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Doing BEP twice

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  • Doing BEP twice

    Hey ive been reading up on testicular cancer and learning and have realised that doing BEP twice is not done. Like for example you do BEP the first time, then say youre clear for a year and get a recurrence. It is normal i read to do VIP or any other combination. Why isnt BEP attempted again?

    I just also read the thread from Kris where he done BEP twice, so it shows it is done like that.

    So why isnt it done more often?

  • #2

    Because of the adaptation of cancer cells to specific chemo regimen. The cancer cells get some imunity and then another chemo combination must be considered
    Stage III EC 85% + Sem 15%
    AFP=2.6; HCG=10, 20,28 and rising
    FULL CAT scan:
    -abdominal lymph clear
    -subpleural lungs metastasis [bipulmonary lesions with diam <= 1cm]
    4 x BEP changed to 3 x BEP at my request
    from 2005-05....Surveillance


    • #3

      BEP twice isnt something Ive heard of before. The biggest problem would be with the toxicity of the drugs - for example, you need to stop at 3 (4 at a push) cycles of bleomycin, as the potential for lung damage is very real. Also keep in mind that if you have a relapse (rather than a second primary tumor) your first treatment wouldnt have been 100% effective, so you wouldnt want to treat the relapse with the same drug combination.

      I guess if your first treatment was 1 BEP cycle you could have more later, or possible complete 3 x EP as a treatment. My second line chemo was Cisplatin, Vinblastine & Ifosfamide (VeIP), which I think is a pretty standard path to take.

      Left I/O March 05, nonseminoma;
      Relapse July 05, single lymph node 3cm;
      2 x BEP Aug / Sept 05, node grown to 4.7cm;
      2 x VeIP Sept / Oct, node grown to 6.7cm, markers normalised;
      RPLND Dec 05, no active cancer;
      back on surveillance


      • #4
        Although I wrote that I had twice BEP, in fact for the first time it was rather 4 EP (I had only 3 injections of Bleomycin because due to poor blood results I couldn't receive it during cycles) and then almost 4 BEP (I avoided 2 injections of Bleomycin after 3rd cycle). The doctor calculated that I didn't get more than maximal life dose of Bleomycin. In my case I was lucky because when I recurred my tumour responded perfectly to treatment and shrank 10 times very quickly after 2 cycles