Cancer drugs A to Z list
VIP made up of the following chemotherapy drugs. How you pronounce each drug is next to the name in brackets:
cisplatin (sis-plat-in)
etoposide (ee-top-o-side)
ifosfamide (eye-foss-fa-mide)
You might have this treatment if you have testicular cancer that has spread or come back.
Find out more about testicular cancer
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
You have these drugs as a drip into the bloodstream (intravenous).
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
central line
PICC line
portacath
You have VIP chemotherapy as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover.
Each cycle of treatment lasts 3 weeks (21 days). You usually have 4 cycles, taking about 3 months in total.
You usually have VIP in the following way.
You have etoposide as a drip into your bloodstream over an hour.
You have cisplatin as a drip into your bloodstream over 1 to 2 hours.
You have ifosfamide as a drip into your bloodstream over 1 to 4 hours.
You have no treatment
You then start the next treatment cycle. You have fluids into your bloodstream for a few hours before and after each cisplatin treatment. You also should drink about 2 litres (3½ pints) of water over 24 hours . The extra fluids help to protect your kidneys.
You usually have ifosfamide together with another drug called mesna. You have mesna as a continuous drip (infusion) into your vein. You might also have tablets to take home.
When having mesna you should drink about 2 litres (3½ pints) of water over 24 hours.
Mesna is not a chemotherapy drug. It stops the ifosfamide from irritating your bladder lining and making it bleed. You usually have mesna from day 1 to day 5 of each treatment cycle.
You might also have injections of a drug called GCSF with each treatment. This is a type of growth factor that makes the body produce white blood cells to try to reduce the risk of infections. You have GCSF as an injection just under the skin (subcutaneously). This usually starts on day 6 of each treatment cycle.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
You have regular urine tests before and during treatment. This is to check if the ifosfamide is affecting the bladder.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.
You may have changes in levels of minerals and salts in your blood, such as low sodium. This will most likely go back to normal when you finish treatment. You have regular blood tests during treatment to check this.
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
You have regular blood tests to check for any changes in the way your liver is working.
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.
The colour of your skin might also change.
Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness. Some allergic reactions can be life-threatening alert your nurse or doctor if notice any of these symptoms.
a blood clots that could be life threatening. Signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your advice line or doctor straight away if you have any of these symptoms.
a serious reaction to an infection. Signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering. Contact your advice line straight away if you have any of these symptoms.
low blood pressure or high blood pressure
dizziness
a blood cancer called acute leukaemia. Talk to your doctor if this of concern to you.
inflammation and or ulcers of the mouth, throat and or food pipe (oesophagus)
inflammation around the drip site which can cause pain and swelling
heart problems such as slow, fast or irregular heartbeat
shortness of breath
lung problems such as pneumonia and difficulty breathing
mental state changes such as not speaking, confusion, panic and anxiety
These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
a low level of magnesium in the blood
problems with hearing such as ringing in the ears (tinnitus) or loss of hearing. Tell your team if this is happening.
numbness, tingling or pain in the hands or feet (peripheral neuropathy)
taste of metal or feeling like the gums are metal
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
chills
swelling
muscle twitching
bone, muscle and joint pain
breakdown of the muscle which can be life threatening or cause permanent damage. Symptoms include muscle pain, muscle weakness, trouble moving arms and legs, red or brown urine or urinating less. Contact your team if you have any of these symptoms.
softening of the bones
nail changes
excessive sweating
a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening.
eye problems such as watery, redness and itchy (conjunctivitis)
problems with your eyesight
changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome). You have regular blood tests to check for this.
a syndrome called SIADH - the body makes too much of the hormone that holds water in the body
kidneys stop working (renal failure)
If you have side effects that aren't listed on this page, you can look at the individual drug pages:
We have more information about side effects and tips on how to cope with them.
Read more about how to cope with side effects
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
You may not be able to become pregnant or get someone pregnant after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment. Women must not become pregnant for at least a year after the end of treatment. Men should not get someone pregnant for at least 6 months after treatment.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Don’t breastfeed during this treatment. This is because the drugs may come through in your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
Read more about immunisations and cancer treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 27 Sept 2023
Next review due: 28 Sept 2026
Testicular cancer is cancer that develops in the testicles, which are part of a man's reproductive system.
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