Breast cancer chemotherapy jargon can get complicated. Most often doctors prescribe not just one drug, but a “chemo cocktail” combination to fight the disease. Each drug comes with its own acronym, mechanism of action and side effects. These differences allow doctors to form more effective drug combinations for the best outcome. Here’s a closer look at various breast cancer chemotherapy drugs and combinations used today.
Common Breast Cancer Chemotherapy Drugs
The most common types of drugs used to treat breast cancer include:
- Anthracyclines — These anticancer powerhouse drugs are extracted from Streptomyces bacterium. Drugs in this class include doxorubicin (Adriamycin) and epirubicin (Ellence). Adriamycin is nicknamed the “Red Devil.” This extremely powerful drug, though effective, causes some serious side effects. Most recently, it came under fire for its toxic effect on the heart muscle. This can lead to heart failure.
- Taxanes — These drugs block cell growth by stopping cells from dividing. Popular taxanes include paclitaxel (Taxol) and controversial docetaxel (Taxotere). Taxotere is controversial because it can cause permanent, irreversible alopecia (hair loss). Studies show Taxotere causes up to 15% of patients to go permanently bald. Taxol, however, is not linked to permanent hair loss.
- 5-fluorouracil (5-FU) — Fluorouracil is an antimetabolite. These are similar to normal substances within the cell. And when cells incorporate antimetabolites into their metabolism, they are unable to divide.
- Cyclophosphamide (Cytoxan) — This drug is an alkylating agent. It can decrease the immune response by blocking the production of DNA in cells.
- Carboplatin (Paraplatin) — Carboplatin interferes with the development of DNA. It prevents it from dividing into two new cells and kills the cell.
Popular Breast Cancer Chemotherapy “Cocktails”
Of these drugs, a huge list of cocktails can be formed. But the most common involve:
- Taxotere (generic name: docetaxel)
- Adriamycin (generic name: doxorubicin)
- Cytoxan (generic name: cyclophosphamide)
- Paraplatin (generic name: carboplatin)
- Taxol (generic name: paclitaxel)
These various drugs make up the most common breast cancer chemotherapy “cocktails.” Their nicknames derive from the drug’s initials used for treatment. Here are a few common chemo drug combinations:
- TAC — Taxotere, Adriamycin, Cyclophosphamide
- TC — Taxotere, Cyclophosphamide
- AC — Adriamycin, Cyclophosphamide
- CMF — Cyclophosphamide, Methotrexate, Fluorouracil
Breast Cancer Chemotherapy Side Effects
Each breast cancer chemotherapy drug and “cocktail” comes with its own unique side effects. And like all medications, they affect each individual differently. All chemotherapy drugs are designed to attack rapidly dividing cells. But normal cells are meant to divide, and they are victims of the drug’s effects as well. These include cells in your mouth, blood, GI tract, nails, and hair. The drugs almost always affect most organs in your body. Eventually, your healthy cells can repair themselves — but until then you’ll experience side effects from the chemo.
The side effects depend on the cocktail or regimen you’re on, how much you’re getting, and how long your treatment lasts.
Common breast cancer chemotherapy side effects include:
- Diarrhea
- Fatigue
- Anemia
- Hair and nail changes
- Memory loss (also referred to as “chemo brain”)
- Menopause and fertility issues
- Mouth and throat sores
- Nausea and vomiting
- Neuropathy (loss of feeling in hands and feet)
- Weight changes
How to Decide Which Chemotherapy Path is Right for You
Every drug has side effects. But some are more lasting than others. That’s why patients should carefully consider which side effects they would rather deal with. And, which side effects could last even after chemotherapy ends.
- Neuropathy — Neuropathy is a painful side effect of chemotherapy that can sometimes extend even after treatment. It is the loss of feeling in the hands or feet — or a numb feeling. And it’s most common when taxanes are involved in your treatment. According to a recent study, more patients experience chemo-induced peripheral neuropathy (CIPN) when using Taxol. Because of this, more doctors recommend single and combination infusions with Taxotere over Taxol. It would seem that Taxotere was superior to Taxol when considering neuropathy.
- Hair Loss — When it comes to hair loss, Taxotere has been the cause of permanent alopecia that extends years after treatment ends. This includes scalp hair, eyebrows, eyelashes, and other areas of the body. In contrast, CIPN symptoms typically resolve with follow-up treatment, according to a study. Treatment includes hand massages and Cymbalta (duloxetine) as an adjuvant drug. Patients should weigh the long and short-term risks of each drug, and the effect it may have on their lifestyle.
Your doctor will also have insight into which drugs should work best for treating your cancer. They can prescribe based on patient risk factors to help reduce certain side effects, like neuropathy. For example, African-Americans, obese patients, and diabetics are more likely to develop severe neuropathy. And while more patients experience CIPN with Taxol, Taxotere-induced CIPN is far more severe. It also lasts longer than Taxol-induced CIPN.
Life After Breast Cancer Chemotherapy
Determining a treatment path, clearly, is not black and white. Your doctor considers your age, length of treatment, race, weight, medical history, and other factors before making a treatment plan. Patients should also take an active role in their plan. Because some breast cancer drugs have long-lasting side effects, you should consider your lifestyle after cancer. Your tolerance for various drugs and your sensitivity to possible effects are also important factors.
Rest assured, that there is life after breast cancer. But it often looks very different than life before your diagnosis. Lingering fatigue is common. Patients must make decisions about how and what they eat. Some patients must deal with body changes after mastectomies. Others deal with continued “chemo brain” or memory deficits. And some, especially those who were treated with Taxotere, must face a lifetime with no or little hair. Sadly, patients must opt for a wig or a head covering long after their cancer’s in remission.
Just like chemotherapy is a process, so is life after cancer. Recovery can last years after such a dramatic assault on the body. Patients should be kind to themselves and listen to their bodies as they journey towards a full recovery.
How to Check Your Eligibility for Compensation Online
If you or someone you love suffered Taxotere permanent hair loss after breast cancer chemotherapy, you may qualify for a cash settlement. That’s because the drug’s manufacturer, Sanofi-Aventis, listed the possibility of permanent hair loss on drug packaging and patient education packets globally outside of the United States. However, the company specifically failed to include this warning for U.S. cancer patients. As a result, permanently bald cancer survivors are now suing the drug’s manufacturer for failure to warn. In fact, plaintiffs say they weren’t given a choice between Taxotere and Taxol, which is equally effective without the risk for permanent alopecia. Without knowing about all possible side effects and alternative treatments, it is impossible for patients to truly give informed consent.
To instantly see whether you may qualify for compensation, fill out your free claim review today. Once you’ve submitted your information, an experienced advocate will call to arrange a confidential onsite consultation to discuss your case. If you do qualify for a cash settlement, you’ll review how to best get the justice and compensation you deserve in person.
Related: Chemo Permanent Hair Loss: What Some Taxotere Patients Can Expect
Mandy Voisin
Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.