AC-T and Cold Capping: Save Your Hair with Scalp Cooling

Published: April 17, 2024

AC-T is a chemotherapy regimen that combines three powerful drugs: Adriamycin, Cyclophosphamide, and Taxol, each playing a crucial role in your fight against cancer.

Adriamycin and Cyclophosphamide are akin to skilled soldiers on a mission, targeting and interfering with the growth and spread of cancer cells within your body. Their job is to disrupt the enemy’s advances. Meanwhile, Taxol, derived from plant alkaloids, acts as a strategic blockade, stopping cancer cells in their tracks by halting their growth.

This trio is often enlisted after surgery with a goal much like a safeguard: to minimize the chance that your breast cancer could make a comeback. In some cases, your medical team might introduce AC-T as a form of neoadjuvant therapy aimed at shrinking the tumor to make surgery more effective. Alternatively, as adjuvant therapy, it serves to clear any remaining cancer cells post-surgery.

It’s a journey many find daunting, but knowing the roles of each treatment can empower you as you embark on this path.

What is AC-T?

When undergoing AC-T chemotherapy, your medical team administers Adriamycin and Cyclophosphamide first. These drugs work together to attack rapidly dividing cancer cells at different points in their life cycle. After this initial phase, Taxol is given to target any remaining active cancer cells.

Adriamycin goes straight for the core, causing damage to the DNA within the nucleus of cancer cells, essentially halting their ability to multiply. Cyclophosphamide takes a different tack, interrupting the cells’ DNA replication process during division, leading to their demise. After these two have done their job, Taxol effectively steps in as the “cleanup crew”. It disrupts the microtubules — the structures that are crucial for cell division — stopping any surviving cancer cells from proliferating further.

In certain situations, particularly with Her2-positive and hormone receptor-negative breast cancers (often referred to as triple-negative), your oncology team might amp up with additional drugs like Herceptin and Perjeta, evolving into what’s known as the AC-THP, or your doctor may choose to give you TCHP instead.

This combination not only targets cancer more precisely but has also been shown to significantly improve outcomes for those with specific cancer subtypes. It’s a tailored approach, adding layers of targeted therapy to the robust foundation provided by traditional chemotherapy, which aims to give you the best possible shot at beating cancer.


The benefits of AC-T

Understanding the benefits of AC-T chemotherapy can give you a clearer picture of why your oncologist has chosen it for your battle against breast cancer.

    • Multi-faceted attack: The key to AC-T’s effectiveness lies in its comprehensive approach. By combining Adriamycin, Cyclophosphamide, and Taxol, this regimen targets cancer cells at various phases of their life cycle. This strategic variety makes it tougher for cancer cells to muster a defense and develop resistance to the treatment.


    • Enhanced efficacy: Attacking cancer from multiple angles not only complicates the cells’ ability to resist treatment but also enhances the overall likelihood of shrinking tumors significantly or even eradicating them. It’s like cornering the enemy in ways they least expect, making AC-T a potent option against the disease.


    • Reduced side effects: The magic of combination therapy also allows each drug to be administered at lower doses, which can decrease the severity of side effects. It’s a thoughtful balance between unleashing a powerful assault on cancer cells and maintaining your body’s resilience.


    • A lifeline for aggressive cancers: For more aggressive breast cancers or situations where cancer has ventured beyond its original site, AC-T chemotherapy delivers a multi-pronged approach, offering a more aggressive response to aggressive cancer.

The challenges of AC-T

While AC-T chemotherapy brings several benefits to the fight against breast cancer, it’s important to consider the other side of the coin. Here’s a look at the challenges that may come with this type of treatment:

    • Higher risk of adverse reactions: The introduction of multiple potent drugs into your system increases the likelihood of side effects. Each drug comes with its own set of potential reactions, and when combined, this risk is amplified compared to treatments that use a single chemotherapy drug.


    • Impact on blood cell counts: One of the critical areas where you might feel the compounded effects of AC-T chemotherapy is in your blood. The therapy can significantly affect your blood cell counts, making you more vulnerable to infections and bleeding complications. This is because the drugs can lower the levels of red blood cells (which carry oxygen), white blood cells (which fight infection), and platelets (which help blood clot).


    • Complex coordination of medications: Managing a chemotherapy regimen that includes multiple drugs requires meticulous oversight from your healthcare team. The potential for interactions between the medicines means that your doctors and nurses need to monitor your treatment’s progress carefully. They must remain vigilant about how your body responds, ready to tweak dosages or manage complications.

Navigating these challenges is a critical part of your journey through AC-T chemotherapy. It’s why your healthcare team will be by your side every step of the way, equipped with the expertise to manage these risks. Their goal is to ensure that the benefits of the treatment outweigh the cons, making your path to recovery as smooth and effective as possible. Remember, communication with your team about how you’re feeling is key to navigating this complex treatment landscape together.

Mapping your AC-T journey

Embarking on AC-T chemotherapy can feel like setting out on a long journey, one that unfolds in carefully planned stages over the course of three to six months. Here’s a roadmap to help you understand the route ahead:

    • The course of treatment: Typically, your journey with AC-T chemotherapy will span a total of six courses. These are spread out to give your body time to respond and recover, with the entire treatment stretching from three to six months.


    • The AC phase: Your initial trek begins with the AC combination — doxorubicin and Cyclophosphamide. This duo is the backbone of the first part of your treatment. You’ll receive this combination once every two to three weeks, making up the first four courses. It’s a phase designed to launch a powerful attack against the cancer cells, laying the groundwork for the next step in your therapy.


    • Transitioning to T: After you’ve completed the four courses of AC, the strategy shifts. You move on to T, which stands for paclitaxel (Taxol). This change marks the next phase of your treatment, focusing on the final two courses. Paclitaxel is administered to continue the fight against cancer, targeting any remaining cancer cells with a different mechanism of action.

This phased approach allows your medical team to target the cancer cells in varied ways over time, maximizing the effectiveness of the treatment while managing how your body copes with the therapy. It’s a structured path, but remember, your healthcare team is with you at every step, ready to adjust the plan as needed based on how you’re responding.

Hair loss is one of the most common and visible side effects of AC-T chemotherapy, with 93% of patients experiencing it.

The side effects of AC-T chemotherapy

This powerful combination of medications is designed to target and destroy cancer cells, but it can also bring along a series of side effects. Being well-informed about these effects and knowing how to manage them can significantly ease your treatment experience.

    • Coping with Hair Loss
      Hair loss is one of the most common and visible side effects of AC-T chemotherapy, with 93% of patients experiencing it. Understandably, experiencing this change can be difficult. However, there are effective ways to manage hair loss and maintain your self-esteem during treatment. Scalp cooling, or “cold capping,” has emerged as a supportive technique for many. Wearing a special cap cooled with gel during chemotherapy sessions can significantly reduce blood flow to the scalp, helping to minimize hair loss. The Penguin cold cap is one example that has benefitted numerous patients.
      Explore more about this technique: What is Cold Cap Therapy?


    • Alleviating nausea and vomiting
      Nausea and vomiting are frequent side effects that can impact your quality of life during AC-T chemotherapy. Open communication with your healthcare team is vital—they can prescribe anti-nausea medications that can offer relief. Additionally, dietary adjustments can help. Eating smaller, more frequent meals and opting for bland, easy-to-digest foods can alleviate nausea. Staying hydrated is essential, but remember, small sips are better than large gulps. Some patients find ginger tea or candies helpful in soothing nausea.


    • Fertility and future family planning
      The impact of AC-T chemotherapy on fertility is a crucial concern for many patients. The treatment can affect your reproductive system, potentially leading to challenges in conceiving in the future. It’s important to discuss fertility preservation options, such as egg or sperm freezing, with your healthcare team before starting treatment. Should you decide to have children in the future, these methods offer a pathway to parenthood post-chemotherapy.


    • Making informed family planning decisions
      During AC-T chemotherapy, decisions about family planning become particularly pressing. Open and honest conversations with your partner are essential, and seeking advice from a fertility specialist can provide clarity and direction. Your healthcare provider is also a valuable resource, helping you navigate these decisions in a way that aligns with your health and future plans.

What is the success rate of AC-T chemo?

The effectiveness of AC-T chemotherapy in combating cancer, particularly breast cancer, showcases a significant stride in medical treatment, offering hope and improved outcomes for many patients. The success rate of AC-T chemotherapy hinges on a combination of factors, each playing a pivotal role in the treatment’s overall efficacy.

    • Type and stage of cancer
      The nature and progression of the cancer are critical determinants of how well AC-T chemotherapy will work. Different types and stages of cancer exhibit varying responses to the treatment, with some showing higher sensitivity to the chemotherapy regimen than others. AC-T has been particularly noted for its effectiveness in early-stage breast cancers, where it significantly reduces the risk of recurrence.


    • Overall health condition
      Your general health status is another vital factor influencing how your body handles AC-T chemotherapy. A stronger, more resilient body can often tolerate the treatment better and recover more swiftly from its side effects, potentially leading to more favorable outcomes.


    • Individual response to treatment
      How your body reacts to AC-T chemotherapy can vary widely among individuals. Some patients may experience a more potent effect of the drugs on cancer cells, leading to a better response in terms of tumor shrinkage or eradication.


    • Compliance with treatment plan
      The success of AC-T chemotherapy also depends on closely following the prescribed treatment schedule. Adhering to the regimen as recommended by your healthcare team is crucial for maximizing the therapy’s effectiveness, ensuring that the drugs are administered at the optimal times to combat cancer cells effectively.

Research and clinical studies have underscored the potential of AC-T chemotherapy to not only reduce the risk of cancer recurrence but also to improve overall survival rates among breast cancer patients. For example, the results of a paper published by NCBI showed that compared with the AC chemotherapy regimen group before surgery, breast cancer in the AC-T chemotherapy regimen group had a better curative effect. The total remission rate was 91%, of which the complete remission rate was 65%, and the pathological complete remission rate was 26%. By effectively targeting cancer cells that may remain after surgery or other treatments, AC-T chemotherapy plays a vital role in achieving long-term remission for many patients.

Managing hair loss during AC-T chemotherapy

For many facing chemotherapy, the prospect of hair loss stands out as an especially poignant concern. It’s not just about losing hair; it’s the visible marker it sets, signaling to the world that you are battling something profound. Understanding why hair loss occurs and exploring ways to manage this side effect can help you reclaim some control during your treatment journey.

Why does chemo cause hair loss?

Chemotherapy targets cells in the body that are dividing rapidly, a characteristic of cancer cells. However, this action isn’t exclusive to cancerous cells; it also affects other rapidly dividing cells, including those within your hair follicles. When these follicles are compromised by chemotherapy, the result is often hair loss or thinning.

Can you prevent hair loss?

The journey through hair loss is deeply personal, with each individual choosing the path that feels right for them. Some find comfort and confidence in wearing headscarves, wigs, or other head coverings, using them as an opportunity to express their style and personality in new ways. Others embrace the bald look, wearing it as a badge of their courage and resilience.

An increasingly popular method for managing hair loss is scalp cooling or cold cap therapy. This non-invasive treatment reduces the temperature of the scalp during chemotherapy sessions. Cooling the scalp reduces blood flow to the area, which may reduce the amount of chemotherapy that reaches the hair follicles. The reduced exposure to chemotherapy can significantly reduce hair loss and is extremely successful for many patients.

Managing hair loss during chemotherapy is a personal decision, and what matters most is finding the option that makes you feel comfortable and empowered. Whether through stylish head coverings, embracing a natural look, or utilizing cold cap therapy, there are avenues available to support you through this challenge.

The mechanics of cold capping

The cold cap is essentially a high-tech hat filled with a gel coolant that’s chilled to a very low temperature. Wearing this cap before, during, and after your chemotherapy sessions set off a series of physiological responses in your scalp.

Vasoconstriction: The cold from the cap causes the blood vessels in your scalp to constrict or narrow. This reaction is key to the effectiveness of cold capping because it significantly reduces blood flow to the area.

Reduced chemotherapy exposure: With the blood vessels constricted, less chemotherapy drug is able to reach the hair follicles. Since chemotherapy targets rapidly dividing cells (like cancer cells), reducing the drug’s reach means that the rapidly dividing cells in the hair follicles are less affected.

Preservation of hair follicles: Cold caps help preserve the integrity of hair follicles by limiting the amount of chemotherapy drugs that reach them. This means that many patients using cold cap therapy experience only minimal hair loss or, in some cases, avoid it entirely during their treatment.

The effectiveness of cold caps can vary from person to person and is influenced by factors such as the type and dosage of chemotherapy. However, many patients report significantly less hair loss, with some experiencing none at all. This can be a substantial emotional and psychological boost during treatment, helping to maintain self-image and privacy.

How can Penguin Cold Caps help?

Penguin Cold Caps is the original cold cap therapy provider and has helped thousands of chemo patients save their hair during treatment. It offers a tangible way for many undergoing the rigorous journey of AC-T chemotherapy to mitigate one of the most visible side effects of treatment: hair loss. Through personal stories and clinical evidence, the impact of these cold caps in preserving hair and, by extension, a sense of normalcy and self-esteem becomes evident.

A retrospective study of Penguin Cold Caps, published on the NCBI website in March 2024, reported a 71.4% success rate for patients receiving doxorubicin-containing regimens, like AC-T.

Brenna’s Story

Brenna retained so much of her hair that no one knew she had just undergone chemotherapy.

“Going through cancer is hard enough, but keeping my hair helped keep my head up and stay confident. When I realized it was working, it gave me something to be proud of. It may sound silly, but keeping my hair became part of beating cancer.”

Read more about Brenna’s experience of cold capping

Stefanie’s Story

Stefanie retained 80% of her hair with minimal shedding due to using Penguin Cold Caps while on an AC-T chemo regimen.

“AC chemo was very hard on my hair. While my hair’s thinner, it’s still long and looks healthy. The added bonus is that I don’t have to wait months for it to grow back. In fact, no one knows I’ve just been through 16 rounds of chemo… unless I tell them.”

Read more about Stefanie’s journey

Clinical Validation

In addition to client stories, clinical studies further evidence the effectiveness of cold capping. Research on various chemotherapy regimens, including AC-T, has provided evidence-based support for using cold caps to reduce hair loss. These studies are crucial, offering anecdotal assurance and scientifically verified evidence of the benefits of cold cap therapy.

For more clinical evidence, see Evidence that cold cap therapy works

Penguin Cold Caps’ utility extends beyond the physical preservation of hair; it plays a crucial role in maintaining patients’ psychological well-being. The option to use cold caps represents more than a cosmetic choice—it’s a decision that can profoundly impact a person’s mental health and emotional resilience during cancer treatment.

For those considering using Penguin Cold Caps or seeking more information on their effectiveness, numerous resources and testimonials are available. These stories and studies not only highlight the potential of cold cap therapy but also offer insight and encouragement to those embarking on their own treatment journeys.

More stories from Penguin Cold Cap Patients

How to decide if cold capping is right for you

Research and Information Gathering

Start by gathering as much information as possible about cold capping, how it works, and the experiences of others who have used it. Understanding the process and potential outcomes can help set realistic expectations.

Check out Penguin Cold Caps on Facebook and Instagram, filled with patient stories and posts.

Consult with Your Healthcare Team

Before making any decisions, it’s crucial to discuss cold capping with your oncologist or healthcare provider. They can offer invaluable insights into how cold capping might fit into your overall treatment plan and whether it’s suitable for the specific chemotherapy regimen you’ll be receiving.

Contact a Penguin Cold Cap Representative

Penguin Cold Cap representatives are knowledgeable about their product and have a wealth of experience in assisting patients through the process. They can provide detailed information about the cold capping process, the costs involved, and what you can expect during your treatment.

If you’re considering cold cap therapy as part of your chemotherapy treatment, reaching out for personalized advice and support is a great next step. Requesting a callback from a Penguin Cold Cap representative is easy and can be the first step toward a more informed decision-making process.

Fill out the form below to request a callback

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Finding a support network

As you navigate the challenges of AC-T chemotherapy, finding a strong support network is invaluable. Open conversations with friends and family about your feelings, especially concerning hair loss, can lighten your emotional load. These discussions invite understanding and support and remind you that you’re not alone in this journey.

Additionally, consider joining a support group. Connecting with individuals facing similar challenges offers a unique form of solidarity and understanding. Support groups, like the Chemotherapy Support Group on Facebook, provide a space to exchange stories, share advice, and discover coping strategies that others have found helpful.

Join the Facebook Chemotherapy Support Group

Get in touch

If hair loss during AC-T chemotherapy concerns you, know that support is available. Consider reaching out for a conversation with a Penguin Cold Cap representative to explore how cold capping might support you during treatment.

Request a callback to talk to your local Penguin Cold Cap rep and learn more about your options for managing hair loss during chemotherapy.