Long Term Follow up following BEP Chemotherapy Treatment for Testicular Cancer

As it is now some time since you completed your BEP chemotherapy, the focus of your follow up appointments will change. Although we will continue to examine you and carry out blood tests and x-rays in order to detect a recurrence of your cancer, the risk of this is now lower and it is important to examine how you can reduce the long term risks associated with the chemotherapy.

Research has shown that the risk of developing cardiovascular disease and/or second cancers following BEP chemotherapy is higher than that in the general population who have not received this treatment. The risk is approximately doubled.

Cardiovascular disease

Refers to diseases involving the heart and circulation. This can include angina, heart attacks and strokes. There are many factors which contribute to developing cardiovascular disease and your risk can be calculated using an online assessment tool (opens in a new tab). This predicts the likelihood of you developing the problem within the next ten years.

Factors which contribute to developing cardiovascular disease include:

• Advancing Age
• Male Gender
• Smoking
• High blood pressure
• High blood cholesterol/triglycerides
• Excessive alcohol consumption
• Obesity
• Family history of early-onset cardiovascular disease
• Diabetes

Assistance in managing cardiovascular risk is usually provided by General Practitioners. We recommend that you consult your GP in order to have a risk assessment and in particular to have your blood pressure and cholesterol/HDL ratio checked. These together with your height and weight and the answers to a number of questions about personal and family history allow a calculation of the risk of developing cardiovascular problems within the next 10 years. Should you be identified as being at increased risk of developing cardiovascular disease, you will be offered advice on how to reduce this risk by lifestyle changes which will be beneficial to your long term health or by prescribing relevant medication.

It is important to understand that the previous treatment provides a small additional increase in risk which may influence decisions and recommendations about weight reduction, blood pressure reduction and the use of statins to reduce cholesterol.

Second cancer

Is a long-term risk of the chemotherapy that can occur many years in the future. As with cardiovascular disease, there are many contributing factors which increase your overall risk of cancer and we would again encourage you to adopt a healthy lifestyle to reduce your overall risk.

The five most important things you can do are:

• Stop smoking
• Achieve and maintain a normal weight
• Take exercise five times a week
• Drink alcohol only in moderation within advised limits (not more than three to four units per day).
• Reduce the consumption of salt and saturated fat and eat more fruits and vegetables and fish.

Your GP will be advised that you are at a higher than average risk of developing cardiovascular disease and/or second cancers. He or she will be able to assist you in cardiovascular risk reduction and will encourage you to seek medical advice should you develop any signs or symptoms which may suggest you are developing a problem in the future.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.