TAC | Cancer Research UK
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What TAC is

TAC is the name of a combination of chemotherapy drugs used to treat early stage breast cancer after surgery. It is made up of the drugs

  • T – Docetaxel (also called Taxotere)
  • A – Doxorubicin (originally called Adriamycin)
  • C Cyclophosphamide

How you have TAC

You usually have TAC chemotherapy as cycles of treatment. Each cycle of treatment lasts 3 weeks. Depending on your needs, you may have between 4 and 6 cycles, taking 3 to 4 months in total.

You have the drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.

You can read our information about having chemotherapy into a vein.

For each cycle of treatment you have all 3 drugs (docetaxel, doxorubicin and cyclophosphamide) as drips or injections on the 1st day. Then you have a rest with no treatment for the next 20 days. This completes one cycle. You then begin another cycle by having the same drugs again followed by the rest period.


Tests during treatment

You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.


About side effects

We've listed the side effects associated with TAC chemotherapy below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.

You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)

The side effects may be different if you are having TAC with other drugs.

Tell your doctor or nurse straight away if any of the side effects get severe.


Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

A temporary drop in the number of blood cells made by the bone marrow, causing

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia

Some of these side effects can be life threatening, particularly infections. Contact your doctor or nurse if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

  • Tiredness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
  • Feeling or being sick is usually well controlled with anti sickness medicines
  • Loss of appetite
  • Complete head and body hair loss affects 8 out of 10 people (80%) but is temporary
  • Fluid retention occurs in about 1 in 2 people (50%) having docetaxel – you will have steroids to help prevent this, but may have swelling of the hands and feet, breathlessness and weight gain
  • A skin rash that may itch affects about 1 in 2 people (50%) treated with docetaxel
  • A sore mouth and throat may happen about 5 days after each treatment and last for a couple of weeks – you may have mouth ulcers and red, sore skin in your mouth
  • Your urine may become a pink or red colour for 1 or 2 days after treatment with doxorubicin – this is due to the colour of the drug and is not harmful
  • Darkening in the creases of your skin
  • Sensitivity to sunlight – it is important not to sit out in the sun, and do cover up or use sun block on exposed skin
  • Women may stop having periods (amenorrhoea) – this may be temporary
  • Loss of fertility – we don’t know exactly how these drugs affect fertility so do talk with your doctor before starting treatment if having a baby is important to you

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Inflammation of the bladder (cystitis) can happen with cyclophosphamide and may cause pain, and occasionally bleeding, when passing urine – drink plenty of fluids to reduce cystitis and contact your treatment centre straight away if you see blood in your urine
  • Aching muscles and joints
  • Fever and chills
  • Numbness or tingling in fingers and toes can cause difficulty doing small things such as fastening buttons – this starts a few days or weeks after treatment and usually goes within a few months of finishing treatment
  • Inflammation around the drip site when having docetaxel or doxorubicin – if you notice any signs of redness, swelling or leaking at your drip site, tell your doctor or chemotherapy nurse straight away
  • Your nails may become darker and white lines may appear on them
  • Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
  • A mild allergic reaction affects about 3 out of 100 people (3%) who have doxorubicin and can cause a sudden rash of pink, itchy bumps on your skin and a reddening of the skin along the veins – it should clear up within a few days
  • Skin in areas treated with radiotherapy in the past may get dry and flaky and may feel sore and hot
  • Change in heart rhythm due to doxorubicin – your heart will be checked before and during treatment. In most people this goes back to normal when the treatment ends but some people may have permanent heart damage

Rare side effects

Fewer than 1 in 100 people have these.

  • Changes in lung tissue may lead to a cough or breathlessness – let your doctor or nurse know if you have these effects
  • Sore eyes – your nurse can give you eye drops to help

There is a small risk that you may get a second cancer some years after TAC treatment.


Important points to remember

You may have a few of the above side effects. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

  • How many times you've had a drug before
  • Your general health
  • How much of the drug you have (the dose)
  • Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies – some drugs can react together.

TAC drugs may have a harmful effect on a developing baby. Talk to your doctor or nurse about contraception before having treatment if there is any chance that you could become pregnant.

Breastfeeding is not advisable during this treatment because the drugs may come through in the breast milk.


Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.


Related information

On this website you can read about

Breast cancer

Docetaxel (also called Taxotere)

Doxorubicin (originally called Adriamycin)



More information on TAC drugs

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 27 April 2015