The AC chemotherapy regimen is a frequently used treatment protocol in cancer care. It combines two specific medications to target and destroy cancer cells within the body. This information provides a clear overview of the regimen, its administration, and potential side effects to help patients and caregivers navigate treatment.
Components and Purpose of AC
The “AC” regimen combines two chemotherapy drugs: Adriamycin (doxorubicin) and cyclophosphamide. These drugs work together to damage the DNA inside cancer cells, preventing them from dividing and leading to cell death. The AC regimen is a common treatment for early-stage localized breast cancer, even if it has spread to lymph nodes. It can also be prescribed for local recurrence or when breast cancer has metastasized to distant sites like bones, liver, lungs, or brain.
How AC Chemotherapy is Administered
The AC chemotherapy regimen is typically administered intravenously, meaning the medications are delivered directly into a vein. This is usually done in a chemotherapy day unit by trained nurses. Patients may receive the drugs through a short, thin tube called a cannula inserted into a vein in the arm or hand, or through a central line, PICC line, or portacath, which are longer tubes placed into a larger vein in the chest.
The treatment schedule usually involves cycles, allowing the body to recover between doses. A common cycle length is 21 days (three weeks), where doxorubicin and cyclophosphamide are given on the first day, followed by a rest period until the next cycle begins. Sometimes, a dose-dense schedule is used, with treatments given every 14 days (two weeks). A full course of AC chemotherapy typically consists of four to six cycles, spanning approximately three to five months. Before each treatment, blood tests are conducted to ensure blood counts are at a safe level for chemotherapy.
Managing Common Side Effects of AC
The AC chemotherapy regimen can lead to several common side effects, which vary among individuals. One frequent side effect is fatigue, where patients may feel extremely tired and lack energy. Resting when needed and engaging in light exercise, such as short walks, can help manage this tiredness. Nausea and vomiting are also common, but healthcare providers typically prescribe anti-nausea medications to help prevent or control these symptoms. Taking these medications as directed, even if not feeling sick, can be effective in prevention.
Hair loss is an expected side effect, generally starting two to three weeks after the first injection, and it can affect hair on the head, face (like eyebrows and eyelashes), and body. Considering a wig or other head covering before treatment begins can be helpful. Low blood counts, specifically a reduction in white blood cells (neutropenia), increase the risk of infection. Patients should monitor for signs of infection, such as a temperature above 37.5°C (100.9°F) or below 36°C (96.8°F), and contact their healthcare team immediately if these occur.
Mouth sores and ulcers can develop, making eating difficult. Maintaining good oral hygiene by brushing teeth twice daily with a soft-bristled toothbrush and using an alcohol-free mouthwash can help. Avoiding spicy, sour, or very salty foods and choosing soft, easy-to-chew options is also beneficial. Cyclophosphamide can irritate the bladder, potentially causing discomfort during urination or even blood in the urine. Drinking plenty of fluids, at least eight glasses per day, and urinating frequently helps to mitigate this irritation.
Preparing for and Navigating AC Treatment
Preparing for AC treatment involves several practical steps to support overall well-being. Maintaining good nutrition and staying well-hydrated are important throughout the treatment period. Patients should discuss with their healthcare team how much and how often to drink fluids daily. It is also recommended to eat what is tolerable, focusing on getting some protein in the diet.
Organizing appointments and understanding the treatment schedule can reduce stress. Patients receive a cancer treatment record book that includes information on treatment types and appointments. Building a strong support system, including family and friends, can provide emotional and practical assistance. Asking questions and communicating openly with the healthcare team about any concerns or symptoms is highly encouraged, as they can provide tailored advice and manage side effects effectively. Keeping a journal to track symptoms, sleep, and food intake can also be useful for discussions with the medical team.