Urology

Chemotherapy

IU School of Medicine and Lawrence Einhorn, MD revolutionized treatment for men with metastatic testicular cancer by discovering the powerful curative potential of combination platinum-based chemotherapy in the 1970s. Since that time, significant research and clinical work has been accomplished to refine this regimen of induction chemotherapy to its current form of bleomycin, etoposide and cisplatin.

Chemotherapy is most often recommended when testis cancer has spread outside of the testicle either via the lymphatic system or hematogenously through the bloodstream to other parts of the body. In a number of patients, the tumor markers are also elevated in this setting. The most common chemotherapy regimen used to treat metastatic testicular cancer is a three-drug regimen using bleomycin, etoposide and cisplatin (BEP).

Risk Classification

Depending on the extent of metastatic disease and level of tumor marker elevation, a risk classification for each patient is established. Patients with good risk disease are generally treated with three cycles of BEP (or an alternative regimen of four cycles of EP), while those with intermediate or poor risk disease are most often treated with four cycles of BEP.

Side Effects of Chemotherapy

Several side effects of chemotherapy can occur during treatment, such as nausea/vomiting, alopecia (hair loss), fatigue, hearing impairment, neutropenia (low white blood cells) – susceptibility to infection, anemia (low red blood cells), thrombocytopenia (low blood platelet count), constipation and neuropathy.