Cumulative effects of CMF

I’ve just completed my 3rd cycle of CMF as part of e-CMF regime (also had surgery x 2 and radiotherapy). I’m finding the general feeling of poisoning, nausea and tiredness is getting worse at each cycle. Is this likely to be the cumulative effect of the meds or just everything put together? I would appreciate it if anyone has any experience or wisdom to impart :). Thanks (my first post).

Pattie there doesn’t seem as many ladies on here having e-cmf my wife is though she only finished the e part last friday so can’t help with the cmf the e part has been ok (her words not mine)the major problem seems to be how long it takes 28 weeks as apposed to 18 weeks on FEC

Hi Pattie and welcome to the BCC forums

In addition to the peer support and shared experiences please feel free to call our helpline for further support on 0808 800n 6000, the lines are open 9-5 during the week and 9-2 on Saturdays

The following link will take you to the ‘Treatments’ page of the website where you will find more support ideas and information which you may find helpful:

Take care

Hi Pattie i am also on E-CMF but i am not as far along as you.I am due to have my first CMF tomorrow,so i will be interested in what anyone has to say.
Emma xx

Hi Pattie

I had E-CMF first time around. Initially I felt better when I switched over to the CMF bit but yes I did notice that I seemed to feel more toxic as the cycles went on. The good thing was that my hair started to regrow whilst on CMF. Good luck with the rest of your treatment

Twinky x

Hi Angel are you having treatment at Clatterbridge?

i am having some of my treatment at Clatterbridge

Oh right we are from chester and my wife has her treatment there the nurses and volunteers are fantastic

Hi, had Ecmf which finished at the end of September last year, I had rads at the same time to shorten the whole process, and I did manage the 2 in tandem. I think with the E part it was a low followed by a high, with the cmf it was a fairly constant feeling of nausea. I was glad when it was over but it was ok. The length of the course was the real pain, but the good thing which has been mentioned, your hair does grow back on cmf!
Good luck!

I had e/cmf in 2008 as part of the TACT2 research trial. Are you having 4 epi and 4 double doses of cmf? I am not sure as it may have changed but I had 12 visits and over 28 weeks, a computer chose my treatment. I found from chatting to others that people seem to either be much better on one section than the other. I agree with others, epi for me was sharp side effects lasting a few days plus being terribly bunged up. CMF gave me the runs, couldn’t eat any fruit or veg the whole time and became milk intolerant for a couple of days after each dose. I too had my first pixie haircut while still on cmf and dyed it. I agree the side effects were milder and hung around but for me it was much better. By the time I got to the cmf I had started to be suspicious that the steroids were actually causing me more trouble than the chemo and didn’t need anti sickness so I started (checked with doc first) to reduce them and for me that really improved everything. The steroids gave me blurred vision and trouble sleeping. If you want to try it check first, to be safe. I was also reacting to the C (cyclophosphamide) with a painful ‘swimmers nose’ and head pain and had to have it really slowly with piriton first. This is a common side effect and not nice so speak up at the time if you get it. Also remember that rads make some people exhausted. I had mine 3 weeks after chemo to recover my onc said so I think both together would def make you feel more.
My very best wishes to all of you. I recently had clear 4 year checks and am very glad I sat it out to the last dose despite threatening to give up many times. Funny how quick you forget it once the last one is out of your system but you won’t forget stopping early and wondering so if you can keep chugging on, getting closer to the finish every time you go in.The other thing about cmf is that you take 4 drugs and that gives you 4 chances of the right one doing its job.take care and keep smiling if you can
Lily x

I also had E-CMF and I faired better on the E part. The CMF which most people found easier floored me. I had really bad sickness (was taking 20 anti sickness tablets a day) and had nose bleeds and fainting spells had terrible sore mouth after each 2nd dose and felt really tired the whole time I changed after the first dose from tablet C to the infusion as was so ill on tablets. So for me it was not nice but I did persevere and finish all 4 after wanting to give up after 2!!! I also had rads along side the first 2 CMF so probably all together it just felt worse and I did work through chemo though only part time.
I finished in Sept last year and feel great now though and it is beginning to be a distant memory!
I also had treatment at Clatterbridge and yes the nurses and volunteers are lovely!

Good Luck x x

thank you for all the useful comments.
Kevinj why did you ask if i was having treatment at clatterbridge??

I didn’t have CMF but had AC and Paclitaxol, but was having it every 2 weeks instead of the usual 3. The side effects of any chemo are cummulative, because after each dose you don’t quite get it all out of the system before the next, and so on so by the time you get to the end you have still got an accumulation in your system.

The effects do wear off quickly though once you have finished, though.

I was just wondering if all people at Clatterbridge have epi-cmf rather than FEC

Hi Pattie,

I too am on Epi-CMF. Had day 8 of cycle 2 of CMF last week. Like you I am finding the CMF tough going and it is taking longer each cycle to recover. My Onc said that there is a cumulative effect and the Staff Nurse at the Cancer Centre that I attend said you need to bear in mind that this is a combination of 3 drugs rather than the 1 with Epi.

My blood count has been borderline for both CMF cycles and I was given 3 daily injections last week following the chemo to boost my blood count. I thought the low blood count explained why I am feeling so fatigued and the injections would give me a boost of energy but the the DN today said that wouldn’t be the case. She suggested getting outside each day just for a short walk - regardless of the weather. So I am going to give it a go starting tomorrow and hope my legs carry me.

My next CMF is on Tuesday 8th May.

Good luck to all of you on this particular regime. I was beginning to think I was on my own & was wondering why so many seem to be on FEC instead of this one. Still not sure I understand why!

K xx

Hi Kevinj

When I was having my chemo there were quite a few on the Epi CMF with me I was under Mr E cant put full name but maybe same onc as your wife??? He seemed to be the one for this regime. If you think about it we get an extra one cos the FEC is the epi c and f they dont get the M bit so dont think we have missed out!


As long as she is having the best possible treatment then i am happy don’t want any postcode rubbish.She is under Dr Hall a lady she has just finished EPI last friday and starts CMF in two weeks on friday

Hi Kevinj

I never thought there was any postcode lottery going on! I had chemo as my cancer was grade 3 and triple negative so no hormone treatment for me but no nodes so was just to mop up. But have met many woman on the same for hormone receptive so not sure how they choose what to give I think it just is what each onc prefers?? who knows but I would not think it was any lesser than any other chemos out there I do know that Tax is usually only used for node involvement?

I do hope she is ok and copes well with the CMF side


hi,those on CMF, did anyone have the chemo tablets alongside the injections??I was just wondering if it was possible to drink wine whilst taking the tablets as they have to be taken for 2 weeks.I dont really drink much at all but i have a girlie weekend next weekend and would be nice to just have a glass or two.

Thank you all for your comments. From what people have said it does seem to be cumulative which is kind of comforting as I was concerned about feeling rubbish alot of the time. I’d also assumed that the steroid injection I get before the CMF was mucking me about ie I have my chemo on a friday and get no sleep over the weekend. The tablets after the epi did the same but didn’t feel as bad but now I’ve got the left overs from the last CMF there to make it worse. I’m not complaining about the CMF - it is my new best friend if it does it’s job!
It is also reassuring that other people are having or have had e-CMF as I was starting to think everyone else had FEC or other abbreviations I did not really understand. I am being treated in Birmingham. My little friend who is now no longer with me was grade 3, ER positive with one positive lymph node.
Once again thanks.