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Joined: Apr 2003

I just went in for a re-excision on Monday as margins weren't clear the first time around (report today is they are now clear:) The surgery has pushed back the start date for my chemo and now I am beginning to question decision of going with CAF (have a choice of CAF or CMF.) Am concerned about heart problems associated with Adriamyicin. Have many of you had problems after treatment with AC or CAF?



Posts: 53
Joined: Apr 2003

I had a heart scan of some sort (nuclear medicine department) BEFORE I started on AC chemo, to check whether my heart could handle it. I'd recommend talking to your oncologist about that, before you start your chemo. I had all kinds of scans (CT, Bone, and heart) before I started chemmo -- to check for spread of bc, and to be sure I was up to the chemo. Worth the extra hassle, I think. Good luck. Barb

Posts: 682
Joined: Feb 2001


Usually a MUGA scan is given to test your heart output before you get Adriamycin. No one tested me afterwards! However Adriamycin is given according to your weight and within a safety margin because too much they know could be dangerous to your heart. The danger was greater years ago when they did not know this.

Before I got the chemo I was scared of this, but then I read that pregnant women get it after the first trimester and I thought if they can take it, I won't worry.

You will be ok with whatever your doctor thinks you should take. Good Luck!

Posts: 252
Joined: Apr 2002

I too had a mugascan to check my heart before AC.
In Dr. Susan Love's book on breast cancer she comments about one of her patients later needing a heart transplant, but that the good news was that she was there to need the transplant. The earlier problems did appear to be related to doseage. I had my start date pushed back because of an infection and that's on reason I chose AC - to be more aggressive. Good luck with your decision. Diane

Posts: 482
Joined: Apr 2003

I had a CT scan, a bone scan and a MUGA scan prior to starting Adriamycin.... am 55 with a history of a functional heart murmur and an echocardiogram on the high end of normal range. I survived the entire four cycles of Adriamycin without a problem. Hope this helps. Hugs, Denise

Posts: 2
Joined: Jun 2003

I had a bone scan, MUGA, and blood work done before starting my chemo. I recieved 6 cycles of Adriamycin, Cytoxan, and 5-FU. My advice is to find an oncologist that you trust and that communicates with your team of other doctors. Communication with them is vital. Let them know your concerns and remember that you are a vital part of the team that makes decisions about your life. My doctor expected questions and together we planned what would be the best choices for me to fight the cancer. You will make the right choice when you have the information you need.

Posts: 2
Joined: Jun 2003

I read your message -- I am also about to start 6 cycles of CAF. I am confident in my oncologist and the rest of the medical team. I had a bilateral mastectomy with TRAM flap reconstruction 6 weeks ago. Feeling stronger every day and planning to go back to work next week. My MUGA scan is this week. Any advice/suggestions about getting through CAF? Thanks, A.

Posts: 2
Joined: Jun 2003

I am about to start the same treatment as you had- also 6 cycles. I had the MUGA this week. How did you do during chemo? Side effects? Any helpful tips for getting through this? Thanks.

Posts: 704
Joined: Jul 2001

Hi Kathy:

I had an echo prior to beginning chemo. Reason was that my oncologist believes that this yeilds more info regarding "ejection fractions" of the heart, as opposed to a MUGA Scan. I also had a bone scan prior to beginning therapy. All was well and my heart seems to have survived just fine. My oncologist did not recommend that I have a follow up MUGA or echo, post chemo. It was her thought that if I was not having any symptoms then my ejection fractions were likely just fine. I have since learned that most cardiologists DO prefer a follow up study, post chemo, just to be safe. I've also learned that cardiac (or any other) side effects, can occur many years following chemo. The majority of women, it seems, have few lasting side effects and when they do, they typically aren't life threatening and are usually treatable with a good outcome. Women who do suffer heart damage from chemo, typically had an undiagnosed (or known)underlying condition prior to having the chemo, according to my dr.. I understand that it's also a more likely occurance when the Adria. is followed by Herceptin. At any rate, I did have a repeat echo, about 4 months ago just so I would have the peace of mind in knowing if anything had changed. My annual CXR is also clear, showing no lung necrosis or changes from rads.

For those of us who have radiation, in addition to chemtherapy and particularly, if the effected breast is our left one, then late cardiac effects can occur from that as well. Typically, a very small area of necrosis on the heart muscle...similar to what we get on the lung, when it's in the path of radiation.

Currently, some of the more progressive treatment centers are using newer technology (PET Imaging, for radiation marking, prior to beginning the therapy) which greately reduces and/or eliminates the radiation touching the heart, directly. Many good things coming down the pike on that front, as well as improved calculation methods for dosages of Adria. and rads, including the short term radiation techniques. If you go to: www.nci.nih.gov you'll find some very solid info re short and long term side effects re the Adriamycin, as well as radiation, together with improved techniques to limit heart and lung radiation exposure. You'll find various studies and data, which will support most claims and statements you'll see there.

I know it's a frustrating time for you but it will pass.

Hope this helps.

Love, light and laughter,

hummingbyrd's picture
Posts: 961
Joined: Sep 2002

Hi Kathy, I had adriamycin w/ cyclophosphomide and NO scans MUGA or otherwise! Can you believe, and of course at the time was to sick/scared to know any better. PLUS...they overdosed me on my 2nd treatment, dropped my white count to .5 and almost killed me from a secondary infection. It was so bad I refused treatments for 8 weeks and when I did go back they reduced the dosage by 15%. All that to say......I didn't have any heart trouble w/ adriamycin, and that was 3 years ago. Course as w/ all meds, they do effect us on an individual basis. I would however, at least get the MUGA scan! God bless. hummingbyrd

Posts: 49
Joined: Dec 2002

I also had a mugascan. My doctor said it depends on your age. A lot of older women choose the CMF because of heart problems. I am 46 and my doctor said I should be fine as long as the scan came out ok which it did. I had 4 treatments of AC and did not have any problems with my heart. Hope I helped. Good Luck.

Posts: 682
Joined: Feb 2001

When I was 63 I had the AC chemo - then taxol. One of my first questions was: Aren't I too old for chemo. Doc said Noooo! I said: How old is too old - he said 85! :-)

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