Fears about Adriamycin Cytoxan A/C Chemo

Adriamycin Cytoxan Chemotherapy is how thousands of people get directed to my Blog.  One of my top searches is from people ready to start Adriamycin Cytoxan Chemo who are afraid.   I was absolutely terrified so I completely understand.  The day I began A/C Chemo was the most frightening day of my life.  I knew it was not nicknamed “Red Devil” and “Red Death” for nothing.

Before I began A/C Chemo my fears were that I would die during the first infusion, that I would become so nauseated I wouldn’t be able to make it home without vomiting, and that I would be knocked out from fatigue before I even left the chemo area.  None of those fears proved to be true.

Here is what I wish I knew before I started Adriamycin Cytoxan Chemotherapy:

1)  When you get to the Chemo Infusion area, it is nicer than you imagine.  The hospitals and breast centers try to make it really comfortable for the patient.  The Chemo Nurses are fabulous and especially on your first chemo infusion, they are practically glued to your side explaining what is going to happen to help you eliminate your fears.

2)  There are numerous preliminary drugs administered via IV before Adriamycin is given.  These are anti-anxiety drugs, anti-nausea drugs, steroids and allergy drugs.  They gave me Ativan which did help relax me a little.  I wish I would have had it for a week before I started chemo.

3)  Many precautions are taken by the Chemo Nurses to make sure you are getting the correct drugs.  You will be asked your name and date of birth many, many times.  Plus, an additional nurse comes in to check and recheck your drugs and dosage.  I always asked to see the drugs themselves to triple check.  No one minded at all and at my infusion center at the University of Michigan.  They were happy I cared about my treatment.

4)  When the nurse comes to administer A/C Chemo, she will have a cap, gown, and gloves on.  This is to protect her.  It is a normal procedure, but is a little bit scarey to see.  The Adriamycin is red in color and will be administered from tubes directly into your port or veins.  The Chemo nurses are well trained.   The dosage you receive will be based upon your weight and body mass.  They are always checking your weight pre-chemo to make sure you haven’t lost or gained weight which would change your dosage.

5)  I did not feel anything right away while the drug was being administered.  The Chemo Nurse warned me when I went to the bathroom, the A/C would turn my urine pinkish red.  I always have to go to the bathroom especially when being given IV drugs.  My urine turned pink right away and this lastest for 24 hours.  They told me to flush the toilet with the lid down at least twice, wipe off the toilet seat, and then to wash my hands with soap for 25 seconds.  If you are sharing a toilet with other family members, take appropriate precautions.

6)  They gave me food during A/C chemo like bagels and juice.  I can’t stand bagels anymore, but that is another issue!  They also gave me ice chips.  Eating ice chips during chemo cuts down on mouth sores.  And most of all, DRINK WATER, DRINK WATER, DRINK WATER!!  Drink at least 8 glasses of water the day before, the day of, and the days after Chemo.  It helps get the toxins out quickly.  The Chemo Nurse told me the A/C Chemo does its work almost instantly.

7)  I was at the infusion center 4 to 5 hours during A/C chemo on average.

8)  When the chemo was finished, they released me immediately.  I knew I had to come back for the Neulasta shot (to keep up the blood counts) on the next day.  Also, they had given me several anti-nausea meds to take if I felt ill.

9)  Because of the steroids, you feel pretty darn good the first couple of days, energetic and kind of hyper.  At least I did.  I did not feel any nausea until Day 3 after the drugs.  Then I immediately began the anti-nausea meds at the first sign of any nausea.


Because I had a hard time finding cute chemo caps all in one place, I started a store –   http://www.hellocourage.com    Please check out my store and cute chemo caps.  Also, another favorite of customers is the Breast Pillow which protects your Chemo Port and surgery site while riding in the car!  I still use mine everyday!






10)  I had a little bit of a headache the first night after A/C, but I did sleep.  I remember thinking, “What if I don’t wake up?”  It was still very frightening as I did not know what to expect.

11)  The next day I felt very energetic, a little drugged, but overall, okay.  The Neulasta shot  stings when they give you the shot, but that is fleeting.  Some people experience bone pain from the Neulasta shot.  Talk to your Oncologist about this.  I was able to take Motrin to help with the bone pain.

12)  I wish I could minimize the side effects, but I cannot.  EVERYONE IS DIFFERENT.I had many side effects.  Some would last only a day.  Others were for the duration.  Extreme fatigue is usually something most everyone has.  I was tired during #1 A/C, but didn’t get extreme fatigue until #2.    Also, I had dose dense A/C (every 2 weeks).  Many people get A/C every 3 weeks, which gives you more recuperation time.  I wish I could sugar coat the side effects.  I cannot.  But amazingly, they get better rather quickly once you are finished.

13)  For me, side effects were more cumulative.  I started slowly and they got progressively worse during the 4 A/C treatments.  One important thing to remember, the steroids and strong chemo drugs affect your brain and your moods.  Don’t be alarmed if you feel mean, angry or depressed.  IT WILL GO AWAY!  Prepare your family and friends for this.  I wrote a separate post about Mood Swings.

14)  While you are in the middle of A/C, you swear it will never end.  Many times, I wanted to quit it and didn’t care if I lived or died.  Those are the cold, hard facts.  You may feel that way, you may not.  If you do, feel the feelings.  You are not alone in these feelings. But you feel so alone because NO ONE UNDERSTANDS unless they have gone through Adriamycin Chemotherapy.  Even the most understanding people, cannot relate to what you are enduring.

Most people who have gone through Adriamycin have felt all these emotions.  You can get through it one day at a time.  That is such an overused phrase, but it is so true in this case.  And memories of it will fade.  I promise!

15)  One important thing to remember about side effects.  Call your Oncologist immediately if something happens that really feels scarey.  I was told to make sure I didn’t have a temperature.   My face became very, very red for 3 days after A/C chemo and burning hot.  No one warned me about it.  It seemed kind of extreme.  I called the oncology nurse. She told me to keep taking my temperature.  If it was normal, don’t worry as my face was just turning red from the steroids, not an infection.  Thankfully, it was just from the steroids.

16)  Food and A/C is really weird.  You will get very strange cravings.  For one solid week, 3 meals a day all I could eat or wanted to eat was cereal with peanut butter.  Do not eat your favorite foods as I guarantee you won’t like them if you eat them during chemo.  It seems many people going through A/C chemo crave white foods – especially carbs – potatoes, bread, pancakes, and noodles.  It is very strange and odd. Make sure to get your protein in.  I mostly ate cottage cheese and peanut butter.  Meats did not work for me, but they may for you.  Within a couple of weeks after you end A/C chemo, your normal appetite will return.

I hope this helps eliminate some of the fears of Adriamycin Cytoxan Chemotherapy.  It is an extremely terrifying, difficult and challenging road to get through, but you can do it.   If I can, you can because I couldn’t even stand to have a blood test before I went through cancer treatment.  I have become strong!  You will too!



  1. This is absolutely my experience too. I was every two weeks and just finished my four A/C courses. After AC anything seems doable (at least for now). I am so glad to be through it though. Felt like a real accomplishment. Thanks for writing all of these Denise. I read them and really find your honesty so helpful.

    • Congratulations on completing A/C Chemo! You are so right, it certainly does feel like
      such an accomplishment. Jumping out of an airplane seems simple right now! Thanks so
      much for your kind words, too! I appreciate them and am so thankful I can be helpful!

  2. Hi Miss Techie. I don’t even know how to find out what search words the ample people use to get to my blog, if any. Maybe they just stumble into mine.

  3. Dear Denise,
    I am going for chemo in 2 days, your blog really helped to understand what to expect…thanks for taking the time to write all these details…God bless!!

    • Jasmine, you are welcome! I am happy to help. It is so scarey to start
      chemo, but as I said, it doesn’t have to be. If I had known it, I wouldn’t
      needed to be so terrified. Please come back for help anytime you need it!
      I am here! God bless you. You will make it through the dark tunnel. Denise

  4. Denise,
    Just five days after first A/C treatment and you are on the money with every word you wrote.
    I, too, looked hot and sunburned from the steroids. Thanks for the support.

  5. Denise,
    Just a quick thank you for your blog. I have been reading every post. I am getting my chemo port installed tomorrow and am just scared to death about everything. Your blogs have really helped!

  6. Denise, I am on day 5 of my intensive 4 x a/c treatment. Thanks for you comments. I try to keep positive but sometimes all I feel like doing is crying. I’m glad you got through it – it gives me hope.

    • Hi Gail – no one ever tells you that often during AC you just feel like dying. You can’t tell
      your family members that because they will totally freak out. But it is how you feel – just some days.
      Some days you feel like “being positive” and other days if one more person says, “Stay Positive” you might
      just slap them in the face!
      The emotions from the chemo drugs and the steroids are one wild ride. And all of it is okay.
      I am 4 years out from chemo – my sister is 10 months out. We both agree – you never forget it.
      But being alive and living life every day, makes it all worth it now. But from where you are, you feel
      like you will never make it through.
      YOU WILL – but feeling your emotions is OKAY! Sending all my best!! Denise

      • Dear Denise, after two AC treatments I’m siting here reading the blog, crying even before stumbling onto your blog. I’ve now stopped crying and started laughing , after reading your sentence about just Slap them in the Face ! TY for a much needed laugh. Love + Blessings, Diane

      • Hi Diane – Oh after two ACs it is so bad – you feel so awful – and I am
        so glad I could make you laugh!! You will make it through, but it doesn’t
        seem possible right now for you!! Sending all my best!!!

  7. I will have my first A/C treatment today for stage 2/ grade 3 breast cancer and I have been terrified since my diagnosis and I thank God my lymph nodes turned out clean. As my journey began the first port clotted and was becoming infected after just two weeks and it hadn’t even been accessed yet! I thought “Oh great is this how it will be the whole time?! It was removed and replaced immediately. My veins are small and could not accommodate the catheter so the new one goes to a larger vein. I just want to thank you for your blogs as they have helped calm my fears! They try to tell you as much as possible but your words provided me with new info and more courage! God bless you Denise and many sincere thanks to you as I begin my own path to being a survivor.

    • Hi Natania, OH SO SORRY you have to go through chemo and to start out with port problems! You will be so glad you have it!
      The first day of chemo was the scariest day of my life. I can conjure up those fears still in a heartbeat!
      I am 4 years out from chemo and my sister is almost 1 year out. We are both doing far better than we ever thought we would be!
      THERE IS MUCH HOPE! Sending all my best – thanks for your kind words about my blog. I don’t hold much back, yet I try to be
      very fair in my evaluation of the road to survivorship! My best!

  8. I am reading all about A/C because it will be my first chemo experience in a weeks time. Thanx for the worthwile information.

  9. Next Thursday I will have my 4th AC treatment followed by 4 Taxols. To be honest, I didn’t do much research on the treatments and went in cold turkey. I just “assumed” I would feel nauseous and I do. I think the best way to describe the side affects is like morning sickness or the first few months of pregnancy. I’m also trying the Dignicap Therapy (Cold Cap) to try and save my hair because I’m getting married in July. As a little girl I never dreamed I would be bald from chemo for my wedding. My hair is thinning, but I still have it. It’s not an easy treatment, but like you said, if we can beat AC, I think we can beat anything. I’m definitely moody and I feel bad for my fiance – I hope he realizes its the treatment. I try to remain strong. No one sees me cry – we have a now 1 year old and my priority is being her mommy. I think I need to get out and walk more. I “work from home” on treatment days and the day after, but I sit at my office desk every other day and try and get through without falling asleep!! Thanks again for your posts.

    • Hi Christine, somehow I missed your post – oh so sorry! You should be almost done with Taxol now!
      Oh my, I am so sorry with planning a wedding and going through chemo. Yep, I hope your fiancé gets
      steroid rage! It is a real thing!! Sending all my best! Denise

    • I have long-term heart issues from Adriamycin Cytoxan chemo. Had a heart attack during chemo, but thought it was side effects.
      I’m still on heart meds 5 years later, but doing well. I urge everyone who had AC chemo to get their heart checked. It may not
      show up for 5 years or more! My sister, who went through AC, also is on medication for heart issues from chemo.

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