AC chemotherapy

What is AC chemotherapy?

AC is a combination of two chemotherapy drugs used to treat breast cancer.

It takes its name from the initials of these drugs:

• doxorubicin (also known as Adriamycin)
• cyclophosphamide

Who is given AC chemotherapy?

AC Chemotherapy is a treatment option for primary breast cancer, which is breast cancer that has not progressed to the lymph nodes under the arm or beyond the breast. It is occasionally used with other anti-cancer medications. Chemotherapy is administered to lower the possibility of breast cancer coming back or spreading.

AC chemotherapy may be administered either prior to surgery (neo-adjuvant treatment; also known as primary chemotherapy) or following surgery (adjuvant treatment).

Additionally, those who have:

1. Breast cancer that has returned locally, or in the skin around the initial site or scar, but has not spread to other parts of the body, is referred to as a local recurrence (also called a regional recurrence)—recurrent breast cancer that has spread to the tissues and lymph nodes in the area around the chest, neck, and under the breastbone.
2. secondary (metastatic) (metastatic) Breast cancer is defined as breast cancer that has spread to other bodily areas.

Before giving AC chemotherapy

Some hospitals will schedule a chemotherapy information session before you begin your treatment. A nurse will go over the details of when and how you’ll receive your chemotherapy, as well as how to deal with any side effects, at this session.

Blood tests and an ECG (electrocardiogram), a quick test to evaluate your heart rhythm, may be performed on you. Additionally, your height and weight will be assessed.

You will be provided with phone numbers so you know who to call with any questions or concerns.

How does AC chemotherapy work?

Chemotherapy medications impede the growth and development of cancer cells in various ways, depending on the agent.

AC chemotherapy prevents the spread of the cancer by preventing the cancer cells from reproducing and growing.

Chemotherapy medications target cancer cells at various phases of development. For this reason, multiple medications are frequently taken in combination rather than just one.

Because AC chemotherapy is a systemic therapy, it has an impact on all of the body’s cells.

How is AC chemotherapy given?

Intravenous AC chemotherapy is administered into a vein. While alternative intravenous methods may be employed depending on factors such as how simple it is for chemotherapy professionals to discover suitable veins and your preferences, this will typically be an infusion (drip) into the hand or arm.

Read about the various chemotherapy delivery methods.

As an outpatient or day case, you will typically receive your treatment at a hospital, allowing you to leave on the same day.

How long treatment lasts

You’ll usually have four to six cycles (doses) of AC chemotherapy, over three-four months. Both drugs are given on the same day, every three weeks.

The time between each cycle of treatment gives your body time to recover.

This may vary depending on whether the number of blood cells has returned to normal between each cycle.

Common side effects of AC chemotherapy

Like any treatment, AC chemotherapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. These side effects can usually be managed and those described here will not affect everyone.

If you’re concerned about any side effects, regardless of whether they are listed here, talk to your chemotherapy nurse or cancer specialist (oncologist) as soon as possible.

Effects of giving AC chemotherapy

While the drug cyclophosphamide is being injected, you may feel hot or flushed and slightly dizzy, and have an itchy nose or a metallic taste in your mouth. These feelings usually go away when the injection is finished, but tell your chemotherapy nurse if you experience any of them. Some people find sucking a boiled sweet helps.

Effects on the blood

AC chemotherapy can temporarily affect the number of blood cells in the body.

You’ll have regular blood tests to check your blood count. If the number of blood cells is too low, your next course of treatment may be delayed or the dose of chemotherapy reduced.

Risk of infection

Not having enough white blood cells can increase the risk of getting an infection.

Contact your hospital immediately if:

• you have a high temperature (over 37.5°C) or low temperature (under 36°C), or whatever your chemotherapy team has advised
• you suddenly feel unwell, even with a normal temperature
• you have any symptoms of an infection, for example, a sore throat, a cough, a need to pass urine frequently or feeling cold or shivering.

Before starting chemotherapy, you should be given a 24-hour contact number or told where to get emergency care by your treatment team. You may need antibiotics. Sometimes your doctor may recommend injections of drugs called growth factors to stimulate the production of white blood cells and reduce your risk of infection.

Having too few red blood cells is called anemia. If you feel particularly tired, breathless, or dizzy, let your treatment team know.

You may also bruise more easily, have nosebleeds, or have your gums bleed when you brush your teeth. Tell your treatment team if you have any of these symptoms.

Hair loss

AC chemotherapy causes hair loss in most people. Scalp cooling may be possible to try to prevent or lessen hair loss. It’s not available in all areas, so ask your specialist or chemotherapy nurse if this is an option for you.

Nausea and vomiting

You may experience nausea (feeling sick) and vomiting (being sick), but many people will not actually be sick. You’ll be given anti-sickness medication into your vein or as tablets on the day of treatment, and you’ll be prescribed anti-sickness drugs to take home to reduce nausea or vomiting. If you still experience nausea and vomiting, talk to your chemotherapy team.

Diarrhoea or constipation

You may have diarrhoea or constipation but your specialist or GP can prescribe medicine to help control it. Contact your chemotherapy team if you have four or more episodes of diarrhoea within a 24-hour period.

Sore mouth and taste changes

You’ll be given mouthwash to try to reduce soreness of the mouth and gums and to try to stop mouth ulcers developing. Good mouth hygiene is very important during treatment. It’s advisable to see your dentist for a dental check-up before chemotherapy begins, but avoid dental treatment during chemotherapy.

While you’re having AC chemotherapy your taste can change and some food may taste different (for example more salty, bitter or metallic).

Pain in the injection site

If AC chemotherapy leaks out of the vein it’s being given in (called extravasation), it can damage the surrounding soft tissue. Tell the nurse giving the chemotherapy immediately if you have pain, stinging or a burning sensation around the cannula (small plastic tube) while the drug is being given.

After treatment, pain can occur where the needle has been inserted or along the vein. After a few weeks you may notice tenderness, darkening and hardening around where the needle was inserted. This should fade in time.

Fatigue (extreme tiredness)

Fatigue is extreme tiredness or exhaustion that doesn’t go away with rest or sleep. It’s common to have fatigue during your treatment. For some people, fatigue can last for several weeks or even months after the treatment has finished, but your energy levels will gradually return. There are different ways of coping with fatigue.

Bladder irritation and pink or red urine

Drink plenty of fluids around the time you have your treatment because chemotherapy drugs (particularly cyclophosphamide) can irritate the lining of the bladder. Try to empty your bladder regularly, as soon as you feel the urge. Tell your specialist if you notice any irritation or a burning/stinging sensation when passing urine.

Doxorubicin can cause your urine to become pink or red for a couple of days. This is because of the colour of the drug, and is completely normal.

Effects on your concentration (cognitive impairment)

Your ability to concentrate or think clearly can also be affected, which can be very frustrating. This is sometimes referred to as ‘chemo-brain’ or ‘chemo-fog’ but is more commonly known as cognitive impairment. It usually improves over time after treatment has ended.

Effects on fertility

AC chemotherapy can cause temporary or permanent infertility (being unable to get pregnant). If this is important to you, talk to your specialist before starting your treatment – they may be able to refer you to a fertility specialist. You can read more about this on our fertility web pages.

Menopausal symptoms

Sometimes AC can cause women who haven’t been through the menopause (pre-menopausal) to experience menopausal symptoms. This is because it affects the ovaries, which produce oestrogen.

Common symptoms include:

• hot flushes and night sweats
• mood changes
• joint aches and pains
• vaginal dryness

Top cancer hospitals in India use the latest chemotherapy and drugs to treat breast cancer. Contact us to learn more about it.

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• February 16th, 2023