Q. Unfortunately, I’ve just found out I need to have chemo. With no node involvement I thought I’d avoid it, but my Oncotype score is in the moderate range, so my oncologist is prescribing TC. What can I expect?

A. TC is currently one of the most common types of chemotherapy given to women with early-stage breast cancer. It’s gradually replacing AC, the Adriamycin-based “gold standard” of chemo for many years. TC comes with fewer serious side effects than AC, and studies have shown it’s more effective for women with node-negative (hasn’t spread to your lymph nodes) cancer; or cancer where three or fewer nodes are involved.

TC includes two drugs: a taxane, paclitaxel (Taxol) or docetaxel (Taxotere); and cyclophosphamide (Cytoxan). (Interestingly, taxanes are one of the few “natural” chemo drugs; they’re made from the bark of the Pacific yew tree.) Anyway, don’t worry about remembering the names; just focus on the initials, because anyone who needs to know will recognize what the letters stand for.

The "T" part of this chemo combo slows or stops cell division, and keeps enzymes from making the proteins cells need in order to grow. The “C” part stops cancer cells from replicating. So between them, you have some pretty powerful agents working to destroy your cancer.

Q. How long will chemo take?

A. You’ll probably have four treatments: one every three weeks, so the whole thing will take about 2 ½ months. Some women have six treatments; if that’s your schedule, you can add another 6 weeks to that estimate. Each treatment is given by IV into your hand or arm, and should last about 2 to 3 hours.

Q. And the side effects?

A. Thankfully, TC is generally better tolerated than many other types of breast cancer chemo. Still, there are a range of side effects you may experience. 

•One immediate (and scary) side effect can be an allergic reaction. You’ll be monitored closely as you receive your first infusion; and if you experience this allergic reaction, the IV drip will be slowed down while you receive drugs to treat it. If it turns out you’re allergic to the taxane, you’ll be given corticosteroid drugs prior to any succeeding treatments; these will prevent a reaction.

•Nausea and vomiting: These can occur – CAN occur – but with the wide array of anti-nausea medications now available, they aren’t nearly as prevalent a side effect as they once were. Usually you’ll be given medication to take directly after your treatment, and this should reduce these nasty symptoms to general queasiness, if not eliminate them completely.

You may be one of the unfortunate women who gets sick anyway, but take heart; you should start feeling better after about 3 days.

•Hair loss: Sorry. No two ways about it, Cytoxan will see to it that you lose some or all of your hair. This will probably happen 2 to 4 weeks after your first injection. Prepare by deciding on a wig, head gear, or if you’re simply going to “go naked.” It also helps to cut your hair short before it falls out. Somehow, going from short hair to no hair is easier than long hair to bald.