If you've had the FAC combo of chemo, please respond!

texas94

Hi everyone! I'm looking for information that's specific to FAC chemo. I know a lot of chemo drugs are combined differently, but knowing what these 3 will do to me together would be helpful. I'm looking for info on side effects and any tips to manage them, plus how you feel the 3 weeks in between the doses (after Taxol, I'm really hoping at least there's a few days in there you feel rather good). I've already been through 12 weeks of Taxol (hated every second), but I know FAC is very different. The only tip I've heard is to hold ice chips in my mouth during the "F" part of the chemo to try and prevent mouth sores, and then of course get the "magic mouthwash" from my oncologist and brush with sensitive toothpaste followed by either Biotine or a mixture of baking soda, salt and water.  

Also, I can't take Zofran, so what anti-nauseau meds do you recommend? I've had plenty of surgeries, and doctors usually give me Phenergan, which does the job, but it completely knocks me out and takes days to wear off. I'd love to try an alternative.

Finally, is neuropathy a side effect? It doesn't seem to be, but I want to hear it from those who've actually been through it! I didn't have neuropathy issues until after the 11th dose of Taxol, so I'm hoping it will continue to wear off, and nothing in FAC will make it worse.

I apologize if this is a repeat topic; I spent an hour looking through messages for "FAC" and found nothing. As we all know, other patients and survivors are typically much more helpful than our oncologists, who are more preoccupied with killing the cancer than they are managing the chemo experience (rightfully so!).

I appreciate your help!

Moderators

Hi Texas,

While you wait for the ever-helpful responses from other members here, you may be interested in checking out the main Breastcancer.org site's pages on fluorouracil ("5–FU" or 5–fluorouracil), Adriamycin, and cyclophosphamide for information about what side effects to expect with each of these drugs, along with links to pages with tips to help manage these side effects.

We hope this is a good start for you and is helpful!

--The Mods

texas94

Thank you! I looked at those and found them very helpful but wanted to hear the "real life" side from another patient or survivor.

flannelette

I had FEC. so, 2 out of 3. I had Epirubicin instead of Adryamicin as I believe E is a little less hard on your heart. I had a muga scan of my heart prior to chemo to see if I could tolerate E, so I'm thinking you will get one too, as your heart flow or something must be measured to see your tolerance.

No neuropathy.

Extremely foul taste in mouth, hated water, could not stand it, had to get hydrated via ice cold watermelon, pineapple and cantaloupe cubes. Ate like a pig, had good appetite, found it felt better than having an empty stomach. Lots of digestive issues. Like eating too much meat - my god the agony as it slowly digested overnight! At a resto, ate one bite of Thai food, which I love, and it was like my mouth caught on fire. as though all of the digestive system from the mouth down is newborn. 

All the little healthy meals I prepared and froze? horrible. i had peculiar tastes and they would taste great going down (say cheesecake with blueberries) then mouth tasted like bottom of garbage can & I brushed and flossed maybe 6 times a day. Resulting in much healthier gums when I finally saw the dentist again.

Hair will fall out. Odd things happen. Lost all my underarm hair - yea! it never grew back! Lost my hair down south (which had been going grey) and it grew back brown while the hair on my head came in silver and curly! what I had wanted all my life.

I used zofran but not much, was mostly "queezy". Only barfed twice, once when I got into an overheated car in the winter and it smelled like plastic, and once when I stupidly took garbage to the dump. My retching could be heard for miles in the still, frozen air.

In those days I don't believe we had neulasta - or at least i didn't. Just had blood sample at local hospital the day before each chemo. Only once I had to wait 1 more day and counts of whtever they count in my blood was up.

I did get to utterly detest that particular colour of red in the E? and I was never offered a port so i can honestly say my worst part was getting jabbed every time, freaking out & crying, taking a tranquillizer, calling the special magic nurse who gets it into a vein every time. We did get popsicles during the part where you need to protect your mouth & I never had 1 mouth sore.

I work at home so used to get up at 3 or 4 am (how nutty) and work till about 11 am when that was it for the day. some days I just conked out. but they give you steroids at chemo so I'd have about 3 great days of energy, then boom - crash. I had 6 rounds, 3 weeks apart. For me the ses were cumulative and I was SO glad to end at 6.

it comes to an end, your taste buds rejuvenate, your hair grows, you have chemo brain, but it was doable. I'd say, for me, the ses of nasty but beneficial arimidex were far worse, but that too ends (after 5 years) and 10 months after ending that I am no longer stiff as a board and unable to walk when I get out of bed. Yea!

Hope i haven't lulled you to sleep. best! you can do it. and they have even better drugs now than they did in 2008.

Trisha-Anne

Like Flannelette I had FEC.

I tolerated FEC fairly well. Had taste changes - nothing really tasted very good, but water was ok. I also took all the precautions to avoid mouth sores, but did get a couple.

I'm trying to remember all the anti-nausea meds they gave me. I know one was Emend and I took one very big tablet just as they were starting chemo, and had two tablets to take one on each of the next two days. I also had dexamethasone and ondansetron. I took all the meds I was supposed to when I was supposed to and never threw up once. I did feel quite queasy from time to time, but never threw up :-) You need to make sure you take the meds they give you at the times they tell you to. It's easier to stop nausea before it starts. Once you start throwing up it's very hard to stop.

I also had very bad diarrhea - some people get constipated, others get the big D. Be prepared for either.

My hair fell out too. Head hair to start with then every single hair on my body fell out lol - even my nose hair!

My worst days were 3 and 4 after infusion, then I started to pick up.

I didn't have Taxol - I had Taxotere and it nearly killed me. I couldn't finish it. So - for me at least FEC was very doable, soooo much better than the taxane.

If I had to do chemo again, I wouldn't worry too much if it was FEC, I think I'd have to pass on a taxane though - too rough on my body. Taxol and Taxotere are part of the taxane group.

Good luck!
Trish

flannelette

bump! before this scrolls too far down

balance

Hi,

I received FAC.  I completed chemo a little over 2 years ago.  This regime was chosen for me in an effort to avoid taxanes secondary to my history of  neuropathy (unknown cause).  You are the only other person I've come across being treated with the same combo.  My number one recommendation is to drink a lot of water post-treatment.  I did not do so during my first few treatments and ended up with severe bladder irritation/UTI's.  Because of this towards the end of treatment course my oncologist added an extra liter of fluid IV to my regime.  I also developed eye irritation/conjunctivitis.  Apparently the drugs are excreted in your tears.  I started using artificial tear drops in the first 48 hours post-treatment with good effect.  I didn't do anything special during treatment in terms of oral care.  I only developed oral sensitivity/metallic taste towards the end of treatment.  It took about a month after finishing treatment for my mouth to return to normal.   I didn't have a major problem with nausea.  The medications they gave me IV seemed to work well.  My appetite was, however, definitely affected. My neuropathy did seem to get a bit worse, but I'm unsure if that was related to the chemo. I do not want to emphasize that you may not experience the same side effects.  I have a history of UTI's, so you might not have the same bladder issues.  Despite these side effects, I was able to continue to work full-time during chemo.   I would leave work early on a Wednesday, receive chemo and return to work for Thurs/Fri.  I felt OK until Friday afternoon, when the fatigue would start to set in.  I would feel pretty lousy all weekend and then return to work Monday morning.  I was lucky that my employer let me take a brief afternoon nap in my office which really helped me to get through some days.  I had chemo every 2 weeks in the beginning decreasing to every 3 weeks toward the end secondary to my bladder issues.  Although I was fatigued in between treatments, I did pretty much carry on with life.   I hope that helps.  Please fell free to check back with me if you like.  Wishing you well.  

Moderators

balance, Welcome to the BCO community. We appreciate hearing about your experience. You have joined a caring and knowledgable group of other who offer compassion and like you personal experiences to help ease the stress of living with breast cancer. Please stay connected.The Mods

texas94

Ladies, thank you so much for responding! I forgot to turn on email notifications when I posted this (chemo brain!), so I didn't see these until today. I've been wondering why no one responded!

My onc recently told me FAC and FEC SEs are the same (they're almost identical chemically). If I could edit the title of this post, I'd add FEC. Also, my onc does things a bit differently than the other oncs at MDA, so I don't get steroids with chemo. He only gives a steroid before the first dose of Taxol, since it's more likely to cause allergic reactions. As for my hair- I'm already completely bald head to toe from Taxol (except my lashes and brows, which I've kept with Latisse... we'll see if they last through FAC too!), so no worries there! I felt very nauseous the first few days after FAC, but otherwise, I've felt pretty good. I continue to feel weak, lightheaded and tired, but I have a feeling those will be a constant until I'm able to be active again (which I can't be now, bc I feel a wave of faintness even walking up stairs quickly).

flannelette- I'm laughing at the way your hair came back. Thanks for the giggle. After my first dose of FAC, I was very nauseous the first few days, and since then I've had digestive issues, though they're fairly minor so far (I still get nauseous super easy if I think about chemo though!). Heat makes me nauseous almost immediately, but it did with Taxol too, so I guess most chemo makes it tough to handle heat. I agree COMPLETELY about the red dye in the "A" ("E" in your case). I wondered from the moment I saw that bag if such a huge shock of red dye is part of the reason we feel sick! YUCK. I'd love to know the reason for adding so much dye to something that is already a poison. As someone who cut out artificial dyes years ago, I'd appreciate having a choice in the matter. I also agree with you about Arimidex. I took Tamoxifen after my first diagnosis and had to stop after 3.5 years due to severe SEs (for example, I'd end up places, like the grocery store, and suddenly realize I couldn't remember getting there. I'm so glad I was driving carpool everyday!). This time, my doctors will put me into menopause if the chemo doesn't (I'm 43). Hopefully the SEs of early menopause aren't as bad as Tamoxifen. 

Trisha-Anne-  I'M WITH YOU on Taxanes. I was absolutely MISERABLE on Taxol and would take FAC over it any day. I lasted 11 out of 12 weeks before I broke down crying and begged my onc not to give me another dose (thankfully, the next week my scan showed Taxol had shrunk my tumors over 83%, so missing the last dose wasn't an issue, AND I was able to forgive him a little bit for putting me through Taxol in the first place and also kind of acting like I was a wuss about it). FAC packs a punch, but it lets you get up again! The chance to feel better between doses is game-changing. I'd MUCH rather have someone beat me up badly for a few days than have someone punch me in the face every hour for 3 months straight. I can't imagine a world in which my doctor could talk me into Taxol or any other Taxane ever again. I almost lost it the other day when I heard yet another person tell a patient Taxol is the "easy chemo!"

balance- I'm also surprised to find FAC isn't that common, because at both MDA and Methodist here in Houston it seems pretty standard. My onc says recent studies show E doesn't actually give a long-term edge over A when it comes to heart problems, so since it's 20x more expensive than E, he goes with A. The first few days I was very out of it on anti-nausea drugs (unfortunately, I can't take Zofran), but even so, I remember how much my eyes bothered me the first few days. It felt like someone had sucked out every bit of fluid from my eyeballs and tear ducts and replaced it with sand. I'm already drinking water like crazy, but your suggestion about the eye drops to flush the eyes is excellent! I have a couple of natural moisturizing eye drops I used while having Taxol, so I'll make sure to use them liberally next week. I have issues with low appetite too (as I did with Taxol), though keeping ice in my mouth during chemo does a lot to keep my taste buds working well. If I didn't use the ice, I don't know if I'd ever eat!

Thank you all again!

flannelette

texas94 - thanks for this piece of info

. My onc says recent studies show E doesn't actually give a long-term
edge over A when it comes to heart problems, so since it's 20x more
expensive than E, he goes with A.  

Was just always curious about that. Very glad it's not knocking you in the head every hour like the taxanes. That icky red dye? Well, someone who understands nothing about colour painted one wall of each examination room in our newly renovated cancer centre a shiny liver colour! what were they thinking? there is a reason for calm, soft blues and greens. I wish you the best, wish cancer had not reoccured, glad to hear you are not being punched hourly by the taxanes.  Was wondering why you never seemed to come back here after you posted so bumped the thread before it scrolled way down. Glad you finally turned your notification on! Wishing you the best.

texas94

Ha- those of you that replied were probably thinking, "Wow that FAC must have really knocked her out!" 

Trisha-Anne

Texas - good to hear from you :-) So glad the FAC isn't too hard on you. Just take it easy - listen to your body, rest and sleep as much as you need to. You'll get through this eventually - and like me be four years out and having trouble remembering it all lol.

Trish

xoxo

texas94

Thanks Trisha-Anne. I'm trying to rest, but it's such a relief to be off Taxol and able to get things done around the house, it's tough! I'm so happy to hear you have trouble remembering all of this. I can't wait! 

flannelette- What in the world were they thinking with that color? That would make me crazy!