Chemotherapy uses anti-cancer drugs to destroy cancer cells and is a common treatment for non-localised testicular cancer. It works by disrupting the growth of cancer cells as they move around the bloodstream.
If cancer is localised (it was only found in the testicle), a short dose of chemotherapy may be an option.
For cancer that has spread beyond the testicle, more chemotherapy will be recommended.
Several types of chemotherapy can be given in different circumstances but a mixture of three chemotherapy drugs, known as BEP (Cisplatin, Etoposide and Bleomycin) is a common treatment.
Blood tests will usually be performed beforehand to check that the body`s immune system is healthy enough for treatment.
A lung function test may be carried out to make sure the lungs are working well as some chemotherapy can affect them.
A drip called a cannula will be placed into a vein in the hand and the chemotherapy will be administered through it. Anti-sickness drugs can also be given through these tubes as well.
Chemotherapy can temporarily cause infertility so storing sperm or sperm banking will usually be recommended
The following table gives examples of three- and five-day cycles of BEP.
| One Cycle 3-Day BEP (3-4 cycles over 2-3 months) | One Cycle 5-day BEP (3-4 cycles over 2-3 months) |
|---|---|
| Day 1 Infusion of all BEP drugs | Day 1 Etoposide and Cisplatin |
| Day 2 Infusion of all BEP drugs | Day 2 All BEP drugs |
| Day 3 Etoposide only | Day 3 Etoposide and Cisplatin |
| Day 8 Bleomycin | Day 4 Etoposide and Cisplatin |
| Day 15 Bleomycin | Day 5 Etoposide and Cisplatin |
| Break | Day 15 Bleomycin |
| Break |
Below are some of the common and less common side effects of chemotherapy, together with some tips that people have found useful.
| Problems | Try | Avoid |
|---|---|---|
| Nausea and vomiting | Anti-sickness medication will be given on a regular basis and it is important to take this.
Ginger, ginger beer, tea or biscuits (eat regularly throughout the day). Peppermint tea: always drink slowly, taking lots of sips. A small meal a few hours before chemo starts. Never have chemotherapy on an empty stomach. | Hot and spicy foods (curry, Cajun cooking etc.)
Foods with a high sugar content. Fatty and greasy foods (chips, burgers etc.) Large meals. Eating and drinking too fast and drinking with meals. Alcohol. Caffeine (which is found in tea, coffee, chocolate, energy drinks). Baby food (this is designed for babies and has very little nutrition for adults!) |
| Taste (Chemo can cause a metallic taste in the mouth) | Fresh pineapple or other sharp-tasting fruit.
Boiled sweets while having treatment. Season or marinade meat for meals to add flavour. Use herbs and spices in cooking to add stronger taste. | |
| Mouth sores or ulcers from chemotherapy. | Fresh pineapple can help prevent and heal mouth ulcers by stimulating saliva which protects the mouth.
Bonjela. Soft baby bristle toothbrush and aloe vera toothpaste. Soft puréed or liquid diet to prevent chewing. Salt water rinses up to 4-5 times a day, if you can tolerate it. Sucking crushed ice during treatment. Artificial saliva which can be prescribed by a doctor. Vaseline for lips. | |
| Tiredness | Try to get small restful naps.
Meditation may help. If you cannot sleep, your doctor can give you sleeping tablets. | |
| Loss of appetite | Try small frequent meals throughout the day.
Try fortified soups and drinks. | |
| Diarrhoea | Rice and pasta.
Dry crackers and biscuits. White bread. Bananas. These are a good source of potassium which is depleted by excessive diarrhoea. | |
| Hair loss (This may occur 2-3 weeks after chemotherapy starts) | Baseball cap.
Shave hair off when it starts to fall out. | Head cooling devices may reduce the circulating blood supply which can reduce the effectiveness of the chemo. |
| Reduced immunity | Be extra careful with hygiene.
Wash hands carefully after going to the toilet. | Travelling to foreign countries where the risk of picking up illness is greater.
Travel vaccinations may not be suitable for you during treatment. |
| Tingling in the arms and feet due to nerve damage (‘peripheral neuropathy’) | Keep hands and feet warm.
Use oven gloves to avoid contact with hot pans. When running hot water, test it with your elbow first to avoid scalding. Gentle exercise. | Extremes of temperature. |
| Problems with oxygenating your blood. (This causes shortness of breath) | Report any breathing difficulties.
Rest as much as possible. You can be given a blood transfusion. | Avoid taxing, strenuous tasks.
Do not smoke. |
| Anaemia caused by low iron levels. (This is leads to shortage of breath and dizziness) | Eat green leafy vegetables and some red meat as these are rich in iron.
You can be given a blood transfusion. | Smoking.
Getting up too quickly as it can cause fainting. Avoid taking a lot of supplements without consulting a doctor. |
| Tinnitus (This is ringing in the ears) | Encourage people to speak slowly and clearly.
Listening to gentle background music may help. | |
| Skin changes. | Electric shave to avoid cuts.
Use unperfumed moisturising creams. Chemo can make skin more sensitive to sunlight. Check with your oncologist before any sun exposure. Allow at least six weeks after radiotherapy treatment before sun exposure. It may be best to cover the treated area for up to a year. Wear a hat in summer to avoid sun burn to your scalp. | Avoid vigorous rubbing of the skin around the treated area.
Sunbathing of any kind as it can cause severe sunburn which can scar for life. |
The effects of chemotherapy can take a year or more to subside after treatment. Men may feel tired and this needs to be taken into account when planning a return to work.
It may also take family and friends time to adjust.
Although there is no definite evidence that radiotherapy or chemotherapy can affect children that are fathered after treatment, it is usually advisable to use contraception, specifically a condom for 6-12 months afterwards. This is because scientists do not yet know how much chemotherapy ends up in a man’s semen and this could be passed on to your partner.
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