Relapsed testicular cancer: chemotherapy treatment

As discussed during your visit, unfortunately your disease has come back despite treatment with chemotherapy and it will be necessary for you to have further chemotherapy.

The standard treatment is a combination of three drugs: paclitaxel, ifosfamide and cisplatin ('TIP'). They are given in a similar way to the previous chemotherapy and will involve an inpatient stay of five to six days once every three weeks. The drugs are given as a continuous infusion via a drip. You would be admitted to the ward as before.

The most serious potential effect is a reduction in the number of your blood cells which can be more severe than the bleomycin, etoposide and platinum (BEP) chemotherapy you have had before. It affects your red blood cells, so you might become anaemic leaving you feeling tired and short of breath. Your platelet count can also fall, which would leave you more prone to bruising and bleeding problems. The most serious potential complication is a reduction in the number of white cells which you have to fight infection. This can leave you at risk of serious infection which can be life-threatening, particularly if not appropriately managed. More information will be given to you about this when you are admitted for chemotherapy so you know what to do to reduce the risk of serious complications. Please ensure you understand it fully and take it home with you. If unsure, please ask before you leave.

Other side effects include hair loss, nausea, bowel upset and a sore mouth. There is also a risk of numbness and altered sensation in the hands and feet and it may also affect your hearing. There is a small risk of damage to your kidneys. In addition, you may experience fluid retention and some pain in your muscles and joints. You will be given medication to limit the effects of these and other side effects.

Your fertility will be affected during your treatment, and there is a greater possibility that it will not return to normal. Please discuss this with your consultant or nurse practitioner if you have not previously had the opportunity to bank sperm.

The response rate to this type of chemotherapy given to people in your situation is good, and there is a good chance of a cure. Depending on how your disease has re-presented, we will assess your response after two courses of chemotherapy with either blood tests or a repeat scan and, if appropriate, will continue with a total of four cycles.

If you have any questions regarding any aspect of your treatment or care, please do not hesitate to contact the clinical nurse specialist in the Oncology Centre on 01223 256453, bleep number 152 367 or 01223 256453 (direct line with answerphone).

Privacy and dignity

We are committed to treating all patients with privacy and dignity in a safe, clean and comfortable environment. This means, with a few exceptions, we will care for you in same sex bays in wards with separate sanitary facilities for men and women.

In some areas, due to the nature of the equipment or specialist care involved, we may not be able to care for you in same sex bays. In these cases staff will always do their best to respect your privacy and dignity, for example with the use of curtains or, where possible, moving you next to a patient of the same sex. If you have any concerns, please speak to the ward sister or charge nurse.