CAF: Cytoxan, Adriamycin and Fluorouracil

Updated 
August 31, 2015

CAF (Cyclophosphamideinfo-icon, Adriamycin and Fluorouracilinfo-icon) is a chemotherapyinfo-icon regimeninfo-icon given for localizedinfo-icon breast cancers with a relatively high risk for recurrenceinfo-icon.

It is a combination of three chemotherapy medicines:

Cyclophosphamide is a type of chemotherapy medicineinfo-icon called an alkylating agent. Doxorubicininfo-icon is a type of chemotherapy medicine called an anthracyclineinfo-icon. Fluorouracil (5-FU) is an antimetabolite chemotherapy medicine.

CAF uses the same medicines as the combination FAC, but has different doses and schedules.

How CAF Works

Each medicineinfo-icon attacks the cancer cells in a different way:

  • Cyclophosphamideinfo-icon stops cancer cells from reproducing.
  • Doxorubicininfo-icon stops cancer cells from making DNA and interferes with the enzymes that repair the DNA in the cells.
  • Fluorouracilinfo-icon stops cells from making and repairing DNA. This causes the cells to die when they try to divide.

How CAF Is Given

CAF can be given two ways:

  • All three medicines together, by veininfo-icon, on the first day of treatment, followed by fluorouracilinfo-icon alone one week later and then a 3-week rest period. This 4-week cycle is usually repeated four to six times over 3 to 4 months.
  • Cyclophosphamideinfo-icon by mouth as a daily pill for 14 days, with doxorubicininfo-icon and fluorouracil together, by vein, on days 1 and 8 of that 2-week period.  This is followed by a 2-week rest period off chemotherapyinfo-icon. This cycle is usually repeated 4 to 6 times every 4 weeks for 4 to 5 months.

Side Effects and Things to Remember

Different medicines have different side effects. You may not have every side effectinfo-icon related to each medicineinfo-icon of the combination therapyinfo-icon. Common side effects of CAF include:

Less common side effects include:

  • Heart damage
  • Leukemia, a blood cancer
  • Skin changes
  • Increased risk of sunburn

Before starting CAF, tell your doctor about any medicines you are taking—including vitamins, herbal supplements and over-the-counterinfo-icon medicines—to make sure they won’t interfere with your chemotherapyinfo-icon treatment.

You will have a blood test before you start treatment. Your providers may suggest you drink a lot of fluids during treatment to avoid kidney and bladder side effects. Ask your doctor how much you and how often you should drink each day.

You should avoid becoming pregnant while you are receiving CAF. Tell your doctor right away if you become pregnant while you are undergoing treatment.

Be sure to talk to your doctor, pharmacistinfo-icon or nurseinfo-icon about all your side effects so that they can help you manage them. You can also go to our section on Side Effects for more information.