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Onc.Protocol:FAC STAGE IV





Cyclophosphamide & Doxorubicin & Florouracil

IDENTIFICATION: Combination chemotherapy with cyclophosphamide (Cytoxan), doxorubicin (adriamycin) and florouracil (5FU); also called "FAC".
These drugs have been approved by the FDA (Food and Drug Administration) for the treatment of breast cancer.
DOSES: Cyclophosphamide 500 mg/M2, Adriamycin 50 mg/M2, Florouracil 500 mg/M2
ROUTE: Intravenously (IV)
DURATION AND TIMING: 5FU is given on the first and fifth day. Adriamycin is given either in a single dose on the first day or by continuous iv infusion over the first 3 days. Cytoxan is given the first day. Treatment is repeated every 3-4 weeks. Treatments are generally continued if the drug keeps the breast cancer from growing unless there are unacceptable side effects.
Possible Side effects:
  • Hematopoetic: decrease in blood cells, especially white cells (neutropenia) but also red cells (anemia) and/or platelets (thrombocytopenia).
  • Gastrointestinal: possible nausea and vomiting (which may be decreased or prevented with medications); diarrhea; mouth sores; decreased appetite.
  • Integmentary: moderate to severe hair loss; dry skin, nail thinning or ridging.
  • Genitourinary: cytoxan may cause irritation to the kidneys or bladder.
  • Fertility: cytoxan may cause damage to the ovaries of premenopausal women. This may lead to temporary or permanent infertility. Patients may also develop an early menopause.
  • Cardiovascular: 5FU has caused rare instances of irregular heart beats or chest discomfort (risk is increased in those with underlying heart disease). Adriamycin may cause weakening of the heart muscle. This may result in congestive heart failure (this occurs in less than 1% of patients treated with standard doses).
  • Neurological: some patients complain of a decrease in their ability to concentrate and/or remember, which improves on completion of therapy.
  • Other: some patients complain of taste changes and/or lack of appetite.

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