• Lewis

Part Seven: esc-BEACOPDac explained

Updated: Oct 12, 2020

As promised - an understanding of escalated BEACOPDAC.

Firstly escalated (esc) means that all the doses are increased from the original BEACOPP protocol, which isn't used as much in younger patients as studies show replacing Procabazine with Dacarbazine has better fertility prospects.

The drugs involved in the regime are;  

Bleomycin,

Etoposide,

Adriamycin (Doxorubicin;)

Cyclophosphamide,

Oncovin (Vincristine;)

Prednisolone,

DACarbazine.

Supportive medicine that sits alongside the regime is equally important; it helps prevent side effects and helps the chemotherapy drugs to work. These include; 

  • Mesna (a drug to prevent your kidneys from bleeding following cyclophosphamide infusion;) 

  • Allopurinol (to prevent chemotherapy drugs breaking up in your muscles and joints, causing gout;)

  • G-CSF Injections (to help your white blood cell count recover to be able to receive more chemotherapy)

  • Ondansetron, Metoclopramide, Cyclosine, Aprepitant (anti-sickness drugs)

  • Co-trimoxazole (an anti-biotic taken three times a week, to help prevent infection.)

The drugs are administered as follows; 

Day One - Adriamycin (Doxorubicin) as a slow injection into the cannula over five minutes, followed by Mesna as a drip over one hour. Cyclophosphamide is then given as a drip over one hour followed by Etoposide, again as a drip, over three hours. Mesna is taken orally three and nine hours after completion of Cyclophosphamide. 

Day Two and Three - Dacarbazine over one hour as a drip. Etoposide over three hours, again as a drip. 

Day 8 - Vincristine as a drip over five minutes. Bleomycin over one hour, again as a drip.

Prednisolone is a steroid given in considerable doses to reduce inflammation, suppress the immune system and help treat cancer. You take this every morning. Allopurinol is also taken every morning, however, only for the first cycle. Co-trimoxazole is continued for three months after treatment finishes. G-CSF injections are taken every morning from day 9-14, you insert the needle into your belly - however, it isn't as bad as it sounds!

esc-BEACOPDAC carries the possibility of many side effects as you can imagine. These are split into two categories short-term side effects and long-term side effects. Short term side effects are things such as hair loss, sickness and nausea, muscle aches, bone pain, risk of infection, anaemia (low red blood count,) sore eyes, breathlessness, mouth sores and neuropathy (pins and needles and/or pain in the nerves.) 

Long-term side effects are; permanent neuropathy; damage to the heart muscle; damage to the lungs; increased risk of heart disease; risk of lung disease or COPD; permanent infertility and risk of developing second cancer, most commonly Leukemia or non-Hodgkin's Lymphoma.

However, esc-BEACOPDAC is very successful. It is 7% more successful in inducing a complete response than ABVD, and the remission rate is around 10-15% better than with ABVD.