BEP Chemotherapy is the usual treatment for germ cell cancer patients who have experienced metastasis. The initials stand for the three chemotherapeutic agents used:
Bleomycin
Etoposide
Cisplatin

These drugs are given individually as intravenous infusions. A typical treatment cycle lasts for 21 days and the drugs are given on the following schedule:

Day 1 – Etoposide and Cisplatin
Day 2 – Etoposide, Cisplatin and Bleomycin
Day 3 – Etoposide
Day 8 or 9 – Bleomycin
Day 15 or 16 – Bleomycin

The schedule can vary slightly from that above depending on the patient and treatment centre. Three consecutive cycles are usually prescribed, but four cycles are used in some cases.

There are several side effects that patients might experience during the treatment cycles including: fatigue, headaches, nausea, appetite loss, hair loss, tinnitus, numb toes and finger tips, changes in taste, greasy skin, brittle nails, shivering, fever, mouth ulcers and cold and flu-like symptoms. Some of these can become long-term side effects, but the occurrence of those is fairly low.

There is also a heightened risk of infection in chemotherapy patients, as the treatment tends to lower one’s white blood cell count, particularly the neutrophils which are the body’s first line of defence against infection. For this reason, chemo patients need to keep good hygiene practices and get checked out urgently if they start experiencing high temperatures or other signs of infection.

The Macmillan Cancer Support website has a page explaining more about BEP chemotherapy.