Testicular cancer medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Medical Therapy

Radiation therapy

• Radiation therapy works best for seminomas. Non-seminomas do not respond well to radiation therapy.
• External beam radiation may be used for stage I and II seminomas after surgery to remove the testicle (called orchiectomy).
• Radiation treatments are usually given once a day, 5 days a week, for 2–4 weeks.

Chemotherapy

Standard-dose chemotherapy

• The most common chemotherapy combinations used to treat testicular cancer are:

• BEP is bleomycin (Blenoxane), etoposide (Vepesid, VP-16) and cisplatin (Platinol AQ). It is usually given through a needle in a vein (intravenously) every 3 weeks for 2–3 months, or 3 or 4 cycles. In some cases, 1 or 2 cycles of BEP may be given for stage I non-seminomas.
• EP is etoposide and cisplatin. EP is used when bleomycin affects the lungs (called pulmonary toxicity) or there is a high risk that it will cause lung damage. It is given intravenously every 3 weeks for 3 months, or 4 cycles.
• VIP is etoposide, ifosfamide (Ifex) and cisplatin. VIP may be used when bleomycin affects the lungs (called pulmonary toxicity) or there is a high risk that it will cause lung damage. It is given intravenously every 3 weeks for 3 months, or 4 cycles.

• If testicular cancer doesn’t respond to the above drugs or if it recurs, the following chemotherapy combinations may be used. These are sometimes called salvage, or second-line, chemotherapy.

• TIP is paclitaxel (Taxol), ifosfamide and cisplatin. It is given intravenously every 3 weeks for 3 months, or 4 cycles.
• VIP is etoposide, ifosfamide and cisplatin. It is given intravenously every 3 weeks for 3 months, or 4 cycles.
• VeIP is etoposide or vinblastine (Velbe), ifosfamide and cisplatin. It is given intravenously every 3 weeks for 3 months, or 4 cycles.

High-dose chemotherapy

• High-dose chemotherapy with carboplatin and etoposide may be used if testicular cancer recurs after it is treated with standard-dose chemotherapy.

Palliative chemotherapy

• Palliative therapy is given to relieve symptoms, rather than to treat the cancer itself. Gemcitabine (Gemzar) may be given with oxaliplatin (Eloxatin), paclitaxel or both as palliative treatment for seminomas or non-seminomas. Etoposide taken by mouth (orally) is also an option for palliative chemotherapy.

References

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