Testicular cancer chemotherapy consists of the drugs like cisplatin, etoposide and bleomycin. This is called BEP chemotherapy. Other combinations of drugs are also used to treat testicular cancer depending on the stage and recurrence after treatment.

Chemotherapy for testicular cancer commonly used in the following situations-

• In case of adjuvant therapy i.e. after surgery to reduce the risk of recurrence testicular cancer.

• In case of testicular cancer that has spread outside the testicle or recurred after orchidectomy.
• In case of testicular cancer that has returned after the initial chemotherapy.

Treatment Cancer Chemotherapy According to the Stages

Adjuvant chemotherapy for men with early stage 1 teratoma generally consists of two cycles of BEP wherein one cycle is of three weeks.

Men with early seminoma are usually recommended a single dose treatment with a drug called carboplatin.

If the testicular cancer has spread outside the testicle or is detected during close monitoring post treatment then four cycles of BEP treatment are usually recommended. In this case, the patient can consult the doctor regarding participation in a clinical trial to try different combinations of drugs.

If testicular cancer recurs after BEP treatment or does not respond then more intensive chemotherapy could be recommended depending on the stage.

Some other drug combinations used to treat testicular cancer are-

• PEI (cisplatin, etoposide, ifosfamide)

• TIP (paclitaxel, ifosfamide, cisplatin)
• CBOP-BEP (carboplatin, bleomycin, vincristine and cisplatin followed by BEP)
• POMB-ACE (cisplatin, vincristine, methotrexate, bleomycin, dactinomycin, cyclophosphamide and etoposide).

High Dose Chemotherapy with Stem Cell Support

High-dose chemotherapy with stem cell support destroys maximum cancer cells.

Stem cells from your blood are stored and used to make new blood cells to replace the cells damaged due to high dose chemotherapy before high-dose chemotherapy.

After the high-dose chemotherapy is over the stem cells are transferred back into the body through an IV drip. They go to the bone marrow and start producing normal cells again.

This is a very intensive treatment and requires hospitalization for a few weeks. It has a longer recovery time and close monitoring by the doctor is essential.

Side Effects of Testicular Cancer Chemotherapy

Some of the common side effects of testicular cancer chemotherapy are-

• Inflammation and redness in the mouth

• Hair loss
• Nausea and vomiting
• Anemia
• Low platelet count leading to problems with blood clotting
• Low white blood cells count leading to decreased immunity

Fertility Issues in Testicular Cancer Chemotherapy

Some chemotherapy drugs cause infertility as a side effect. This leads to a low sperm count after the treatment. This is common usually in case of a very high dose of drugs.

You need to discuss with your doctor regarding fathering a child in future. You have options like freezing the sperms and storing them before the treatment.

It is essential that your partner does not conceive during your treatment, as these drugs are harmful to a developing baby. You may be advised to wait for a year after treatment until the sperm count becomes normal and the viability of sperms improves.

Side Effects with Particular Drugs used in Testicular Cancer Chemotherapy

• Chemotherapy slightly enhances the risk of developing another cancer in future. However, this risk outweighs the benefits.

• Treatment with etoposide increases the risk of developing leukemia.
• Chemotherapy with cisplatin causes hearing disabilities or kidney problems.
• BEP chemotherapy causes restriction of normal blood supply to the hands.
• Bleomycin causes scarring of the lungs that leads to breathlessness.

Overall, testicular cancer chemotherapy is extremely effective as a single therapy or in combination with surgery or other treatments. Many men can lead a normal life if due care is taken and if the cancer is stopped from spreading. Disease free prolonged survival is observed in many cases.