by EBSCO Medical Review Board

Chemotherapy uses drugs to kill testicular cancer cells. The drugs enter the bloodstream and travel through the body. It's mainly used after surgery, if cancer has spread beyond the testicles, or to ease symptoms from cancer that's spread. For nonseminomas, it may be used with radiation therapy (called chemoradiation).

Chemotherapy Drugs and Delivery

There are many types of these drugs. For testicular cancer, they work better when more than 1 is used. The choice and blend of drugs will be based on your cancer type and how you react to the drugs. The most common are:

  • Cisplatin
  • Bleomycin
  • Etoposide
  • Paclitaxel
  • Vinblastine
  • Ifosfamide

Chemotherapy is most often given through an IV. But some come in pill form. They're delivered in cycles over a set time. Your doctor will help find out how many cycles are needed and which drugs will work best.

High-Dose Chemotherapy

Even with chemotherapy, testicular cancer can come back. If this happens, a peripheral stem cell transplant may be done.

This uses healthy stem cells (immature and unformed) from the circulating blood in your body or a donor. They're used restore normal blood cell function in your body. The stem cells are frozen until all the cancer is killed using high-dose chemotherapy. Then, they're returned to your body. The cells travel to bone marrow sites slowly repopulate numbers of red or white blood cells, or platelets. If it works, the new cells should be cancer-free and go on to make healthy blood cells.

Side Effects and Management

Drugs are made to kill cancer, but they also harm healthy cells. The death of cancer cells and impact on healthy cells can cause a range of problems. The most common are:

  • Nausea or vomiting
  • Diarrhea
  • Feeling tire because of anemia
  • Low blood cell counts (white cells or platelets) that can lead to infection or bleeding
  • Numbness, pain, or burning feeling in the hands and feet—peripheral neuropathy
  • Kidney damage
  • Breathing problems (bleomycin)
  • Bleeding from the bladder (ifosfamide)

There are many ways to control problems. In some cases, the drugs can be changed to lessen how they make you feel. The earlier these problems are brought up to your doctor, the more likely they will be controlled.

References

Chemotherapy for testicular cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/testicular-cancer/treating/chemotherapy.html. Accessed October 1, 2020.

Drugs approved for testicular cancer. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/drugs/testicular. Accessed October 1, 2020.

High-dose chemotherapy and stem cell transplant for testicular cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/testicular-cancer/treating/high-dose-chemo-stem-cell.html. Accessed October 1, 2020.

Management of nonseminoma testicular cancer. EBSCO DynaMed website. Available at:  http://www.dynamed.com/topics/dmp~AN~T908522/Management-of-nonseminoma-testicular-cancer . Accessed October 1, 2020.

Management of seminoma. EBSCO DynaMed website. Available at:  http://www.dynamed.com/topics/dmp~AN~T908524/Management-of-seminoma . Accessed October 1, 2020.

8/11/2011 DynaMed Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T908524/Management-of-seminoma : Oliver RT, Mead GM, Rustin GJ, et al. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214. J Clin Oncol. 2011;29(8):957-962.

Revision Information

  • Reviewer: EBSCO Medical Review Board Mohei Abouzied, MD, FACP
  • Review Date: 09/2020
  • Update Date: 12/04/2020