Hospital Again! - CHEMOTHERAPY CYCLE 4
9Bleomycin, etoposide and platinum (BEP)
BEP is commonly used as a treatment for men with testicular cancer. It's a combination of 3 chemotherapy drugs:
bleomycin
etoposide
platinum (cisplatin)
Doctors may also use BEP to treat a rare type of ovarian cancer called teratoma of the ovary.
You usually have BEP 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). The first day of treatment cycle is called day 1.
You might have between 2 and 4 treatment cycles. The number of cycles you have depends on:
whether your cancer has spread
how well your cancer responds to BEP
If you have an early testicular cancer, you may have 2 treatment cycles of BEP. This is to stop the cancer from coming back (recurrence).
If your testicular cancer has spread to another part of your body, you may have 3 or more treatment cycles. Each of these effects happens in more than 1 in 10 people (more than 10%). You might have one or more of them. They include:
Risk of infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Bruising and bleeding
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
Breathlessness and tiredness
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
Loss of appetite and weight loss
You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Hair loss
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Diarrhoea or constipation
Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help.
Lung problems
You might develop a cough or breathing problems. This could be due to infection, such as pneumonia or inflammation of the lungs (pneumonitis). Let your doctor or nurse know straight away if you suddenly become breathless or develop a cough.
Skin problems
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your nurse will tell you what products you can use on your skin to help.
The colour of your skin might also get darker. And your skin might also thicken.
Tummy (abdominal) pain
You might get pain in the tummy (abdomen). Contact your healthcare advice line or tell a member of your healthcare team.
Changes to how your liver works
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.
You might also have yellowing of the skin and whites of the eyes.
Changes to the amount of minerals in your blood
You may have changes in levels of minerals and salts in your blood, including low levels of sodium or high levels of uric acid (causing gout). You have regular blood tests during treatment to check this.
Sore mouth
It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy.
Inflammation of the lining of your throat, gut and bowels
The lining of your throat, gut and bowels might become sore and swollen. Contact your healthcare advice line or tell a member of your healthcare team if this happens.
Inflamed sore fingertips
Your fingertips might become swollen and tender. Contact your healthcare advice line or tell a member of your healthcare team if this happens.