This leaflet provides information on a course of chemotherapy called BEP. The leaflet will explain what this is and when and how it is given. It will also tell you about common side effects that you may experience. Contact telephone numbers and details of how to obtain further information on BEP are given at the end of the leaflet.
This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ folder. If you haven’t received this folder please ask your nurse for a copy.
What is BEP chemotherapy?
BEP chemotherapy consists of 3 drugs:
These 3 drugs together are called BEP for short.
Why am I having BEP chemotherapy?
Your doctor has prescribed BEP chemotherapy because it has been found to be particularly effective in treating your type of cancer.
How often will I receive my BEP chemotherapy?
For this treatment to be most effective it is given at specific time intervals. These are known as cycles. It is usual to have a cycle of BEP every 3 weeks for up to 4 cycles. Your doctor will discuss with you the exact number of cycles you will receive.
How will my BEP chemotherapy be given?
Before each cycle you will have an out-patient appointment. You will have regular blood tests and we will check how you are feeling and discuss any problems you may have. This is so we can check how the chemotherapy is affecting you. If your blood results are satisfactory, your chemotherapy will be prescribed.
The chemotherapy will be given through a drip connected to a small needle which is placed in your hand or arm. As well as having the chemotherapy drugs, we will also give you other fluids through your drip.
You will need to attend the in-patient ward as a day patient for the first 5 days of each three weekly cycle. The chemotherapy will last for 5 - 6 hours each day. As long as you feel well you will be able to go home at the end of each day.
The bleomycin part of your treatment will be given to you on days 1,8 and 15 of each cycle. You will need to be assessed regarding your breathing prior to receiving bleomycin on days 1, 8 and 15. Day 1 will be given whilst on the ward. Days 8 and 15 will be given on the day units. Please allow approximately 1 to 2 hours for this treatment.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
What are the possible side effects?
There are a number of possible side effects which can occur with BEP chemotherapy. The doctor, nurses and pharmacy team can give you advice or answer any questions you may have.
Hair loss
Unfortunately you will lose your hair with this chemotherapy. This is only temporary. Your hair will grow back when your treatment has finished.
We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for a copy.
Sickness
Nausea and vomiting are uncommon these days as we will give you anti-sickness medicines which are usually extremely effective. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine when you are at home after your chemotherapy please contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Infection
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or if your temperature is below 35.5°. The telephone number is at the end of the leaflet.
Tiredness and fatigue
Chemotherapy can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as rest.
Fertility
BEP chemotherapy may affect your ability to father a child. We have a leaflet about male fertility and cancer treatments which gives information on sperm banking. Please ask your nurse if you would like a copy of this leaflet. Further information and advice is available from your doctor or the Urology Specialist Nurse. The telephone number is at the end of the leaflet.
Blood clots
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other less common side effects
Effects on your nerves
Cisplatin may damage the nerves of your hands and feet. You may experience some numbness or changes in sensation such as tingling or pins and needles. Although this is very rare it is important that you tell your doctor if this happens so that we can modify your treatment before this side effect becomes permanent.
Cisplatin may also damage the nerves responsible for hearing, although this is rare. If this occurs you may experience some loss of hearing which may be permanent.
Effect on your kidneys
Cisplatin can affect the way your kidneys work. The blood test which you have before your chemotherapy will check how well your kidneys are working at the start of treatment. We will also monitor you carefully by taking regular blood tests throughout your treatment.
We always give cisplatin with plenty of fluids in the drip to reduce the effect on your kidneys. It is also important that you drink plenty of fluids during the five days of treatment and for at least two days after each treatment. We suggest a cup or glass of fluid every hour during the day and evening.
If you are unable to drink this amount of fluid because of sickness you may need to be admitted to Velindre. You would need to have extra fluids in a drip and anti sickness medication.
Effects on your skin
Bleomycin may cause skin changes. These can include darkened patches on your skin, ridges to your nails or tenderness and swelling to the tips of your fingers.
Diarrhoea
You may have diarrhoea with this chemotherapy. If this occurs it is important that you drink plenty of fluids. Medication is available to control diarrhoea. If you have 4 or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Rare side effects of BEP chemotherapy
Bleomycin may damage the lungs when given in high doses. Although this is extremely rare it can be potentially life-threatening. We carefully calculate your dose of bleomycin to reduce the risk of this happening. If you are at risk of lung damage, your dose of bleomycin may be reduced or omitted. This effect is more likely to occur in people who smoke, so cutting down or stopping is very important. If you develop breathlessness or a dry cough please contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
A very rare complication of cisplatin treatment can be a stroke or a heart attack. Whilst this is very rare if you are concerned please discuss this with your doctor.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
Ask for the treatment helpline if you are unwell at home and need immediate advice at any time of the day or night. For example you should phone if you:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Macmillan freephone Helpline 0808 808 0000
Tenovus freephone 0808 808 1010
cancer helpline
Urology Specialist Nurse 029 2061 5888 ext 4680
Monday to Friday 9am to 5pm
Help me quit Wales 0808 252 8307
This information is also available in Welsh
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.