Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It works by disrupting the growth of cancer cells as they circulate in the bloodstream.

Localised testicular cancer

Early stage seminoma or non-seminoma which is confined to the testicle with no evidence of spread can usually be treated with a policy of surveillance. This means regular CT scans and blood tests will be performed to detect any recurrence. Should testicular cancer reoccur then chemotherapy will be given and the chances are that a man will be cured. However some men may find that they want to get on with their lives and not keep returning for scans as frequently as surveillance requires. In this situation a limited dose of chemotherapy can be given after surgery to reduce the risk of cancer returning.

If men opt for up front chemotherapy it will usually be a one off dose which may take around 1-2 hours to administer. Men may feel tired and suffer some minor side effects for a week or so after.

Non localised testicular cancer

For cancer that has spread outside  the testicle a longer course of chemotherapy for instance BEP (see below) will be suggested.

The drugs most commonly used to treat testicular cancer are Cisplatin, Etoposide and Bleomycin. A combination of all three is a treatment known as BEP. BEP chemotherapy can be given as a day case treatment or during a short stay in hospital. Blood tests will usually be performed prior to BEP to check that the body’s immune system is healthy enough to cope with the treatment.

A Breathing test called a lung function test will be performed to ensure the lungs are functioning well as one type of chemotherapy, bleomycin may affect lung function.

A drip (cannula) will be sited into a vein in the hand, arm or neck and the chemotherapy administered through it. Anti-sickness (antiemetic), drugs can also be given through these tubes as well.

BEP chemotherapy can be given in different ways and the exact duration of treatment will be decided by an oncologist. It can be given as a regime over three days or five days on an inpatient or outpatient basis. The treatment regime is also known as a cycle. Each cycle of treatment is given over 3 weeks and 3 or 4 cycles of BEP chemotherapy are given depending on the extent of the disease.

Men who had high tumour markers or more widespread disease may be offered higher or different doses of chemotherapy.

Chemotherapy can temporarily cause infertility so men will be advised to store some sperm (sperm banking).

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 Belomycin Day 5 Etopside and Cisplatin
Break Day 15 Belomycin
Break

Below are some of the common and less common side effects associated with chemotherapy along with some tips that people have found useful on how to manage the symptoms.

Problems

Try

Avoid

Nausea and Vomiting

Anti-sickness medication will be given on a regular basis and it is important to take this.

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 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 including chocolate bars/ 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.

Seasoned or marinated 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 childs/baby bristle toothbrush and baby/ soothing (for instance) aloe vera toothpaste.

Soft puréed or liquid diet to prevent chewing.

Rinse the mouth with salt water on a regular basis if it can be tolerated; up to 4-5 times a day.

Try sucking crushed ice during treatment.

 

Artificial saliva which can be prescribed by a doctor.

 

Vaseline for lips.

Tiredness

Try and get small restful naps.

Some people find benefit in Meditating.

Sleeping tablets can be prescribed if insomnia becomes a problem.

Loss of appetite

Try small frequent meals throughout the day.

Try fortified soups/drinks or milk shakes.

Diarrhoea

Rice and pasta.

Dry crackers/biscuits.

White bread.

Bananas (a good source of potassium which is essential for the body’s metabolism). Excessive diarrhoea will deplete potassium levels.

Hair loss

This may occur 2-3 weeks after chemotherapy

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.

Low immune system from chemotherapy

Pay meticulous attention to hygiene.

Wash hands after going to the toilet.

Travelling to foreign countries where risk of picking up illness is greater.

Vaccines. Men will need to ask their oncologist if they will be able to travel and receive vaccines after treatment

Tingling in the arms and feet due to nerve damage (peripheral neuropathy)  from chemotherapy

Keep hands and feet warm and avoid extremes of temperature.

Take care when preparing food (use gloves) or when running hot water (test with an elbow) to prevent the risk of burning.

Gentle exercise.

Inflammation in the lungs with shortness of breath due to low circulating heamoglobin (oxygenated blood) from chemotherapy

A blood transfusion.

Rest.

Report any breathing difficulties.

Avoid taxing, strenuous tasks.

Do not smoke

Short of breath with dizziness due anaemia. This is due to low circulating haemoglobin

If anaemia is severe may require blood transfusion.

Eat green leafy vegetables and some red meat as these are rich in iron.

Most nutrients can be obtained from eating normal food.

Smoking, getting up too quickly as can cause sudden fainting.

Avoid taking a lot of supplements without consulting a doctor.

Tinnitus (ringing in the ears) from chemotherapy

Encourage people to speak slowly and clearly.

Some people find that listening to gentle background music may help.

 

Skin changes

Electric shave to avoid cuts.

Non perfumed moisturising creams.

Chemo can make skin more sensitive to sunlight, check with the oncologist

to see how long prolonged exposure to the sun should be avoided. Use factor 15 if sunbathing.

 

Allow 6 weeks after radiotherapy treatment before exposure to the sun it may be best to cover the treated area for up to a year.

 

Wear a hat in summer to avoid sun burn to the scalp.

Avoid vigorous rubbing of the skin around the treated area.

Sun bathing in direct sun light as at risk of severe sun burn which can leave scarring for life.

The effects of chemotherapy may take some time to subside after treatment. This can take a few months to a year or more. Men may feel tired or exhausted and should take this into account when considering going back to work or for a busy lifestyle.It may also take family and friends time to adjust to long term changes in a man’s health so do not be surprised if they are acting a bit strange or distant.

For a video clip discussing chemotherapy please see below.

To read personal stories of men who have been affected and treated for testicular cancer please click here

 

To download information on chemotherapy please click here

 

Last reviewed 26/1/17 Next review July 2017

 

References available on request.

Was this page useful?

  • This field is for validation purposes and should be left unchanged.