Chemotherapy for testicular cancer

Find out when and how you have chemotherapy for testicular cancer and the possible side effects.

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).


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

COVID swab test

Due to coronavirus, you need to have a test to check for coronavirus before you have treatment. The test is called a COVID swab test.

To have the test your nurse takes a sample from the inside of your nose and the back of your throat. They use a long cotton bud to take the sample. Or the sample might be saliva or other fluid. Depending on which test your hospital uses, it can take from 90 minutes to a few days to get a result.

At most hospitals, you have a COVID swab test 48 to 72 hours (up to 3 days) before going for your treatment in the chemotherapy unit.

This means you might have the swab test on the same day that you visit the hospital for blood tests and your doctor’s clinic appointment. If you have treatment weekly or more often, some hospitals will ask you to have the swab test on the day of treatment.

Check with your team about when you’ll have the test as there are some differences between hospitals.

Blood tests

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.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that 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 (teratoma) you usually have 1 cycle 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
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C, 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 a few days or so. Your treatment team can help to manage any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

  • take any supplements
  • have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. They 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: 
15 Dec 2017
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