Chemotherapy uses drugs to kill or slow the growth of cancer cells while doing the least possible damage to healthy cells.
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When is chemotherapy used?
Chemotherapy may be used at different stages of testicular cancer.
| To reduce the risk of cancer coming back | If you have early testicular cancer that has not spread (stage 1), you may be offered chemotherapy after surgery. This is called adjuvant chemotherapy. Adjuvant chemotherapy usually consists of 1–2 cycles of chemotherapy, and is followed by 5–10 years of active surveillance. |
| To treat cancer that has spread | Chemotherapy may be recommended after surgery to destroy any cancer cells that have spread. This usually involves 3–4 cycles of chemotherapy. Your doctor will discuss the treatment plan with you. Depending on how you respond to the treatment, you may need more surgery or chemotherapy. You will then have active surveillance for 5–10 years. |
| Before surgery (neoadjuvant) | Rarely, when the cancer has spread to other parts of the body, chemotherapy may be given before surgery to help control the spread and reduce symptoms. |
How chemotherapy is given
Chemotherapy is generally given through a drip inserted into a vein (intravenously) but some drugs may be given by injection into a muscle (intramuscularly). Usually, you have chemotherapy during day visits to a hospital or treatment centre. For some types of chemotherapy, you may need to go to hospital several days in a row.
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Side effects of chemotherapy
Everyone reacts differently to chemotherapy. Some people do not experience any side effects, while others have a few. Most side effects are temporary, and there are medicines that can help reduce your discomfort. Talk to your doctor or nurse about any side effects you have and ways to manage them.
Common side effects include:
- fatigue
- nausea
- hair loss
- tingling in the hands and feet.
You may experience erection problems and bowel issues.
It is important to tell your treatment team if you have a cough that won’t go away, or are experiencing shortness of breath, as chemotherapy can affect the lungs. Chemotherapy can also affect your fertility.
About a week after a treatment session, your white blood cell levels may drop, making you more likely to get infections. If you feel unwell or have a temperature of 38°C or higher, call your treatment team or go to a nearby hospital emergency department.
Longer-term side effects of chemotherapy
Chemotherapy for testicular cancer can sometimes lead to other long-term side effects, including:
Heart and blood vessels problems – Chemotherapy can increase the risk of heart disease, stroke or blood circulation problems. Ask your doctor if you need regular heart checks after treatment.
Risks of other cancers – People who have chemotherapy for testicular cancer are at a slightly higher risk of developing leukaemia, which is a blood cancer. Having chemotherapy may also increase the risk of developing a new unrelated cancer.
Low testosterone levels – Having chemotherapy after surgery can increase the risk of developing low testosterone levels (hypogonadism). Low testosterone levels may cause symptoms such as tiredness, muscle loss and reduced sex drive. Testosterone levels will be checked as part of follow-up care, and some people may need testosterone replacement therapy.
You’ll probably be advised you to use barrier contraception (condom, female condom or dental dam) during chemotherapy and for a time after. This protects your partner from any chemotherapy drugs that may still be in your body fluids. You will also be advised to use contraception to prevent pregnancy, as chemotherapy drugs can damage sperm.
→ READ MORE: Surgery to remove lymph nodes
The chemotherapy made me feel tired and left a funny taste in my mouth. These side effects passed quickly, and it helped to drink a lot of water.
Bradley
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A/Prof Peter Grimison, Medical Oncologist, Chris O’Brien Lifehouse and Royal Prince Alfred Hospital, NSW; Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC; A/Prof Peter Heathcote, Urologist, Brisbane Urology Clinic, QLD; Dr Michael Huo, Radiation Oncologist, Princess Alexandra Hospital, QLD; A/Prof Joseph McKendrick, Medical Oncologist, Epworth Eastern Hospital, VIC; Dr Tonia Mezzini, Sexual Health Physician, East Obstetrics and Gynaecology, SA; Dominic Oen, Clinical Psychologist, Bankstown Cancer Centre, NSW; Dr Benjamin Thomas, Urological Surgeon, The Royal Melbourne Hospital and The University of Melbourne, VIC; Paul Zawa, Consumer.
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