Chemo Regimen FAQs: AC Chemotherapy

Q. I'm scheduled to have chemotherapy. The doctor says it's AC. I can't remember all the details...

A. AC is one of the five most common types of chemotherapy given to women with breast cancer. And it's probably the MOST common drug combination given to women with node-negative (hasn't spread to your lymph nodes) cancer. AC includes two drugs: doxorubicin (Adriamycin), and cyclophosphamide (Cytoxan). But you don't have to remember the names; just the initials, because anyone who needs to know will recognize what the letters stand for.

The "A" part of this "chemo cocktail" both blocks DNA production in your cells, and also inhibits the enzymes responsible for repairing DNA. Cells can't live without DNA; thus when they're deprived of it, they die (in fact, some even kill themselves when their DNA is damaged). "A" can't distinguish between cancer cells and normal cells; but because cancer cells are dividing so rapidly, it has a greater negative effect on them than on your normal cells. The "C" part of this chemo combo stops cancer cells from replicating. So between them, you have some pretty powerful agents working to destroy those cancer cells.


Q. How long will it take to get AC treatment?

A. Delivery methods and schedules vary, as the pharmacology is constantly changing. That said, you'll probably have four treatments, one every three weeks, so the whole thing will take just over two months, barring any complications that slow down the process.

Each AC treatment is given by IV into your hand or arm, and should last about two 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 each time. 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...

A. Each time you begin AC chemo treatment, you'll have blood drawn first. One of chemo's side effects is lowering your white blood cell count; i.e., 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 chemo until your white cells have built themselves back up to an acceptable level.


Q. And the side effects of the AC chemotherapy regimen?

A. Ah, here's what you hate to ask about but need to know, right? It's like putting your hands over your eyes at the scary part of a movie, then peeking out and looking anyway.

• Nausea and vomiting: These can occur-CAN occur-but aren't nearly as prevalent a side effect as they once were. Usually you'll be given medication to take directly after your AC treatment, and this should reduce this nasty symptom to general queasiness, if not eliminate it completely. You may be one of the unfortunate women who gets sick anyway, but take heart; you should start feeling better after about three days.