Care During Chemotherapy and Beyond

ACT Chemotherapy

QUESTION:  My friend has been prescribed ACT Chemotherapy for breast cancer.  Can you tell me about this?  Does Taxol have side effects?

ANSWER:  "ACT" stands for A-Adriamycin, C-Cytoxan, T-Taxol.

Chemotherapy is recommended as adjuvant therapy for high-risk patients following surgery. Adjuvant treatment is treatment given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor.   There are several acceptable combinations of medications for adjuvant therapy depending on the preferences of the physician and patient.  One standard regimen for adjuvant treatment for breast cancer is a combination of Adriamycin and Cytoxan, and more recently, Taxol has been added to hopefully enhance disease free survival. The combination of these chemotherapies is prescribed in different sequences depending on your physicians or institution's protocol.

The basic idea of chemotherapy is to rid the body of faster growing cancer cells. While doing this, the drug also has an effect on the faster growing normal cells in our bodies.  These include; the hair, the lining of our mouth, or the cells in the bone marrow that produce white blood cells (which help to fight infection), red blood cells (which carry oxygen through our blood), and platelets (which help to clot the blood and stop bleeding).  The chemotherapy is timed to allow the body's normal cells time to recover between treatments.

Each chemotherapy drug has its own side effects.  When combining drugs, the goal is to enhance the treatment effect and not enhance side effects. The common side effects of the three drugs in the ACT regimen - Adriamycin, Cytoxan, and Taxol - are listed below. Side effects may vary in severity depending on the dose of the medications.  Most side effects are temporary.
Adriamycin Side Effects: decrease of white blood cells, red blood cells and platelets, hair loss, mouth sores, nail changes, discolored urine, severe sunburn with sun exposure

Cytoxan Side Effects: decrease of white blood cells, red blood cells and platelets, mouth sores, decreased appetite, taste changes, hair loss or thinning, changes in menstrual cycle, bladder irritation, nasal congestion

Taxol Side Effects: decrease of white blood cells, red blood cells and platelets, allergic-like reaction, numbness and/or tingling to fingers and toes, muscle aches, bone pain, mouth sores, hair loss, diarrhea

Some things your friend can do during treatment to help minimize side effects of Taxol, Adriamycin, and Cytoxan are: increase fluid intake especially in the 24 hours after cytoxan, good mouth care using an alcohol free mouth wash, avoid sun exposure, wearing protective clothing and sunscreen (at least SPF 15) if sun exposure is unavoidable.

The goal of treatment is to render a person disease-free after treatment so it is important to receive the full doses and to avoid postponing regularly scheduled doses for minor reasons or for less than significant toxicity.  Although the treatment side effects may be harsh, all attempts will be made to keep your friend on schedule with treatment and receiving the full doses.  The health care team will work with your friend to accomplish this task through side effect management, support, and information.  Your support of your friend through this process can be very helpful to her and your seeking information on what to expect is a step in the right direction.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit