Chemotherapy for testicular cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate around your body in the bloodstream. 

You might have chemotherapy if you have a higher risk of your cancer coming back. Or if your cancer has already spread. You usually have a combination of chemotherapy drugs. 

You have the drugs into your bloodstream by injection or through a drip (intravenously).

When you have it

You might have chemotherapy to:

  • help prevent the cancer coming back after you've had surgery to remove a testicle (this is called adjuvant chemotherapy)
  • treat cancer that has come back (relapsed) after initial treatment
  • treat cancer that has spread outside the testicle

Types of drugs

You usually have a combination of drugs to treat testicular cancer. Or you might have a drug called carboplatin on its own. The most common types of chemotherapy drugs are:

  • bleomycin, etoposide and cisplatin (BEP)
  • etoposide and cisplatin (EP)
  • vinblastine, ifosfamide, cisplatin (VeIP)
  • carboplatin

Other combinations include:

  • etoposide, ifosfamide, cisplatin (VIP)
  • paclitaxel (Taxol), ifosfamide, cisplatin) (TIP)
  • cisplatin, vincristine, methotrexate, bleomycin, actinomycin, cyclophosphamide and etoposide (POMB/ACE)
  • gemcitabine, ifosfamide and cisplatin (GIP)

Check the name of the chemotherapy treatment with your doctor or nurse. Then you can find out about it on our A to Z list of cancer drugs.

How you have chemotherapy

You usually have several types of chemotherapy drugs together. You have them into your bloodstream (intravenously).

Into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Cycles

You usually have chemotherapy as a course of several cycles of treatment. A cycle of treatment is the time between 1 round of treatment and the start of another. Usually each treatment cycle lasts 3 weeks (21 days).

You have chemotherapy on set days of each cycle. 

The number of cycles you have depends on:

  • whether your cancer has spread
  • where it has spread to
  • your tumour marker Open a glossary item blood test results
  • how well your cancer responds to the drugs

Preventing blood clots

Having chemotherapy can increase your risk of developing blood clots. Your risk of getting a blood clot will depend on your situation. 

Your doctor might suggest you take a drug to lower your risk of developing a blood clot. They will talk to you about your risk. And they will tell you about the risks and benefits of taking medicines to lower your risk. 

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • increased risk of getting an infection
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

  • take any supplements
  • have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

When you go home

Chemotherapy for testicular cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

  • Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up
    J. Oldenburg and others
    Annals of Oncology, 2022 Volume 33, Issue 4, pages 362 - 375

  • EAU Guidelines on Testicular Cancer
    MP Laguna and others
    European Association of Urology 2021

  • Advances in the treatment of testicular cancer
    Y Ehrlich and others
    Tranlational Andrology and Urology 2015, Vol 4 (3) pages 381-390

  • Cancer and its Management (7th edition)
    J Tobias and D Hochhauser 
    Wiley Blackwell 2015

  • Cancer Principles & Practice of Oncology (10th edition)
    V T DeVita Jr, T S Lawrence and S A Rosenberg
    Wolters Kluwer 2015

Last reviewed: 
06 Feb 2022
Next review due: 
06 Feb 2025

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