Understanding AC Chemotherapy
AC is a powerful chemotherapy combination used primarily to treat breast cancer. It consists of two drugs:
- A – Doxorubicin (dox-oh-ROO-bi-sin), also called Adriamycin
- C – Cyclophosphamide (sye-kloe-FOSS-fa-mide)
This regimen works by destroying rapidly dividing cancer cells, helping to shrink tumors and prevent cancer spread.
How is AC Chemotherapy Given?
Administration Methods
- Intravenous (IV) infusion through:
- Central line (long-term chest port)
- PICC line (arm-inserted central catheter)
- Portacath (implanted venous access)
- Short-term cannula (arm vein, replaced each session)
Treatment Schedule (Cycles)
- Each cycle lasts 21 days (3 weeks)
- Day 1:
- Doxorubicin (IV injection or drip)
- Cyclophosphamide (IV injection or drip)
- Days 2-21: Recovery period
- Total cycles: Typically 4-6 cycles (3-4 months total)
Note: Most patients also receive G-CSF (granulocyte colony-stimulating factor) injections to boost white blood cell production and reduce infection risk.
Common Side Effects (>10% of Patients)
| Side Effect | Management Tips |
|---|---|
| Infection risk (low white blood cells) | Watch for fever (≥37.5°C), chills, cough. Seek urgent medical help. |
| Hair loss | Scalp cooling may help. Hair usually regrows post-treatment. |
| Nausea & vomiting | Take anti-sickness meds as prescribed. Eat small, bland meals. |
| Fatigue | Prioritize rest; light exercise may help maintain energy. |
| Mouth sores | Use a soft toothbrush, avoid acidic/spicy foods, rinse with saltwater. |
| Hand-foot syndrome | Moisturize skin; avoid hot water & friction. |
| Red/pink urine (1-2 days post-treatment) | Harmless—caused by doxorubicin color. |
Other Possible Side Effects
- Anemia (low red blood cells) → Fatigue, pale skin
- Low platelets → Bruising, nosebleeds
- Bladder irritation (cystitis) → Drink plenty of fluids; report blood in urine.
Serious Side Effects (Seek Immediate Help)
⚠ Severe infection (fever, shaking chills)
⚠ Chest pain or irregular heartbeat (heart toxicity risk from doxorubicin)
⚠ Severe allergic reaction (rash, swelling, breathing difficulty)
⚠ Uncontrolled bleeding or bruising
Important Precautions
Before Treatment
✔ Blood tests (check liver, kidney function, blood counts)
✔ Heart tests (ECG/echocardiogram) – Doxorubicin can affect heart function
During Treatment
- Avoid grapefruit (interferes with drug metabolism)
- Stay hydrated (helps prevent bladder irritation from cyclophosphamide)
- Use sunscreen (increased sun sensitivity)
Pregnancy & Fertility
- Contraception required (for both men & women during and 12+ months post-treatment)
- Possible infertility – Discuss sperm/egg preservation options before starting chemo
Vaccinations
🚫 No live vaccines (MMR, BCG, yellow fever) during & 12 months after treatment
✅ Safe vaccines: Flu shot, COVID-19 vaccine (may be less effective)
Long-Term Monitoring
- Regular heart check-ups (doxorubicin can cause delayed heart damage)
- Cancer screening (small risk of secondary cancers like leukemia)
Additional Resources
- Patient Leaflet: UK eMC Website
- Side Effect Reporting: MHRA Yellow Card Scheme
Final Thoughts
AC chemotherapy is a highly effective breast cancer treatment, but it requires careful monitoring due to potential side effects. Working closely with your oncology team ensures the best outcomes.
Have questions about AC chemotherapy? Ask in the comments below!
Disclaimer: This guide is for informational purposes only. Always follow your healthcare team’s advice for personalized care.