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Testicular Cancer

Side effects of chemotherapy for testicular cancer

Chemotherapy may be given for a short period to prevent cancer coming back, or over many months to cure cancer if it has spread from the testicle to other parts of the body (see 'Chemotherapy'). Many of the men had had chemotherapy, but they didn't always remember which drugs they had been given.

Chemotherapy affects everybody differently. Men who just had a single dose of chemotherapy to prevent the spread of the cancer had very few side effects. They felt a bit tired, lost their appetite for a day or two, and experienced some nausea and change in taste.

When chemotherapy is given for longer the side effects can be more severe. A common side effect is nausea and vomiting, though anti-sickness drugs can help prevent this. Many men remembered a horrible metallic taste they had in their mouths, which some said was due to cisplatin. Others described severe nausea or sickness, which often led to weight loss. However, one man said he didn't feel sick at all, even after three months of treatment, though his taste had changed, and another man said that he was always hungry.

 

Recalls that he was constantly sick during the chemotherapy and lost a lot of weight.

Recalls that he was constantly sick during the chemotherapy and lost a lot of weight.

Age at interview: 33
Sex: Male
Age at diagnosis: 26
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I was constantly being sick by that stage, just couldn't get the anti-sickness tablets or the drugs right to stop me being sick, I was constantly being sick. And I think it's probably, that was the point when the weight started to drop off. Overall I lost a stone and a half and that was basically because I didn't eat, I stopped eating. The food used to come in the food trolleys at 11 o clock and the waft, the smell would come down and as soon as it reached me that would be it, I would start being sick. And so there was no point in bringing me food, there was no point bringing anything anywhere near me. People started bringing me bits in, but I was just, I was ill, that was it I couldn't eat. And I think at the finish I was on Weetabix and cornflakes for breakfast, dinner and tea, that was the only thing I could eat that actually stayed down, I don't know why. I don't like Cornflakes now but I still eat Weetabix, but they managed to stay down. And I actually got the nurses at the finish to close my door before the food trolley came down and open a window to try and stop the smell from getting through and making me ill.
 

Recalls that he wasn't sick and that he felt better than he expected during the chemotherapy.

Recalls that he wasn't sick and that he felt better than he expected during the chemotherapy.

Age at interview: 30
Sex: Male
Age at diagnosis: 27
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Once the chemotherapy started it was just a case of lying there and really waiting for the effects to, to take hold. I thought I'd probably feel, start feeling sick pretty quickly but throughout the chemotherapy I can honestly say I didn't feel sick once and I was actually really relieved that everything I'd read probably didn't apply to most people. I think the drugs they use now are obviously better now than they have ever been, they are constantly being developed and obviously the one thing they're looking to do is have as minimal an impact on the body as possible. So I wasn't sick once with chemotherapy. I think the closest I came to being sick was possibly the hospital food! But that wasn't necessarily the food but because my taste buds had gone part way through the treatment. That was probably the closest I came to being sick. So the treatment itself, once I'd decided that, I realised this would probably be fine.

During chemotherapy some men we spoke to temporarily put on weight due to the corticosteroid they were given while having chemotherapy, and associated fluid retention.

Another common side effect of chemotherapy is hair loss, which many of the men associated with cancer. After about three weeks of chemotherapy they lost all their body hair, including eyebrows. Some of the men found this quite traumatic. However, shaven heads have become more stylish in recent years and some of the men told us that hair loss didn't bother them.

 

Arthur Frank recalls that losing his hair was one of the most traumatic moments of his illness.

Arthur Frank recalls that losing his hair was one of the most traumatic moments of his illness.

Age at interview: 55
Sex: Male
Age at diagnosis: 40
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Arthur Frank said' Losing hair is weird and in some ways losing hair was almost more powerful than losing the testicle, even though I took it by then that losing hair was temporary. I had an interesting experience at the end of chemotherapy about hair, I still didn't have any hair but I was through chemotherapy and the chemotherapy had apparently been quite successful. 

And I remember being, visiting my older daughter and as soon as chemotherapy was over I didn't feel any need to wear hats or anything and some people were kind of, this child I think was asking his mother you know why this guy was virtually bald er and I remember thinking actually I didn't care. To me the problem with hair loss was that it marked me as someone who had cancer and as soon as it no longer was associated with cancer for a man at least it wasn't that much of a problem. 

Today it would be even less of a problem because it's stylish to have your head shaved anyway and, and again though there's a big difference between shaving your head because it's stylish and knowing your head is shaved because you've lost your hair, because you're a cancer patient. And it's that visible marker of having cancer that I think is the really difficult thing about hair loss. Plus all of a sudden having these great amounts of your hair fall out is just, it's a horrible thing. I mean there's no getting around it, this is one of the traumatic moments of illness er but as I say fortunately now there are a lot of models who have been stylishly head-shaved and I hope it wouldn't be as much problem for men now as it was for me back in the mid 80s before shaved heads had that kind of niche in fashion.
 
 

Explains that he did not mind losing his hair, partly because it convinced others that he was...

Explains that he did not mind losing his hair, partly because it convinced others that he was...

Age at interview: 41
Sex: Male
Age at diagnosis: 35
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How did you feel when you lost your hair?

When I lost my hair it was my party trick at first because obviously I wasn't that ill the first few times I went so I was still managing to go out with friends. And sort of like my party trick you could grab hold of it and pull out a load of hair which was quite funny at the time (laughs). But unfortunately I was ill in the winter time during sort of like the October, November, December, January, so I had no hair then. I got very, very cold. But the stigma side of it I didn't, I didn't worry about that at all, didn't worry me at all, you're ill and that's it really. I mean in a way it shows that you are ill and people sort of have a different attitude. Because if you just, if you're ill and something is wrong with you and people can't see there's something wrong with they don't, how can I, not sympathy, you don't want sympathy but it's not the same. If you've got no hair and that lot, people realise that you're ill and not just skiving off work or whatever you know. So I've no worries at all about losing the hair at all.

The men recalled numerous other side effects, including short-term memory loss, fatigue, diarrhoea, mouth ulcers, bleeding gums, skin rashes, and in one case, blood in the sputum. Some said that the drug cisplatin caused tingling in the fingers and toes, and affected balance, and one man said that bleomycin made him have amazing dreams.

Some men reported that they had mood swings, and one man said he had to take anti-depressant drugs. Others said that the chemotherapy made them feel as though they had a hangover, or a bad attack of flu.

Chemotherapy drugs may temporarily reduce the number of normal cells in the patient's blood. Some men who received high doses of chemotherapy for long periods reported they developed infections due to the effects on their immune system, and one described his fatigue and shortness of breath due to anaemia.

 

Explains that he caught an infection because his immune system was affected by chemotherapy.

Explains that he caught an infection because his immune system was affected by chemotherapy.

Age at interview: 30
Sex: Male
Age at diagnosis: 27
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Now the one thing that did happen then was I, I did feel very ill for a day or two and I really started to heat up and that was probably the worst experience of the chemotherapy itself. Which was my immune system had apparently dropped so low that I think I'd caught something, a bug or something and my body was actually not, my body was unable to defend itself against this. What actually happened I took myself into hospital, to the local hospital to, to be checked over and they gave me something called, I think it's barrier nursing, which is basically everyone who sees me including the nurses must be completely frocked up and plastic gloves on and masks on because they needed to treat me as soon as they could and as quickly as they could. So I was given treatments over a couple of days with antibiotics. And this is I guess the final effect of the chemotherapy was I, at that stage my white blood cells, I think my immune system had come down very low which was obviously an effect of the chemotherapy. 

So although I tried to keep myself away from people when I could because obviously the chances of catching something is out there all the time, I'd obviously caught something from someone, which I've seen, made me go into hospital. And I was there for about two or three days and then the antibiotics worked, I felt better and then I slowly recovered after that.

 

Explains that he became very anaemic and was prone to infection as the result of the chemotherapy.

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Explains that he became very anaemic and was prone to infection as the result of the chemotherapy.

Age at interview: 24
Sex: Male
Age at diagnosis: 22
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Over time the chemotherapy knocks out your immune system because they're kind of, you know they're cells that rapidly divide which is what a cancer is, which is what the chemo is aiming for. So you knock your immune system, you know it's knocked out so you become kind of prone to infection and your red blood cells aren't produced as readily and so you kind of find yourself being quite anaemic. And so after awhile, after chemo four, I was, you know all my blood was utterly wiped-out so I was very, very anaemic and I had no immune system. And that was appalling because I couldn't stand up and I was just kind of, to lie down I was fine and once I was resting it was no problem. I'd lie down. I'm fine now. But to actually have to walk, even from like the living room to the front door, to let someone in was such hard work. And it's just, it's just really difficult to describe how really severe anaemia feels. You just can't do anything and you're thinking, okay I have to like go and switch over the telly channel now, and it's like I've got to plan this and work out what is the most direct way of doing it is to stop too much effort. And then they gave me two bags of blood next time I went for chemo and you're fine, just like that, it's incredible. 

So I wish actually I'd asked at the time, you know, 'I feel weak and anaemic, can you just check out my blood and may be give me a blood transfusion'. Because the anaemia was bizarre and just, and once you've got the blood in you it's fine and you feel right as rain again. And I got an infection after chemo, three or four I think, because my immune system was just wiped out.

Sometimes the side effects of chemotherapy are more serious and may be permanent. For example, cisplatin can cause tinnitus (ringing in the ears) and may damage hearing. Two men, who had chemotherapy for three months, told us about their partial loss of hearing. One man said that he had suffered lung damage, which he attributed to bleomycin, and kidney damage from cisplatin. Another man said that carboplatin had damaged his liver, kidneys and pancreas.

 

Explains that the chemotherapy affected his hearing and gave him tinnitus (ringing in his ears).

Explains that the chemotherapy affected his hearing and gave him tinnitus (ringing in his ears).

Age at interview: 41
Sex: Male
Age at diagnosis: 35
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Another side-effect was that my hearing went as well for a little while, my hearing wasn't very good. I went for a hearing test and everything, and every single time I went for the chemo it seemed to be getting worse. In the end, well I've still got it now, I've still got tinnitus which is like a ringing in the ears. Every single chemo session I went for, it seemed to be getting worse. Now when I told the doctors and that lot they did change part of the chemotherapy, one of the drugs they give you, and it seemed to stop getting worse then. But I have actually got tinnitus now, which is like I say ringing in the ears, which was from the side effects from the cancer treatment.

Has the hearing improved?

No, not really no, it's about the same level as it was and like I've got this ringing in my head all the time but..

Oh dear that must be annoying?

I've got used to it now, it's like an unnecessary friend really (laughs) is how I can explain it.

But you actually lost some of the hearing?

My hearing wasn't good. I actually lost, because I went for a hearing test and they put you in a booth with this machine put your ears on and it's very weird in like a soundproof booth, can't hear a word, a single sound in there and then they start giving you buzzing through a machine and you have to switch it off. And through that I found that my hearing has dropped a few degrees really now.

 

Explains that chemotherapy damaged his lungs and kidneys.

Explains that chemotherapy damaged his lungs and kidneys.

Age at interview: 35
Sex: Male
Age at diagnosis: 30
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Another 2 months of it and on top of that they also told me that they did regular scans and regular blood tests and they also do lung function tests and kidney function tests. And one of the worst things, as you asked me before, one of the worst things was the lung function, my lungs were damaged by the drugs. I'm not sure, I think it was the bleomycin that damaged my lungs. I was left afterwards with a lot of scarring in my lungs so they stopped me on the bleomycin. And the cisplatin was causing me kidney damage so I had to go onto a drug called carboplatin which was slightly less effective but instead of being on the three drugs I was on two drugs, one of which was changed. So me being the inquisitive person I was wanted to know what does this mean for me? And it meant that the treatment might be slightly less effective but they couldn't at that time afford to continue with it because I was just getting so much lung damage and kidney damage as well.

Has that left you with long-term lung and kidney damage?

Initially I had lung scarring for, oh at least a good 12 months there was lung scarring and I was out of breath. If I walked up a flight of stairs I was out of breath. And they also gave me steroids for my breathing because my breathing was bad, they gave me steroids to help with the breathing. And in fact one of the things that came out of that was the determination to do the Great North Run, which I did. And as far as the kidneys are concerned I was left with kidney impairment. 

Last reviewed December 2017.

Last updated December 2017.

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