Testicular cancer chemotherapy side effects

All chemotherapy increases your risk of infection. This is because the chemotherapy lowers your white blood cell count. If you get a temperature, or other signs of infection such as a cough, you should contact your hospital doctor straight away. If you have an infection, you may need antibiotics to treat it. There is more about infection and other general side effects of chemotherapy in the main chemotherapy section of CancerHelp UK.

Men with testicular cancer are often treated with a combination of drugs called BEP

• Bleomycin
• Etoposide
• Cisplatin

Treatment with BEP may cause

• Sickness
• Hair loss
• Low blood cell count
• A flu like reaction, with fever and chills
• Changes in your skin and nails (including dark lines on the skin which take a few months to fade after treatment)
• Mouth sores
• Changes in hearing
• Taste changes
• Pins and needles in fingers and toes

Many of these side effects can be reduced with medicines that your doctor or nurse can prescribe. So do let them know if you have any side effects. Paracetamol may help reduce flu like symptoms. Your doctor or nurse will give you mouthwashes to help stop mouth ulcers getting infected and to reduce soreness. All these side effects will improve after your treatment has ended. Mostly they will go altogether. Your hair will grow back after 3 to 6 months.

Many men who lose their hair decide to wear a wig or a hat. Most patients can get a free wig from the NHS. Your doctor or nurse can arrange for a wig specialist to visit you.

Most people do not have permanent side effects. But some may have side effects that do not disappear completely. Your doctor or nurse will monitor you for any side effects once your treatment has ended. It is important to let them know if you have side effects because they can often suggest things to help. Occasionally permanent side effects include

• Infertility (inability to father a child)
• Lung changes
• Hearing changes
• Numbness or tingling in fingers and toes

You should use contraception while you are having chemotherapy and for a couple of months afterwards. The drugs may damage your sperm so it is not a good idea to father a child during this time. You may be infertile for a while after treatment. But many men regain their fertility. There is more about this in CancerHelp UK.

Lung changes

Bleomycin can sometimes cause inflammation in your lungs. Usually this is mild, but rarely it can be permanent. If you notice any breathlessness or develop a cough while you are being treated, you should tell your specialist straight away. It may be necessary to change your dose, or change to another drug.

Hearing changes

Cisplatin can affect your hearing. Some men develop ringing in the ears. Sometimes hearing is affected permanently, with a loss of hearing of high pitched sounds. The range of sound affected is outside the normal level of speech, so it is very unusual for anyone to need to have any sort of hearing aid after this treatment. But you should tell your specialist if you notice any hearing difficulties.

Numbness or tingling in your fingers and toes

Cisplatin can also cause numbness and tingling in the fingers and toes. This is because the drug is affecting your nerves. You may find it more difficult to do fiddly things, such as doing up buttons or even writing. This usually gets better slowly, after you finish the treatment. But sometimes people treated with cisplatin do have permanent nerve damage. Again, tell your specialist if you notice any problems.

There are books and booklets about chemotherapy side effects, some of which are free. Look at the testicular cancer reading list page for details.