Why EC first and then Docetaxol

Is anyone able to tell me why some of us are first put on EC or FEC for three cycles, and then Docetaxol for three? What are the advantages of using both prescriptions?

Many thanks, from one who’s still in the dark regarding much of my treatment.

Hi there

I recall being advised why they would do it in this way for me when I had my chemo end last year and beginning of this, however I can’t recall the specifics. Something about targeting the area of where the tumour was and then a mop up of the rest of the body for any ‘escapees’! Hopefully someone will come along and give you a more precise answer, hence my bumping this for you. Take care. J.

Hi from what I remember fec can be very good with more solid rumours and tax is good at any that are in your system. But am not an onc. They are supposed to kill the cells in different ways so if one doesn’t work so well hopefully the other wil. I would ask at your next clinic app as there may be a lot more to it.


I had FEC-T, three of each, as have a lot of folks here (the T is Taxotere, another name for Docetaxol - one’s the generic name but I can’t remember which!).

I THINK that Tax/Docetaxol is more often given when there’s lymph node involvement and is also given sometimes for secondaries. I think it’s one of the most toxic chemos so isn’t usually given unless they think it’s necessary - i.e. if they think or know that the cancer cells have spread beyond the breast tissue.

Don’t quote me on that but it seems to fit in with what jaynek and midge have said.

By the way, I’m HER-ve, PR-ve, ER+ve so not TN but did have quite high lymph node involvement (6/12 including a level 3 node)

Jane xxx

Except that my lymph nodes were clear and I had FEC-T so probably a number of reasons why they use both rather than just one reason. Perhaps one of the BCN on here can enlighten us please?

I also had FEC - T and had clear lymph nodes. But my microinvasions were hormone negative. So 2 perceived higher risk factors there, non hormonal and multi focal (I think). I was subsequently found to be HER2+, but that was after I’d begun the treatment plan.
BCN enlightenment would be good!

I second that Cherrytom. Please can we have an experts verdict? I am also HER2+


I had FEC-T. Again clear nodes, but I had a biggish tumour, multi-focal and lobular.

Hi ladies,

Thank you for replying to my query. We all seem to be a bit in the dark, don’t we?

I too would appreciate an answer from an expert, but maybe it isn’t possible as we are all individual cases, and as such the reason could be different for each of us.

My lymph nodes were clear, hormone negative, 5cm tumour. I was told my treatment was primarily to shrink the tumour, which would mean easier sugery, but also to kill any stray cells.

After 2xEC my prescription was changed to Tax as an MRI scan showed my tumour hadn’t shrunk at all. One thing I don’t understand is, if Tax is known to have better results in shrinking tumours why are we not started on tax?

Thanks again ladies.

Good wishes to you all.

My understanding about using two is that it is a little like using disinfectant and following up with bleach - more likely to get everything.

Why not just use TAX? I suspect that for many (F)EC does the job, and I suspect it costs a lot less than TAX. I think when my wife was being treated TAX was running at a little under £1000 a treatment.

TAX was also deeply unpleasant for my wife. If people can be spared that it is a good thing.



Just to let you know that following your request for expert comment, our clinical team have read this thread and will be looking to post a comment soon.

Best wishes
June, moderator

I was told that they do 2 types of chemo because they come at the cancer from different angles so are more likely to blitz it from all sides rather than on 1 front.

Thanks for that June - you’re a star! :slight_smile:

Jane xxx

My OH was diagnosed with Triple Negative. There was no node involvement but there were signs of stray cells leaving the breast tissue. She had surgery first and then 6 weeks later started the chemo.

She was put on FEC every third week and then weekly cycles of Tax.

Then a break followed by the rads.

Like others have said I believe it is done to throw everything possible at it, especially when it is TN as there are no follwo up drugs once chemo/rads finished.

Looking forward to reading the Clinical Teams comments.

Thank you for showing an interest.

I am making this post on behalf of the clinical team:-

Hi everyone,

With regard to ‘libsue’s query about why some people are put on EC or FEC for three cycles and then Docetaxol for three, and what the advantages are of using both prescriptions.

You’ll all know that chemotherapy is a treatment using anti-cancer drugs. Their aim is to destroy breast cancer cells. It’s known as systemic treatment because the whole body is exposed to drugs. Various factors are taken into consideration when deciding on whether or not to recommend chemotherapy in the first place and if chemotherapy is recommended which type of drugs would be best to use. These factors include, for example, the size of your breast cancer, the grade and whether the lymph nodes under the arm are affected. Also your general medical health and any other medical conditions will also be considered.

There are many different types of chemotherapy drugs used to treat breast cancer. They can be given in different ways and also in different combinations, according to your particular situation.

The way chemotherapy works is that it interferes with the way cancer cells grow and divide (the cell cycle). Using different chemotherapy drugs in combination will interfere with the cell cycle at different phases of its growth.

That is why a combination of drugs is used.

The NICE (National Institute for Health and Clinical excellence) guidelines recommend that chemotherapy after surgery for breast cancer should consist of 4-8 cycles of a combination of drugs, including an anthracycline (epirubicin or doxorubicin). NICE have also approved docetaxol (Taxotere) after surgery for women with early stage breast cancer who have lymphnodes under the arm that contain cancer cells. In 2009, a review of chemotherapy trials for early breast cancer found that adding a taxane based chemotherapy regime to anthracycline chemotherapy seems to reduce the risk of the cancer coming back more than using anthracyclines alone.

It’s important to remember that everyone’s cancer is individual to them, and therefore treatments will vary. Oncologists will weigh up the benefit (or additional benefit of different drugs) of chemotherapy versus the side effects before making any of their recommendations.

Do talk to your specialist team if you are unsure about the combination of chemotherapy drugs that you’ve been offered.

Best wishes Sam, BCC Facilitator

I think EC isn’t as widely used as FEC in the UK, for primary bc anyway, but if it’s of interest to anyone, here’s my experience.

I had 6xEC (my first chemo) in 2009-2010. Result: slight (millimetres), temporary shrinkage of all my liver mets.

In autumn 2010 I knew I would need more chemo, and knowing about the anthracycline/taxane recommendations, I asked my oncs for docetaxol. I’d heard how effective this strong chemo can be… I was told by the consultant that this would be against his advice - weekly taxol was now the gold standard, giving a “trickle-charge” dose of chemo in 18 sessions.

After 5 taxol - and bad side effects more typical of docetaxol - a scan showed progression :frowning: :frowning: :frowning:

Thankfully I’ve been much better on capecitabine, which is converted in the body to the chemo drug 5-FU - the “F” in FEC.

Many thanks Sam for coming back with an explanation for us, and in language that we can all understand.

Thank you so much Sam for your explanation, as Mazzalou commented it’s written in a language we can all understand.

I now feel out of the dark, and appreciate your time.

Thanks Sam xxx