VeIP is a combination of chemotherapy drugs made up of:
- Ve – vinblastine
- I – ifosfamide
- P – cisplatin
It is a treatment for testicular cancer that has spread or come back.
How VeIP works
The chemotherapy drugs in VeIP destroy quickly dividing cells, such as cancer cells.
How you have it
You have VeIP into your bloodstream (intravenously).
You 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
If you don't have a central line
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
When you have VeIP
You usually have VeIP as cycles of treatment. A cycle of treatment means that you have a combination of drugs, and then have a rest to allow your body to recover. Each cycle lasts 3 weeks (21 days).
You have 4 cycles, taking around 3 months in total. You may need to stay in hospital for the first 5 days of each cycle.
You might have VeIP in the following way:
- You have vinblastine as a drip over 10 minutes.
- You have cisplatin as a drip over 2 hours.
- You have ifosfamide as a drip over 1 hour.
- You have cisplatin as a drip over 2 hours.
- You have ifosfamide as a drip over 1 hour.
- You have no treatment.
You also have fluids and a drug called mesna. You have this as a drip into your bloodstream. Mesna isn't chemotherapy. It helps to stop the ifosfamide from irritating your bladder and making it bleed.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely 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.
Common side effects
These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:
Increased risk of infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally 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.
High temperature (fever)
If you get a high temperature, let your health care team know straight away. Ask them if you can take paracetamol to help lower your temperature.
Bruising, bleeding gums or nose bleeds
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 (known as petechiae).
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all 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 treating it once it has started.
Hair loss or thinning
You could lose all your hair or it may just thin. This can affect your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will grow back once treatment has finished. But it is likely to be softer. And it may grow back a different colour or be curlier than before.
Irritation of the bladder and kidneys
This treatment can irritate your bladder and kidneys. Drink as much water as possible to flush out the drugs. Make sure that you pass urine often, especially before you go to sleep. You’ll also have a drug called Mesna to protect your bladder and kidneys.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Tiredness and weakness (fatigue)
Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Loss of appetite and weight loss
You might not feel like eating and may lose weight. It is important to eat as much as you can. 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.
Changes in levels of minerals in your blood
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 might also have low magnesium but this is rare.
You have regular blood tests during treatment to check this.
Tummy (abdominal) pain
Tell your doctor or nurse if you have this. They can check for the cause of the pain and give you medicine to help.
Sore mouth and ulcers
Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges, lemons and grapefruits; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.
Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.
Changes to your hearing
You might have some hearing loss, especially with high pitched sounds. You might also have some ringing in your ears (tinnitus). Tell your doctor or nurse if you notice any changes.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:
- a severe whole body infection that can be life threatening (sepsis)
- heart problems such as slow, fast or irregular heartbeat – rarely this can cause a heart attack
- liver changes – these are usually mild and unlikely to cause symptoms, you have regular blood tests to check for changes
- swelling and pain around the drip site
- numbness and tingling in the fingers and toes
- metallic taste in your mouth
- jaw pain
- 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
Rare side effects
These side effects happen in fewer than 1 in 100 people (1%). 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
- a second cancer called acute leukaemia
- low blood pressure
- skin problems that can cause rash, dry skin, itching and blistering
Other side effects
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:
- high blood pressure
- pain in your muscles, bones and tumour site
- loss of reflexes
- feeling very thirsty and dry mouth
- high levels of uric acid and other substances in your body caused by the break down of tumour cells
- difficulty controlling your bowels
- difficulty speaking
- problems with your balance
- redness of the skin
- soreness, redness, peeling on palms and soles of the feet
- 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
For more information about the side effects of individual drugs:
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Loss of fertility
You may not be able to become pregnant or father a child 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.
Contraception and pregnancy
This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don’t breastfeed during this treatment because the drugs may come through in your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
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, yellow fever and the shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.