Cancer drugs A to Z list
BEP is a combination of chemotherapy drugs. You have:
bleomycin (blee-o-my-sin)
etoposide (ee-top-o-side)
cisplatin (sis-plat-in) - this is a platinum drug and stands for the P in BEP
It is a treatment for testicular cancer, a type of germ cell tumour of the ovary called teratoma and sex cord stromal tumours.
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These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
You have these drugs into your bloodstream (intravenously). Or you might have bleomycin as an injection into your muscle.
You have the injection into a muscle, usually into your buttock or upper thigh.
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
central line
PICC line
portacath
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.
When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling.
Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.
You usually have BEP as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover.
Each cycle of treatment usually lasts 21 days (3 weeks). You might have up to 4 cycles of treatment.
Exactly how you have the cancer drugs depends on your situation. Your doctor, nurse or pharmacist will tell you how you will have it. The following is an example of how you might have BEP over 3 or 5 days.
You have etoposide as a drip into your bloodstream (intravenously) over 60 minutes.
You have cisplatin as a drip into your bloodstream over 90 minutes.
You have bleomycin as a drip into your bloodstream over 30 minutes.
You have etoposide as a drip into your bloodstream over 60 minutes.
You have cisplatin as a drip into your bloodstream over 90 minutes.
You have etoposide as a drip into your bloodstream over 60 minutes.
You have no treatment.
You have bleomycin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You have bleomycin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You then start the next cycle of treatment.
You have etoposide as a drip into your bloodstream over 1 hour.
You have cisplatin as a drip into your bloodstream over 90 minutes.
You have bleomycin as a drip into your bloodstream over 30 minutes.
You have cisplatin as a drip into your bloodstream over 90 minutes.
You have etoposide as a drip into your bloodstream over 60 minutes.
You have cisplatin as a drip into your bloodstream over 90 minutes.
You have etoposide as a drip into your bloodstream over 60 minutes.
You have bleomycin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You have bleomycin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You then start the next cycle of treatment.
You also usually have a drug called granulocyte colony stimulating factor (G-CSF). This makes your produce more quickly after treatment. It helps lower your risk of getting an infection.
This is an injection under the skin (subcutaneous). Your doctor will tell you when you need to have it.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
You might have a chest x-ray before each treatment of BEP.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. 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. This is known as petechiae.
You might be breathless and look pale due to a drop in . This is called anaemia.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Sickness is a common side effect with this treatment. Speak to your doctor if your sickness is not controlled.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a if needed.
You might develop a cough or breathing problems. This could be due to infection, such as pneumonia or inflammation of the lungs (pneumonitis). It might also be because of scaring on the lung (fibrosis).
Less commonly you might develop a life-threatening breathing problem this is called acute respiratory distress syndrome (ARDS) or lung failure.
Let your team know straight away if you suddenly become breathless, have changes in your breathing, feel faint due to not being able to breath properly, feel drowsy or confused or are getting very tired.
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.
The colour of your skin might also get darker. Your skin might have areas of thickening and your fingertips might be tender or swell.
There might be changes to the shapes and colour of your nails.
Rarely you might have reddening of the skin in areas treated with radiotherapy. Or a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening.
Contact your advice line if you have this. Depending on what is causing the pain, they might give you medicine to help.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
You have regular blood tests to check for any changes in the way your liver is working.
You might also have yellowing of the skin and whites of the eyes.
This is usually mild. You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard and eat a well balanced diet.
Talk to your doctor or nurse if this effect is stopping you from doing your usual daily activities.
You may have changes in levels of minerals and salts in your blood, including low levels of sodium or high levels of uric acid (causing gout). You have regular blood tests during treatment to check this.
It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy.
Rarely you might get red, cracked painful sores at the corners of your mouth.
The lining of your throat, gut and bowels might become sore and swollen. Contact your healthcare advice line or tell a member of your healthcare team if this happens.
Your fingertips might become swollen and tender. Contact your healthcare advice line or tell a member of your healthcare team if this happens.
You may get ringing in your ears (tinnitus). You may have some hearing loss, especially with high pitched sounds.
These changes can be either temporary or permanent. Tell your doctor or nurse if you notice any changes.
To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have blood tests before your treatments to check how well your kidneys are working.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness. Some allergic reactions can be life threatening, alert your nurse or doctor if notice any of these symptoms
blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
sepsis is a serious reaction to an infection - signs can include feeling very unwell, not passing urine, a very high or very low temperature, shivering, slurred speech or confusion, breathlessness, mottled or discoloured skin, extreme shivering or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms
fluid build up in different parts of the body (oedema)
developing a blood cancer (leukaemia)
heart problems such as your heart beating fast or slow and
high blood pressure. You might have low blood pressure during your etoposide treatment if it is given too quickly
redness, swelling and pain around the injection site. Tell your nurse if this happens
headaches
dizziness
a high temperature (fever) and chills
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
pain where the cancer is
confusion
low blood pressure
nerve changes causing pain or numbness in the hands, feet or both
inflammation of the vein (phlebitis)
thickening of the walls of the veins
fluid filled blisters at pressure points on your skin
muscle and joint pain
lack of blood flow to part of the brain (a stroke) – call 999 if you have face or arm weakness, or have speech problems such as slurring your words
scleroderma an autoimmune condition. It can cause areas of thick, hardened skin and sometimes weak muscles, stiff joints, problems with the bones, organs and blood vessels
problems peeing including, not being able to pee or discomfort when peeing
inflammation of the blood vessels in the brain
a fit (seizure)
eyesight changes such as pain with eye movement and temporary loss of sight
abnormal sperm production in men
taste changes
difficulty swallowing
unusually cold hands and feet and your skin may look very pale – this is due to your blood not flowing properly (Raynaud’s phenomenon)
severe bleeding
a rare disorder of the nerves causing headaches, fits, confusion and changes in vision - contact your healthcare team straight away. This condition is usually reversible
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome) - you have regular blood tests to check for this
hiccups
dehydration
a sudden sharp pain or electrical buzzing feeling down your neck and spine and may go into your arms and legs
If you have side effects that aren't listed on this page, you can look at the individual drug pages:
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
You may not be able to become pregnant or get someone pregnant after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for at least 6 months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Don’t breastfeed during this treatment. This is because the drugs may come through in your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about each drug and the possible side effects go to the electronic Medicines Compendium (eMC) website. You can find patient information leaflets for each drug on this website.
You can report any side effect you have to the Medicines and Healthcare Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 07 Jul 2026
Next review due: 07 Jul 2029
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
Germ cell tumours develop from germ cells. These are the cells that become sperm or eggs. Some germ cell tumours are non cancerous (benign). And some are cancerous (malignant).
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