Chemotherapy for testicular cancer

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs travel around the bloodstream and can reach cancer cells anywhere in the body.

The drugs most commonly used to treat testicular cancer are bleomycin, etoposide and cisplatin. This combination is known as BEP chemotherapy. Other combinations of drugs are also used depending on the stage and type of the cancer, or if it’s come back after treatment.

Chemotherapy for testicular cancer is given:

  • after surgery, to reduce the risk of testicular cancer coming back (adjuvant chemotherapy)
  • to treat testicular cancer that has spread outside the testicle or come back after an orchidectomy
  • to treat testicular cancer that has come back after initial chemotherapy.

Adjuvant chemotherapy

If you have early (stage 1) non-seminoma, you’ll normally have one to two cycles of BEP, usually given three weeks apart.

If you have early (stage 1) seminoma, you’ll usually have a single treatment with a drug called carboplatin.

If the cancer has spread or comes back during surveillance

If testicular cancer has spread outside the testicle, or comes back during surveillance, you may have three or four cycles of BEP. Occasionally, the bleomycin is left out and four cycles of EP (etoposide and cisplatin) are given instead. Bleomycin may cause breathing problems in men who already have a lung condition.

If the cancer doesn’t completely respond to BEP, or it comes back again, you’ll usually be given more intensive chemotherapy. Some men, depending on the stage of the cancer, are given more intensive chemotherapy straight away.

Some drug combinations that may be used are:

PEI (cisplatin, etoposide, ifosfamide) – this drug combination is also sometimes called VIP

TIP (paclitaxel, ifosfamide, cisplatin)

VeIP (vinblastine, ifosfamide, cisplatin)

Occasionally, high-dose chemotherapy with stem cell support is given. This may be as part of a clinical trial.

How chemotherapy is given

You usually have the chemotherapy drugs as an outpatient. The drugs are usually given  into a vein as an injection or as a drip (infusion). This is called intravenous chemotherapy.

The drugs may be given through:

  • a thin, flexible tube inserted into a vein in the back of your hand (cannula).
  • a plastic line called a central line, which is put into a vein in your chest
  • a thin tube inserted into a vein in your arm near the bend of your elbow (PICC line).

Chemotherapy is given in cycles of treatment. A cycle usually takes three weeks. If you’re having BEP, you’ll usually spend 3 -5 days going to hospital as an outpatient. Sometimes you’ll stay overnight.

This is followed by weekly outpatient visits to have the rest of your treatment. Other combinations of chemotherapy drugs may involve spending more time in hospital and having the drugs more often. Your doctor or nurse will tell you how many cycles of treatment are planned for you and explain how you’ll be given your chemotherapy.

I was given chemotherapy by a Macmillan nurse. Once I was hooked up she just stayed and chatted with me. She was fantastic.

David, affected by cancer

Back to Chemotherapy explained

Where can you have chemotherapy?

You usually have chemotherapy in a chemotherapy day unit or clinic. If your treatment is more complex, you may need to stay in hospital.