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CMF
 
 
Cyclophosphamide, Methotrexate and 5-Fluorouracil ("CMF")

CMF is a commonly used chemotherapy combination for the treatment of both early and established breast cancer. There are a number of different schedules used in the administration of these three chemotherapy drugs.
The first of these, "oral CMF”, is given as a combination of tablets and injections. The cyclophosphamide is given in tablet form. The tablets are taking each morning for the first 14 days only of each month. Normally, the pharmacist gives out only enough tablets to last for 14 days. If, however, you are given more tablets than this, it is important that you do not take them for more than 14 days. The other two drugs are given in injected form, by an intravenous drip, on the first and 8th day of each monthly cycle.
The second commonly used schedule (“Intravenous CMF”, “IV CMF”) involves giving all three drugs by intravenous drip altogether on the first day of a 21 day cycle.




Side-effects of CMF

The main side-effects are considered in detail elsewhere – just follow the links to find out more about each one and to read some tips on how to manage and minimize the symptoms.
They include:

  • Alopecia
    (hair loss). CMF usually causes some hair loss, but this tends to be a gradual thinning with successive cycles of treatment. With oral CMF it may be complete (though always reversible). With intravenous CMF, only about 20% of patients will require a wig.

  • Nausea

  • Low white blood cells and infection

  • Altered menstrual cycle and early menopause.
  • Infertility.
  • Mouth soreness and ulceration
    (“mucositis”)

  • Changes to mental function
    . (“Cognitive dysfunction”)

  • Bladder irritation (“cystitis”). Sometimes the cyclophosphamide can irritate the lining of the bladder as it is excreted. Occasionally this may cause bleeding in the urine (“haemorrhagic cystitis”). This is very rare with the doses used in CMF. However, it is the main reason that we encourage you to keep your fluids up for the first 24 hrs after chemotherapy. Try to take 1.5-2 litres in the day, but don’t panic if you can’t cope with that volume, or if it is making you nauseated. One litre is usually quite sufficient.

  • Fatigue.

  • Bad taste in the mouth
    (“dysgeusia”).

  • Indigestion, heartburn.

  • Diarrhoea
  • Nose bleeds





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