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Chemotherapy is the use of drugs for treating cancer. The drugs can be
swallowed in pill form, or they can be injected by needle into a vein
or muscle. To treat testicular cancer, the drugs are usually given into
a vein. Chemotherapy is considered systemic therapy. This means that
the drug enters the bloodstream and circulates throughout the body to
reach and destroy the cancer cells. Chemotherapy is an effective way to
destroy any cancer cells that break off from the main tumor and travel
in the bloodstream to lymph nodes or distant organs. Chemotherapy is
often used to cure testicular cancer when it has spread outside the
testicle. It is not used to treat the cancer in the testicle.
Most types of chemotherapy kill cancer cells directly. Using 2
or more drugs is often more effective than using any single drug. The
main drugs used to treat testicular cancer are cisplatin, vinblastine,
bleomycin, cyclophosphamide, etoposide, paclitaxel, and ifosfamide.
These drugs are used in various combinations. The chemotherapy regimens
most commonly used as the initial treatment for testicular cancer are
cisplatin, etoposide, and bleomycin (called PEB), or cisplatin and
etoposide (also known as EP). Some doctors believe that a more
intensive regimen should be used for patients with high-risk disease,
and may suggest a different combination of chemotherapy drugs or even a
stem cell transplant.
Drugs used in chemotherapy can also affect some of the normal,
healthy cells in your body, causing side effects. Rapidly growing
cells, such as the blood-producing cells of bone marrow, the cells of
hair follicles, and the lining of the digestive tract, are particularly
sensitive to chemotherapy. Among the possible early or acute side
effects are:
- nausea and vomiting
- a decrease in appetite
- temporary loss of hair
- mouth sores
- increased risk of infections (due to low white blood cell
counts)
- bleeding or bruising (due to low blood platelet
counts)
- fatigue (due to low red blood cell counts)
- diarrhea or constipation
If you have side effects, your cancer care team can suggest
steps to ease them. For example, there are very good drugs available to
help prevent and control nausea and vomiting. For more information
about chemotherapy and its side effects, please see the American Cancer
Society document, Understanding
Chemotherapy: A Guide for Patients and Families.
Long-term side effects of
chemotherapy
Some of the drugs used to treat testicular cancer can cause
long-term side effects. Cisplatin can cause kidney damage; can damage
small blood vessels, causing sensitivity to cold temperatures; and
damage nerves, causing numbness, abnormal tingling, and hearing loss.
Bleomycin can damage lungs, causing shortness of breath and trouble
with physical activity. Development of a second cancer (usually
leukemia, related to etoposide) is a very serious but fortunately, a
rare side effect. It occurs in less than 1% of testicular cancer
patients treated with chemotherapy. People who have had chemotherapy
for testicular cancer seem to have a higher risk of heart problems
later in life. Several studies have also suggested that this
chemotherapy treatment can sometimes cause high blood cholesterol to
develop over time, which may later require treatment.
Last Revised: 11/14/2007
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