group.
Our testicular cancer reading list has information about books and leaflets on treatments. If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or you can go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.
Rated 4 out of 5 based on 3 votes
Question about cancer? Contact our information nurse team