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Neoadjuvant EC Regimen precautions

Posting this on behalf of my wife (aged 34) who had been diagnosed with TNBC in October 2023.

She had recently completed her weekly 12 sessions of TC regimen : Paclitaxel (120mg) and Carboplatin (200mg). Although there was Hair Loss and slight nail discoloration from 3rd week onwards, she had Nausea from Day 1-4 post every session and severity increased cumulatively. The meds like Domperidone, Ondansetron helped a little with the nausea. Thankfully the Cold Therapy to hands and feet helped avoid neuropathy.

She's now scheduled to start the second regimen of anthracyclines EC regimen : Epirubicin (120mg) and Cyclophosphamide (900mg) for 4 sessions every 3 weeks.

I would like to understand what precautions to be taken for this EC regimen which I heard would be severe than our previous TC regimen. Would we still have to continue the cold therapy during these sessions too? And what other tips / experiences / advice would you'll guide us with.

Thanking in advance.


  • moderators
    moderators Posts: 7,884

    Hi @kara1122, and welcome again to

    We're so sorry for the reasons that bring you here, but we're really glad you've found us. You're sure to find our community a wonderful source of advice, information, encouragement, and support — we're all here for you and your wife!

    We'd suggest checking out these pages for common side effects and ways to manage them while going through EC treatment:

    Also, our members @iamnobird and @clars have both gone through EC treatment. We hope they can provide some insight for you!

    We hope this helps and we wish your wife great luck through her treatment.

    —The Mods

  • clars
    clars Member Posts: 40

    Hi there, sorry to hear about your wife and that’s so kind you are here researching for her.

    Yes, I had EC chemo, but before my Paclitaxel. EC is much more “sicky”, more nauseous feelings, no neuropathy stuff (so no need for cold therapy).

    I felt fine after my first EC but then vomited a lot about 9 hours after. My partner was cooking lamb and the smell of it turned my stomach. All I could eat was dry toast on that first day. White carbs really help with the sickness.

    However that was the only day I vomited! I just took my anti nausea meds earlier. I still felt a little sick with subsequent ones but nothing as bad as that first one which was a shock - every subsequent one I felt better.

    I had mild taste changes but avoided the mouth ulcers a lot do people seem to forget. I had lots of homemade ice lollies in the freezer prepared for it I got any but I didn’t! Worth having some of them to hand.

    Good luck xx

  • kara1122
    kara1122 Member Posts: 4
    edited February 25

    Thanks a lot @clars.

    It's Day 2 after our first Cycle of EC. Nausea and weakness has been severe, it's way more than the paclitaxel regime! She's been dozing off a lot lately and I'm fine by it as long as that helps overcome her nausea.

    The meds she's currently on are Domperidone, Ondansetron, Pantoprazole; and hydrating her with lots of electrolyte drinks / coconut water.

  • moderators
    moderators Posts: 7,884

    That sounds rough, @kara1122. Have you reached out to palliative care? Perhaps they can recommend something in addition to the anti-nausea medication, such as acupuncture (if you are both open to trying this). There is a list of recommendations for managing nausea in this article. Holding you and your wife in our thoughts. 🤗

  • moderators
    moderators Posts: 7,884

    @kara1122 We're just checking in on you and your wife. How's she doing?

    Thinking of you both!

    —The Mods