1. DR. MAHARAJ & ASSOCIATES
PRACTICE NO. 0546526
ALL RIGHTS RESERVED
DR N MAHARAJ
Specialist Radiation & Clinical Oncologist
MBChB (Natal), MMed (Rad Onc) (Stellenbosch)
IMRT/IGRTfellowship(IcahnSchool ofMedicine at Mount Sinai) (New
York)
PRACTICE NO: 0546526
BEP Chemotherapy
Tel: 035 780 0246
Fax: 035 789 4566
Email: isis.oncology@gmail.com

2. DR. MAHARAJ & ASSOCIATES
PRACTICE NO. 0546526
ALL RIGHTS RESERVED
This information is for patients who are going to receive a course of Bleomycin,
Etoposide and Cisplatin (BEP) treatment for cancer.
The leaflet will explain:
 The treatment plan
 The most common side effects you may have and ways in which you
can reduce or even overcome them when you are at home
 Any serious side effects that may affect your lifestyle
 Who to contact when you need advice about the treatment.
Every patient is different and you may not have the same side effects as somebody else. Your
doctor and nurse will talk to you about the side effects you may experience. You might find it
helpful to read the CCO booklet called Chemotherapy, which explains how chemotherapy
works and gives some general information.
Treatment Plan
The nurses will give you your treatment. It is usually given as an infusion (drip) into a vein in
the back of your hand or forearm using a plastic needle called a ‘cannula' in cycles. The first
day of each cycle of chemotherapy is called ‘day one' and each cycle lasts 21 days. BEP can
be given as either a three or five day treatment as follows: Your doctor will discuss with you
which treatment you are going to have and how many cycles will be given. If the skin around
the cannula burns, stings, or is painful during the infusion please inform the nurse
immediately.
3 day BEP 5 day BEP
Bleomycin on days: 1, 8 and 15 1, 8 and 15 for first 3 cycles
Etoposide on days: 1, 2 and 3 1, 2, 3, 4, and 5
Cisplatin on days: 1 and 2 1, 2, 3, 4, and 5
Number of nights in hospital 2 5
Number of cycles 2 or 3 6

3. DR. MAHARAJ & ASSOCIATES
PRACTICE NO. 0546526
ALL RIGHTS RESERVED
Checking Your Temperature
If you are receiving chemotherapy treatment we will ask you to monitor
your temperature. If you take regular pain medications for any reason, it
is important that you check your temperature before taking them.
Fertility
We advise you not to become pregnant or to father a child during and
for some time after your treatment. You should discuss methods of
contraception with your partner and, if necessary, a nurse or doctor
before starting treatment. If you have completed treatment and are
considering having a child, please talk to your Oncologist first.
Chemotherapy can cause infertility, if fertility is important to you, or if
you have not completed your family, please discuss it in more detail with
your doctor.
Contact Telephone Helpline
If you need to speak to a chemotherapy nurse for advice about your
treatment or side effects, please phone 035 780 0240 (24
hours).
Please call if you have any queries, but it is particularly important if you are
experiencing any of the following:
• A temperature greater than 37.5°C
• A temperature greater than 37.5°C
• Any unexplained bruising or bleeding
• Diarrhoea for more than 24 hours
• Unrelieved shortness of breath
• Mouth ulcers that stop you eating or drinking

4. DR. MAHARAJ & ASSOCIATES
PRACTICE NO. 0546526
ALL RIGHTS RESERVED
Side Effects
Bone Marrow
Bone marrow produces blood cells in the hollow spaces of bones and
chemotherapy may temporarily lower the three main types of blood cells:
• White cells leaving you more prone to infection
• Red cells causing anaemia
• Platelets, which may leave you prone to bruising or bleeding
Because of this, we will require regular blood tests. It is urgent that you
contact the telephone helpline with any symptoms that may mean you
have a low blood count. These are:
• A temperature greater than 37.5°C
• Unrelieved shortness of breath, dizziness or fatigue
• Unexplained bruising or bleeding
Nausea and Vomiting (feeling sick and being sick)
Nausea and vomiting may start a few hours to a few days after
treatment. It is important to take your anti-emetics (anti-sickness)
medication as prescribed. Some people find eating small, frequent meals
and avoiding rich, spicy foods and alcohol can help. If your anti-emetics
do not help please telephone for advice and inform your nurse or doctor
at your next hospital visit. A different anti-emetic may help. Some antiemetics
may cause drowsiness, and if you feel sleepy it is important that
you do not drive or operate machinery.
Hair Loss
Over the first few weeks, you will lose the hair on your head and your
body hair may thin out. If you wish, the nurse will refer you to a wig
supplier. Hair loss is usually temporary and your hair should return once
the chemotherapy is complete.
Tiredness
Many patients feel very tired and this is not relieved by rest. This is quite
normal and there are many reasons for this. Maintaining your usual
activities as much as possible may help. Try to incorporate some activity
such as a short walk into your daily routine, but do rest when you feel
you need to. If your treatment makes you feel sleepy do not drive or use
tools or machines. Please telephone for advice and inform your nurse or
doctor at your next hospital visit if you become much more tired than
usual.

5. DR. MAHARAJ & ASSOCIATES
PRACTICE NO. 0546526
ALL RIGHTS RESERVED
Mouth and Throat
Your mouth and throat may be prone to ulcers and infection and you can
help this by cleaning your teeth and gums after each meal with a soft
toothbrush and using dental floss daily. Salt water mouthwash may help
and you can make this by adding one teaspoon of salt to one pint boiled,
cooled water. You may also experience taste changes. If your mouth is
very sore or becomes ulcerated, telephone for advice.
Diarrhoea
You may experience diarrhoea, if it is severe, (more than 4 times in 24-
hours) it is important to telephone for advice immediately.
Kidney Problems
Your kidneys make urine (water, wee) and they can be harmed by the
chemotherapy. We will give you plenty of fluids through the drip to help
prevent this and you may be asked to measure your urine while you are
in the hospital. We will check how well your kidneys are working using
blood tests each time you attend, if the blood results show changes the
doctor may decide to change your chemotherapy.
Nerves
You may experience pins and needles or numbness in your fingers and
toes, this sensation tends to improve with time. If you experience this
please be aware that you may not be able feel extremes of temperature
and take extra care. It is important to inform your nurse or doctor at your
next hospital visit if this happens to you.
Hearing
Sometimes the chemotherapy can affect your hearing. If you notice a
ringing or buzzing in your ears, or you become hard of hearing, let the
nurse or doctor know at your next visit.
Flu-like Symptoms
For the first 24-hours following bleomycin injections, you may experience
fever and chills. Paracetamol can help with this, but please check your
temperature before taking any tablets. If pain medications don't help
please telephone for advice and inform your nurse or doctor at your next
hospital visit.
Breathing
Very rarely, the bleomycin may cause problems with your lungs and
breathing. If you notice that you become short of breath or start
coughing or wheezing, let the doctor know at your next visit.

6. DR. MAHARAJ & ASSOCIATES
PRACTICE NO. 0546526
ALL RIGHTS RESERVED
Weight
You may find you gain or lose some weight during or after your
treatment. Whilst this may cause you some concern, it is important that
you eat healthily and do not diet until your treatment is complete. Please
ask for advice on healthy eating if you wish. We can refer you to a
dietician if needed.