CAF is an abbreviation for a chemotherapy combination used with other types of therapy used to treat localized breast cancer with a relatively high risk for recurrence. It includes the drugs cyclophosphamide (as a pill), doxorubicin hydrochloride (Adriamycin), and fluorouracil (Adrucil, 5-FU).
Chemotherapy
Image by Bill Branson (Photographer)
CAF Chemotherapy
Breast Cancer: treatment for triple negative breast cancer
Breast Cancer: treatment for triple negative breast cancer
U.S. Air Force Capt. Candice Adams reacts to the effects of a chemotherapy treatment Jan. 25, 2011 at Walter Reed Army Medical Center. Adams was diagnosed with triple negative breast cancer at age 29. (U.S. Air Force photo by Staff Sgt. Russ Scalf)
This chemotherapy combination contains the drugs cyclophosphamide, doxorubicin hydrochloride (Adriamycin), and fluorouracil. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.
Drugs in the CAF combination:
C
= Cyclophosphamide
A
= Doxorubicin Hydrochloride (Adriamycin)
F
= Fluorouracil
Each of the drugs in this combination is approved by the Food and Drug Administration (FDA) to treat cancer or conditions related to cancer.
Use in Cancer
CAF is used to treat:
Breast cancer.
This combination may also be used with other drugs or treatments or to treat other types of cancer.
Source: National Cancer Institute (NCI)
Additional Materials (4)
How does chemotherapy work? - Hyunsoo Joshua No
Video by TED-Ed/YouTube
Cancer Treatment: Chemotherapy
Video by Stand Up To Cancer/YouTube
What Does Chemotherapy Actually Do To Your Body?
Video by Seeker/YouTube
Chemotherapy Treatment for Cancer
Video by CancerQuest-EmoryUniversity/YouTube
5:26
How does chemotherapy work? - Hyunsoo Joshua No
TED-Ed/YouTube
1:12
Cancer Treatment: Chemotherapy
Stand Up To Cancer/YouTube
3:56
What Does Chemotherapy Actually Do To Your Body?
Seeker/YouTube
1:04
Chemotherapy Treatment for Cancer
CancerQuest-EmoryUniversity/YouTube
C = Cyclophosphamide
Cyclophosphamide
Also called: Cytoxan, CTX
Cyclophosphamide is a prescription medicine used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). It is also used for retinoblastoma, multiple myeloma, and mycosis fungoides. Cyclophosphamide is also used for a certain type of kidney disease. It is a type of alkylating agent.
Cyclophosphamide
Also called: Cytoxan, CTX
Cyclophosphamide is a prescription medicine used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). It is also used for retinoblastoma, multiple myeloma, and mycosis fungoides. Cyclophosphamide is also used for a certain type of kidney disease. It is a type of alkylating agent.
Cyclophosphamide is a prescription medicine used to treat many types of cancer and a certain type of kidney disease in children. Cyclophosphamide damages the cell’s DNA and may kill cancer cells. It may also lower the body’s immune response. Cyclophosphamide is a type of alkylating agent.
Cyclophosphamide is approved to be used alone or with other drugs to treat:
Acute lymphoblastic leukemia (ALL) in children.
Acute monocytic leukemia.
Acute myeloid leukemia (AML).
Breast cancer.
Chronic granulocytic leukemia.
Chronic lymphocytic leukemia (CLL).
Chronic myelogenous leukemia (CML).
Hodgkin lymphoma. It is used in patients with stage III or stage IV disease.
Multiple myeloma.
Mycosis fungoides (a type of cutaneous T-cell lymphoma) that is advanced.
Neuroblastoma that is disseminated.
Non-Hodgkin lymphoma (NHL). It is used in patients with stage III or stage IV NHL, including the following types:
Lymphocytic lymphoma (nodular or diffuse).
Mixed-cell type lymphoma.
Histiocytic lymphoma.
Burkitt lymphoma.
Ovarian cancer.
Retinoblastoma.
Cyclophosphamide is also being studied in the treatment of other types of cancer.
Cyclophosphamide - NCI. National Cancer Institute. Nov 6, 2007 [accessed on Jul 26, 2023]
Cyclophosphamide. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Cyclophosphamide. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (4)
Cyclophosphamide-3D-vdW.png
Image by upload.wikimedia.org
Cyclophosphamide 50 MG Oral Tablet
Image by National Library of Medicine
Mees' lines
Mee's lines due to chemotherapy. Patient had received 4 triweekly infusions of AC (cyclophosphamide, doxorubicin). Lines were not ridged, and migrated outward with nail growth.
Image by Yannick Trottier
Chemotherapy bottles NCI
Six bottles of different types of cancer drugs over a graded blue to white background. Clockwise from center: Blenoxane (bleomycin), Oncovin (vincristine), DTIC-Dome (dacarbazine), Cytoxan (cyclophosphamide), Adriamycin (doxorubicin), and VePesid (etoposide).
Image by Unknown photographer/artist, National Cancer Institute/Wikimedia
Cyclophosphamide-3D-vdW.png
upload.wikimedia.org
Cyclophosphamide 50 MG Oral Tablet
National Library of Medicine
Mees' lines
Yannick Trottier
Chemotherapy bottles NCI
Unknown photographer/artist, National Cancer Institute/Wikimedia
A = Adriamycin
Doxorubicin Injection
Also called: Adriamycin®, Doxorubicin Hydrochloride
Doxorubicin is an anthracycline antibiotic with antineoplastic activity. It is used to treat several forms of cancer, including acute leukemia, lymphomas, sarcomas and solid tumors.
Doxorubicin Injection
Also called: Adriamycin®, Doxorubicin Hydrochloride
Doxorubicin is an anthracycline antibiotic with antineoplastic activity. It is used to treat several forms of cancer, including acute leukemia, lymphomas, sarcomas and solid tumors.
Doxorubicin hydrochloride may cause serious side effects including:
Heart failure. Doxorubicin hydrochloride may cause heart muscle damage that may lead to heart failure, which is a condition in which the heart does not pump well. Heart failure is irreversible in some cases and can lead to death. Heart failure can happen during your treatment with doxorubicin hydrochloride or months to years after stopping treatment. Your risk of heart muscle damage increases with higher total amounts of doxorubicin hydrochloride that you receive in your lifetime. Your risk of heart failure is higher if you:
already have other heart problems
have had or are currently receiving radiation therapy to your chest
have had treatment with certain other anti-cancer medicines
take other medicines that can have severe side effects on your heart
Tell your doctor if you get any of these symptoms of heart failure during or after treatment with doxorubicin hydrochloride:
extreme tiredness or weakness
fast heartbeat
shortness of breath
swelling of your feet and ankles
Your doctor will do tests to check the strength of your heart muscle before, during, and after your treatment with doxorubicin hydrochloride.
Risk of new cancers. You may have an increased risk of developing certain blood cancers called acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) after treatment with doxorubicin hydrochloride. Talk with your doctor about your risk of developing new cancers if you take doxorubicin hydrochloride.
Skin damage near the vein where doxorubicin hydrochlorideis given (Injection site reaction).Doxorubicin hydrochloride can damage the skin if it leaks out of the vein. Symptoms of infusion reaction include blisters and skin sores at injection site which may require skin grafts.
Decreased blood cell counts. Doxorubicin hydrochloride can cause a decrease in neutrophils (a type of white blood cells important in fighting bacterial infections) and platelets (important for clotting and to control bleeding). This may lead to a serious infection, the need for blood transfusions, treatment in a hospital and death. Your doctor will check your blood cell count during your treatment with doxorubicin hydrochloride and after you have stopped your treatment. Call your doctor right away if you get a fever (temperature of 100.4ºF or greater) or chills with shivering.
Doxorubicin hydrochloride is a prescription medicine used to treat certain types of cancers. Doxorubicin hydrochloride may be used alone or along with other anti-cancer medicines.
DOXOrubicin hydrochloride injection is indicated as a component of multi-agent adjuvant chemotherapy for treatment of women with axillary lymph node involvement following resection of primary breast cancer.
DOXOrubicin hydrochloride injection is indicated for the treatment of:
acute lymphoblastic leukemia
acute myeloblastic leukemia
Hodgkin lymphoma
non-Hodgkin lymphoma (NHL)
metastatic breast cancer
metastatic Wilms’ tumor
metastatic neuroblastoma
metastatic soft tissue sarcoma
metastatic bone sarcoma
metastatic ovarian carcinoma
metastatic transitional cell bladder carcinoma
metastatic thyroid carcinoma
metastatic gastric carcinoma
metastatic bronchogenic carcinoma
Do not receive doxorubicin hydrochloride if:
you have had a recent heart attack or have severe heart problems
your blood cell counts (platelets, red blood cells, and white blood cells) are very low because of prior chemotherapy
you have a severe liver problem
you have had a serious allergic reaction to doxorubicin hydrochloride
Before you receive doxorubicin hydrochloride, tell your doctor if you:
have heart problems including heart failure
are currently receiving radiation therapy or plan to receive radiation to the chest
have severe liver problems
have had an allergic reaction to doxorubicin hydrochloride
have any other medical conditions
are pregnant or plan to become pregnant. Doxorubicin hydrochloride can harm your unborn baby. Women who are able to become pregnant and men who take doxorubicin hydrochloride should use effective birth control (contraception) during treatment and for 6 months after treatment. Talk to your doctor about birth control methods. If you or your partner becomes pregnant, tell your doctor right away.
are breastfeeding or plan to breast feed. Doxorubicin hydrochloride can pass into your breast milk and harm your baby. You and your doctor should decide if you will receive doxorubicin hydrochloride or breastfeed. You should not do both.
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Doxorubicin hydrochloride can interact with other medicines. Do not start any new medicine before you talk with the doctor that prescribed doxorubicin hydrochloride.
Know the medicines you take. Keep a list to show your doctor and pharmacist each time you get a new medicine.
Doxorubicin hydrochloride will be given to you into your vein.
Doxorubicin hydrochloridemay cause serious side effects, including:
See “What is the most important information I should know about doxorubicin hydrochloride injection?”
Doxorubicin hydrochloride may cause lower sperm counts and sperm problems in men.
This could affect your ability to father a child and cause birth defects. Talk to your healthcare provider if this is a concern for you. Talk to your healthcare provider about family planning options that might be right for you.
Irreversible amenorrhea or early menopause. Your periods (menstrual cycle) may completely stop when you receive doxorubicin hydrochloride. Your periods may or may not return following treatment. Talk to your healthcare provider about family planning options that might be right for you.
The most common side effects of doxorubicin hydrochloride include:
Total hair loss (alopecia). Your hair may re-grow after your treatment.
nausea
vomiting
Other side effects:
Red colored urine. You may have red colored urine for 1 to 2 days after your infusion of doxorubicin hydrochloride. This is normal. Tell your doctor if it does not stop in a few days, or if you see what looks like blood or blood clots in your urine.
Darkening of your nails or separation of your nails from your nail bed.
Easy bruising or bleeding.
Call your doctor if you have severe symptoms that prevent you from eating or drinking, such as:
nausea
vomiting
diarrhea
mouth sores
Tell your doctor or nurse if you have any side effect that bothers you or that does not go away.
These are not all of the possible side effects of doxorubicin hydrochloride.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
LABEL: DOXORUBICIN HYDROCHLORIDE- doxorubicin hydrochloride injection, solution [accessed on Nov 13, 2018]
Doxorubicin, Epirubicin, Idarubicin, Valrubicin. LiverTox. [accessed on Nov 13, 2018]
Doxorubicin injection. U.S. Department of Veterans Affairs. [accessed on Nov 13, 2018]
Doxorubicin. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Doxorubicin Injection. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (3)
Doxorubicin intravenous administration
Doxorubicin intravenous administration. This drug is often used in cancer combination chemotherapy as a component of various regimes. Doxorubicin shows a characteristic red color.
Image by Gabriel Sozzi/Wikimedia
Cylindrical squalenoyl-doxorubicin nanoparticle
Squalenoyl-doxorubicin is a prospective anti-cancer nanomedicine, which is delivered in the form of elongated self-assembled nanoparticles. It possesses a number of advantages in comparison with well-known drug doxorubicin itself including lower toxicity and improved efficacy [1].
This picture shows a model of cylindrical squalenoyl-doxorubicin nanoparticle obtained by means of all-atom molecular dynamics simulations [2]. The doxorubicin part is shown as balls and sticks surrounded by transparent molecular surface. The squalene part is shown as sticks. The blue spheres are sodium ions. Colored semi-transparent cylinders show the size of the nanoparticle and have the radii of 0.3, 0.8, 1.1 and 1.9 nm.
Image by Yesint/Wikimedia
Doxorubicin - cancer treatment drug used for chemotherapy | Onco Cancer Care
Video by Onco /YouTube
Doxorubicin intravenous administration
Gabriel Sozzi/Wikimedia
Cylindrical squalenoyl-doxorubicin nanoparticle
Yesint/Wikimedia
0:43
Doxorubicin - cancer treatment drug used for chemotherapy | Onco Cancer Care
Onco /YouTube
F = Fluorouracil
Fluorouracil Injection
Also called: Adrucil®, 5-Fluorouracil, 5-FU
Fluorouracil (Adrucil) is a prescription medicine used to treat cancer of the colon, rectum, breast, stomach, or pancreas. It is given as an injection into the vein (IV), or as an infusion. Fluorouracil is a type of antimetabolite.
Fluorouracil Injection
Also called: Adrucil®, 5-Fluorouracil, 5-FU
Fluorouracil (Adrucil) is a prescription medicine used to treat cancer of the colon, rectum, breast, stomach, or pancreas. It is given as an injection into the vein (IV), or as an infusion. Fluorouracil is a type of antimetabolite.
Fluorouracil is a type of chemotherapy drug called an antimetabolite. It mimics one of the building blocks of RNA and DNA, which disrupts the ability of the cells to make DNA and proteins. This slows or stops the growth of cancer cells and other rapidly dividing cells and causes them to die.
Fluorouracil injection is approved to treat:
Breast cancer.
Colorectal cancer.
Gastric (stomach) cancer.
Pancreatic cancer.
Fluorouracil is also called 5-FU. Fluorouracil is also being studied in the treatment of other conditions and types of cancer.
Fluorouracil is also available in a topical form.
Fluorouracil Injection - NCI. National Cancer Institute. Apr 13, 2007 [accessed on Nov 09, 2023]
ADRUCIL (fluorouracil) injection, solution [accessed on Aug 15, 2019]
Fluorouracil Injection. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
These FAQs provide a summary of the most important information about Fluorouracil Injection. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (6)
Bowen's disease plaque
Bowen's disease typically presents as a gradually enlarging, well-demarcated red colored plaque with an irregular border and surface crusting or scaling. Bowen's disease may occur at any age in adults, but is rare before the age of 30 years; most patients are aged over 60. Any site may be affected, although involvement of palms or soles is uncommon. Bowen's disease occurs predominantly in women (70–85% of cases). About 60–85% of patients have lesions on the lower leg, usually in previously or presently sun-exposed areas of skin.
This is a persistent, progressive, unelevated, red, scaly or crusted plaque which is due to an intraepidermal carcinoma and is potentially malignant. The lesions may occur anywhere on the skin surface, including on mucosal surfaces. Freezing, cauterization, or diathermy coagulation is often effective treatment. Pathomorphologic study of tissue sampling revealed: polymorphism of spiny epithelial cells has progressed into atypism; increased mitosis; giant and multinucleate cells; acanthosis; hyperkeratosis and parakeratosis; basal membrane and basal layer are retained.
Causes Edit
Causes of Bowen's disease include solar damage, arsenic, immunosuppression (including AIDS), viral infection (human papillomavirus or HPV), chronic skin injury, and other dermatoses.[4]
Histology Edit
In Bowen's disease, atypical squamous cells proliferate through the whole thickness of the epidermis. The entire tumor is confined to the epidermis and does not invade into the dermis. The cells in Bowen's disease are often highly atypical under the microscope, and may in fact look more unusual than the cells of some invasive squamous cell carcinomas.
Bowen's disease as seen under a microscope
Bowen disease (2).jpg
Bowen disease (3).jpg
Bowen disease (4).jpg
Treatment Edit
Photodynamic therapy, cryotherapy (freezing), or local chemotherapy (with 5-fluorouracil) are favored by some clinicians over excision. Because the cells of Bowen's disease have not invaded the dermis, it has a much better prognosis than invasive squamous cell carcinoma.
Good results have been noted with the use of imiquimod for Bowen's disease, including on the penis (erythroplasia of Queyrat), although imiquimod is not (as of 2013) approved by the U.S. Food and Drug Administration for the treatment of any type of squamous cell carcinoma, and serious side effects can occur with use of imiquimod.
References Edit
^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
Image by Masryyy/Wikimedia
Severe Toxicity Under 5- Fluorouracil-Based Therapy
Video by Mayo Proceedings/YouTube
Fluorouracil and Pet Safety | How You Can Keep Your Pets Safe When Using 5-FU
Video by U.S. Food and Drug Administration/YouTube
What is FEC and Docetaxel combination chemotherapy and what are its side effects? | OncoPower
Video by OncoPower/YouTube
What is FEC chemotherapy and what are its side effects? | OncoPower
Video by OncoPower/YouTube
What is FEC and Paclitaxel combination chemotherapy and what are its side effects? | OncoPower
Video by OncoPower/YouTube
Bowen's disease plaque
Masryyy/Wikimedia
4:47
Severe Toxicity Under 5- Fluorouracil-Based Therapy
Mayo Proceedings/YouTube
4:43
Fluorouracil and Pet Safety | How You Can Keep Your Pets Safe When Using 5-FU
U.S. Food and Drug Administration/YouTube
5:57
What is FEC and Docetaxel combination chemotherapy and what are its side effects? | OncoPower
OncoPower/YouTube
6:13
What is FEC chemotherapy and what are its side effects? | OncoPower
OncoPower/YouTube
5:59
What is FEC and Paclitaxel combination chemotherapy and what are its side effects? | OncoPower
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CAF Chemotherapy for Breast Cancer
CAF is an abbreviation for a chemotherapy combination used with other types of therapy used to treat localized breast cancer with a relatively high risk for recurrence. It includes the drugs cyclophosphamide (as a pill), doxorubicin hydrochloride (Adriamycin), and fluorouracil (Adrucil, 5-FU).