A. Have you heard about FEC in the news? Well, that’s the Federal Election Commission, reporting on political finagling. Your FEC stands for fluorouracil (5FU); epirubicin (Ellence); and cyclophosphamide (Cytoxan). Don’t worry, there won’t be a quiz on this! Just remember the initials, and you’ll be fine.
Why three drugs? This is a common combination of drugs given to women with node-positive breast cancer: i.e., the cancer has traveled to one or more of your lymph nodes. So, what does each of these drugs each do?
Basically, each attacks your cancer cells in a different way. “F” is made up of molecules that look very much like the molecules in normal cells, but they’re structured slightly differently; this very small difference is enough to keep cells from functioning properly, once “F” makes its way into them.
“E” has lots of tricks up its sleeve. It stops the enzymes that support cell reproduction; it damages the cell by altering its membranes; and it stops cell reproduction by attaching itself to the cell’s DNA, which then gets tangled up and is unable to replicate itself (pretty sneaky, huh?).
Finally, “C” sticks to the cell’s DNA, like “E,” preventing it from replicating. And that, really, is what killing cancer is all about: stop the cells from dividing, and you stop the cancer.
Q. What’s the timeframe here for FEC treatment? How long does it take?
A. Delivery methods and schedules for FEC treatment vary, as the pharmacology is constantly changing. That said, the majority of women being treated with FEC get it intravenously, every three weeks, for six treatments. So, basically it takes fifteen weeks, barring any complications that slow down the process. And the FEC treatment itself takes between two and three hours. Add to that the ride to and from the hospital, the blood tests before (to make sure your white cells are up to the battle), and the inevitable waiting around, and you’re looking at half a day for each FEC treatment. Bring stuff to distract or amuse yourself: books, knitting, a friend or family member. You don’t want to just sit around and twiddle your thumbs the whole time.
Q. You mentioned complications to FEC…
A. Each time you begin FEC treatment, you’ll have blood drawn first. One of chemo’s side effects is lowering your white blood cell count by killing off some of the cells that help fight infection. If your doctor decides your white cell count isn’t high enough to keep you healthy, he or she will delay your next FEC chemo treatment until your white cells have built themselves back up to an acceptable level.
Q. Hate to ask, but what are the side effects of FEC?
A. Be strong; you might as well know what you’re facing, so you can be prepared. And anyway, isn’t it better having an idea what’s in store? Sometimes what you imagine is worse than the reality! So here goes:
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