How Adriamycin (Doxorubicin) Chemotherapy Treats Breast Cancer

Adriamycin—also known as Rubex, Doxil, doxorubicin and The Red Devil (informal term)—is a chemotherapy drug. More specifically, it's a type of anthracycline antibiotic that is an anti-tumor drug. It is made from the bacterium Streptomyces.

Adriamycin can be used to treat early-stage or node-positive breast cancer, HER2-positive breast cancer, and metastatic disease. Adriamycin is sometimes combined with Cytoxan and/or 5-fluorouracil to make a cocktail of breast-cancer-fighting chemotherapy drugs.

This drug is also approved for the treatment of other cancers, including ovarian, bladder, soft tissue and osteogenic sarcoma, small cell lung cancer, thyroid and gastric cancers, as well as neuroblastoma, lymphoma, leukemia, Wilms tumors and Kaposi's sarcoma.

Adriamycin fights cancer by slowing or stopping the growth of cancer cells. This drug gets into the cancer cells, intercalates within the DNA structure and stops cell replication by inhibiting the activity of an enzyme called topoisomerase-II. Adriamycin also forms oxygen free radicals, which damage cell membranes and proteins and may also affect the heart.

This drug is given by injection during a chemotherapy infusion. If the dose of Adriamycin that you are being given is very thick, it may be given as a "push" injection, rather than through an intravenous drip. This red fluid drug will be delivered in a large plastic syringe, which will be attached to your catheter tubing, and your infusion nurse will slowly depress the plunger manually, to inject the Adriamycin into your vein.

Because this drug can cause heart problems, you should have a MUGa scan, LVEF (left ventricular failure) test or heart health evaluation done before starting treatment. This baseline exam will be used to compare with your heart function during and after treatment. Other tests for kidney and liver function may also be needed.

• Use reliable contraception -- avoid a pregnancy
• Drink lots of fluids, especially water, to flush your kidneys and bladder
• Avoid drinking alcohol and caffeine -- these dry out your tissues
• Don't take aspirin, because it thins your blood
• Don't get vaccinations

• Allergic reaction to adriamycin
• May harm fetus, if you become pregnant during treatment
• Possible future infertility
• Low blood counts, greater danger of infections
• In some cases, there is a risk of heart damage

• Red-colored urine first two days after treatment
• Neutropenia (low white blood cell count, greater risk of infection)
• Chemotherapy-induced anemia (low red blood cell count)
• Thrombocytopenia (low platelet count)
• Hair loss, or thin, brittle hair
• Nausea
• Vomiting
• Diarrhea
• Fatigue
• Mucositis (irritated mucous membrane in your mouth, stomach, and digestive tract)
• Amenorrhea (monthly menstrual cycle stops)
• Changes in nails (brittle or yellowed)

If you have any of these symptoms, call your doctor:

• Fever of 100.5F or higher
• Pain or redness at your injection site
• Bloody urine or reddish sweat
• Unusual bruises or persistent bleeding

• Persistent cough, sore throat, pneumonia
• Allergic symptoms: shortness of breath, swelling of feet or ankles, rash, swollen throat or tongue

Please note that Extravasation happens only during the infusion.