TIP is used to treat testicular cancer and a rare cancer of the ovary called malignant germ cell tumour. It is best to read this information with our general information about chemotherapy and the type of cancer you have.
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TIP is a combination treatment used to treat testicular cancer and a rare cancer of the ovary called malignant germ cell tumour.
It is best to read this information with our general information about chemotherapy and the type of cancer you have.
TIP is given into a vein. You have TIP either in the chemotherapy day unit or during a hospital stay. Your cancer doctor, nurse, or pharmacist will tell you how often you will have it.
TIP can cause side effects. Some of the side effects can be serious, so it is important to read the detailed information below.
Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you:
Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.
You may have TIP in the chemotherapy day unit or during a stay in hospital. A chemotherapy nurse will give it to you.
During treatment you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse, and a specialist pharmacist. This is who we mean when we mention doctor, nurse, or pharmacist in this information.
Before or on the day of treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that your blood cells are at a safe level to have chemotherapy.
You will see a doctor or nurse before you have chemotherapy. They will ask you how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Your nurse usually gives you anti-sickness (anti-emetic) drugs before the chemotherapy. The chemotherapy drugs can be given through:
TIP is named after the initials of the chemotherapy drugs:
The nurse will also give you a drug called mesna (Uromitexan®) with your chemotherapy. Mesna helps prevent irritation of the bladder wall, which can be caused by ifosfamide.
TIP chemotherapy is usually given over 5 days.
This completes a cycle of treatment. Each cycle of TIP takes 21 days (three weeks). At the end of the 21 days, you start your second cycle of TIP. This will be the same as the first cycle. You usually have 4 to 6 cycles of TIP for about 3 to 4 months. Your doctor or nurse will tell you the number of cycles you are likely to have.
If you are being treated as a day patient, you can usually go home after you have had the chemotherapy. If you are staying in hospital, you can usually go home after you have had the chemotherapy on the fifth day.
We explain the most common side effects of this treatment here. We also include some less common side effects. You may get some of the side effects we mention, but you are unlikely to get all of them.
You may also have some side effects that we haven’t listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night.
Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) to download a Patient Information Leaflet (PIL) for these drugs. The leaflet lists all known side effects.
Some people may have side effects while they are being given the chemotherapy or shortly after they have it:
Some people have an allergic reaction while having this treatment. Before treatment, you will be given medicines to help prevent or reduce any reaction.
Signs of a reaction can include:
Your nurse will check you for signs of a reaction during your treatment. If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, it can be treated quickly.
Sometimes a reaction can happen a few hours after treatment. If you develop any signs or feel unwell after you get home, contact the hospital straight away.
If this happens it can damage the tissue around the vein. This is called extravasation. Extravasation is not common but if it happens it is important that it’s dealt with quickly. Tell your nurse straight away if you have any around the vein:
If you get any of these symptoms after you get home, contact the doctor or nurse straight away on the number they gave you.
TIP can cause pain at the place where the injection is given or along the vein. If you feel pain, tell your nurse or doctor straight away so that they can check the site. They may give the drug more slowly or flush it through with more fluid to reduce pain.
This treatment can reduce the number of white blood cells in your blood. These cells fight infection.
If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.
If you have an infection, it is important to treat it as soon as possible.
Contact the hospital straight away on the 24-hour contact number you have if:
Symptoms of an infection include:
It is important to follow any specific advice your cancer treatment team gives you.
The number of white blood cells will usually return to normal before your next treatment.
You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.
This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.
Tell your doctor if you have any bruising or bleeding that you cannot explain.
Some people may need a drip to give them extra platelets. This is called a platelet transfusion.
This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body.
If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.
You may feel sick in the first few days after this treatment. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you.
It is easier to prevent sickness than to treat it after it has started.
If you feel sick, take small sips of fluids and eat small amounts often.
If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.
You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection.
Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.
If your mouth is sore:
If you have diarrhoea, contact the hospital for advice. Try to drink at least 2 litres (3½ pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.
You may get a bitter or metal taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste different or have no taste. Try different foods to find out what tastes best to you. Taste changes usually get better after treatment finishes. Your nurse can give you more advice.
Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished.
Try to pace yourself and plan your day so you have time to rest.
Gentle exercise, like short walks, can give you more energy.
If you feel sleepy, do not drive or operate machinery.
You usually lose all the hair from your head. You may also lose your eyelashes, eyebrows or other body hair. Hair loss usually starts after your first or second treatment.
Your nurse can talk to you about ways to cope with hair loss. There are ways to cover up hair loss if you want to. It is important to cover your head to protect your scalp when you are out in the sun.
Hair loss is usually temporary, and your hair will usually grow back after treatment ends. But rarely, the hair loss is permanent. Hair may not grow back or it may be thinner than before. If you are worried about this, talk to your cancer doctor or nurse.
Cisplatin can affect how your kidneys work. You will have blood tests before and during treatment to check this.
Before and after each treatment, your nurses will give you extra fluids through a drip. This is to protect your kidneys. It is also important to drink at least 2 litres (3½ pints) of fluids each day.
If you pass less urine than usual, tell your nurse.
Ifosfamide may irritate your bladder and cause discomfort when you pass urine. Make sure you drink at least two litres (three and a half pints) of fluids during the 24 hours following chemotherapy. It is also important to empty your bladder regularly and to try to pass urine as soon as you feel the need to go.
To help prevent bladder irritation, the nurse will give you fluids through a drip (infusion) along with the chemotherapy. They will also give you a drug called mesna (Uromitexan®) as an infusion, tablets, or both.
Contact the hospital straight away if you have any of the following when you pass urine:
This treatment affects the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks.
Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug.
The symptoms usually improve slowly after treatment finishes, but for some people they may never go away. Talk to your doctor if you are worried about this.
Cisplatin can affect your hearing. You may have a hearing test before you start treatment. You may get ringing in your ears. This is called tinnitus. You may also lose the ability to hear some high-pitched sounds. Tinnitus usually gets better after treatment ends. Some hearing changes can be permanent. Tell your doctor if you notice any changes in your hearing.
You may get pain in your muscles or joints for a few days after chemotherapy. If this happens, tell your doctor so they can give you painkillers. Tell them if the pain does not get better. Having warm baths and taking regular rests may help.
TIP may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. TIP can cause a rash, which may be itchy. Your skin may also darken during treatment. It will return to its normal colour after you finish treatment. If you have had radiotherapy, either recently or in the past, the area that was treated may become red or sore.
Always tell your doctor or nurse about any skin changes. They can give you advice and may give you creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
Your nails may grow more slowly or break more easily. You may notice white lines across your nails, or other changes to their shape or colour. Once the treatment has ended, any changes usually take a few months to grow out.
There are things you can do to look after your nails:
Stuart talks about he how coped with neutropenic sepsis, an infection which can be a side effect of chemotherapy.
Stuart talks about he how coped with neutropenic sepsis, an infection which can be a side effect of chemotherapy.
Your blood pressure may fall when you have paclitaxel. Tell your doctor or nurse if you have ever had any problems with your blood pressure. You should also let them know if you feel dizzy. Your nurse will check your blood pressure regularly during treatment.
This treatment may affect how your liver works. This is usually mild and goes back to normal after treatment. You will have blood tests to check how well your liver is working.
Paclitaxel and cisplatin may cause changes to your heartbeat. This does not usually cause serious problems and goes back to normal after treatment finishes. Let your doctor or nurse know if you notice your heartbeat is irregular or slow.
Sometimes ifosfamide can affect the nervous system and cause these symptoms:
Tell your doctor or nurse straight away if you notice any of these symptoms, or if the people you are with notice you have these symptoms. If this does happen, there is a drug they can give to help. They may also make some changes to your treatment.
It is important not to drive or operate machinery if you notice these effects.
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
If you have any of these symptoms, contact a doctor straight away.
A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.
This treatment contains alcohol. If this is a problem for you, tell your doctor, nurse or pharmacist. Your blood alcohol level may be above the legal limit after you have the treatment. It is best not to drive or operate machinery for a few hours after having this treatment, even if you feel okay.
Some medicines can affect chemotherapy or be harmful when you are having it. This includes medicines you can buy in a shop or chemist.
Tell your cancer doctor about any drugs you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your doctor will advise you not to get pregnant or father a child while having this treatment and for some time afterwards. The drugs may harm the developing baby. It is important to use effective contraception during your treatment.
Women are advised to use effective contraception for one year after finishing treatment. Men should use effective contraception for at least six months after finishing treatment.
Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.
Some cancer drugs can affect whether you can get pregnant or make someone pregnant.
If you are a woman, your periods may become irregular or stop. This may be temporary, but for some women it is permanent. Your menopause may start sooner than it would have done.
If you have sex in the first few days after chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluids.
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment.
Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.
If you have a lot on your mind, you might find it useful to make a checklist. You can use our checklists for home, work and travel to help you get organised.
Order booklets or audio CDs about chemotherapy. It includes how it works, having treatment and how it might affect you.
All types of treatment can have different side effects. Know what to expect to help you find the best way for you to handle them.
What's happening near you? Find out about support groups, where to get information and how to get involved with Macmillan where you are.
Read about our Community champions' experience of chemotherapy. They talk about what to bring to treatment, side effects and friendship between patients.
A support group for everything about chemotherapy, being treated and side effects. Tell others about your experiences and get answers to your questions.
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