When you hear the words cancer treatment, what’s the first image in your head?
If you’re like most people, it’s probably a hospital chair, an IV drip, maybe a nurse checking the bag every few minutes. Needles, wires, that beeping sound from the monitor.
But here’s the thing — that’s not the only way chemo works anymore. There’s another option: oral chemotherapy. Instead of going to a hospital for every dose, you take the medicine at home. Pills, capsules, sometimes even a liquid. No drip stand in sight.
Sounds convenient, right? Well… yes and no. Let’s walk through it.
What is Oral Chemotherapy?
Chemotherapy may eliminate or inhibit the growth of cancerous cells. In certain situations, chemotherapy will completely remove cancerous tissues. In other situations, it will simply slow the progression of the illness, thereby extending the life of the patient. Chemotherapy is administered through an IV needle placed in the arm (intravenous or IV). The treatment is done on an outpatient basis (meaning patients are not admitted to hospital, and are “treated and released”). Oral chemotherapy refers to tablets or capsules that patients are able to take orally, thus eliminating the need for needles or IV access. Some examples of oral chemotherapy medications include: capsules of cyclophosphamide and etoposide capecitabine temozolomide methotrexate.
What to expect from oral chemotherapy
A person’s oral chemotherapy regimen will vary based on their specific circumstances, including their personal health, however, there are some overarching basics that can be outlined:
Dosage and schedule
The type of cancer a person has, affects their medications, and even their hormonal balance will all determine what dosage is deemed appropriate. Dosage recommendations come with various risks, and in this scenario, one of the greatest dangers is under or over-prescribing.
A patient must follow the strict schedule set by the doctor as far sch as schedule goes. Missing some doses or taking them too close together can significantly weaken the effectiveness.
Patients should receive precise dosing guidance from the prescribing clinician, especially with respect for the dos and don’ts of missing pills or overwise overdose. Managing the medication is easier with diaries or reminder apps.
Special Handling and Storage
Oral chemotherapy medication come in pill form and pose a health risk, so they must be handled carefully, the same as other types of chemotherapy, which requires the handling of gloves. Some medication must be kept at a specific temperature. A person must also store it in the following manners: Keeps the original container Separation from other pills
In a cool dry place, away from heat, sunlight, and moisture
Secured from children and pets, and out of their reach If a chemotherapy medication needs refrigeration, the pill bottle must be stored in a labeled airtight container, separate from food. Proper marking minimizes the chances of using the incorrect medication. Labeling of all containers is essential.
Side Effects of Oral Chemotherapy
Chemotherapy, whether targeted at oral or IV administration, is known to be particularly aggressive; it is capable of obliterating both healthy and malignant cells, leading to a multitude of undesirable symptoms.
Chemotherapy may cause side effects, both for oral and IV routes of administration, and these include:
- Hair loss
- Skin changes
- Sores in the mouth
- Easy bruising
- Fatigue
- Infection or flu like symptoms
- Nausea, vomiting or diarrhea
Like other forms of medication, the type and severity of side effects one experiences is unique to each individual and, in some cases, the combination of some drugs used in chemotherapy and other supplements may aggravate the side effects.
Discussing alcohol consumption as well as herbal and dietary supplement intake with a physician is emphatically recommended prior to the commencement of chemotherapy.
Physicians well trained in these matters can help the individual avoid such interactions and resulting side effects.
Whilst undergoing oral chemotherapy, it is imperative for the individual undergoing therapy to maintain a log of chemotherapy-sensitive side effects.
Chronic vomiting can disable a person from being able to retain medication, and chronic malaise can render a person too sick to take their medication.
In these situations, it is critical to consult with the physician as promptly as feasible to adjust the treatment as required.
Advantages of Oral Chemotherapy
The majority of individuals prefer oral chemotherapy rather than IV chemotherapy due to the reduced number of hospital and clinic visits. Instead of traveling to clinics and hospitals, people can receive treatment from the comfort of their homes.
Additional benefits of this form of treatment may also include:
- fewer child care issues
- lower disruption to daily activities
- reduced time off from work
- lower travel costs
- increased privacy
Others may wish to avoid treatment centers due to feeling anxious, needle phobias, ease of bruising, or having difficult veins. For these people, oral chemotherapy may provide a less distressing and more comfortable treatment option.
Disadvantages of oral chemotherapy
Oral chemotherapy does come with a number of advantages, but as with every treatment, there are disadvantages to consider.
Once again, with IV chemotherapy, medical staff are present to ensure that the patient receives the right amount of medication and management of adverse reactions is promptly addressed.
In the case of oral chemotherapy, treatment is done in the patient’s home, which may delay treatment in case of adverse reactions.
Another challenge with oral chemotherapy is that the individual or their family is the one responsible for ensuring the medication is taken, which can lead to errors.
Possible issues with oral chemotherapy can include:
- making errors with the dosage
- not being able to stick to the treatment plan
- overadhering to the treatment, such as taking excessive medication
- experiencing medication interactions
These complications, as well as missteps in oral chemotherapy, can be mitigated by proactive patient education, routine monitoring, follow-up appointments, and comprehensive care.
Another drawback of oral chemotherapy is the need for proactive management of prescription refills. In some cases, medicines need to be ordered weeks in advance. Those who lag behind in maintaining the ordering routine risk missing doses, which will jeopardize treatment.
Chemotherapy is orally administered, and as with all forms of chemotherapy, it is potent and demands strict safeguards against misuse. Some substances are so dangerous that gloves must be worn for handling themTrusted Source. Care must be exercised to securely store and dispose of all unused castings out of reach of young children and pets.
Can Oral chemotherapy cure cancer?
Oral chemotherapy could lead to cancer remission and signs and symptoms of cancer could be found to be absent. Remission can be temporary or permanent.
There are two types of remission; partial remission is when symptoms are diminished and complete remission is when symptoms are fully absent.
Oral chemotherapy may be just as effective or in some cases more effective than IV chemotherapy. Different types and stages of cancer will be more or less effective and lead to higher or lower chances of remission and survival.
In a 2019 study of 402 patients with metastatic breast cancer, participants responded better to an oral formulation of the drug, paclitaxel and equidurar, in comparison to IV paclitaxel. However, oral paclitaxel is not yet commercially available, requiring more research and clinical trials.
It is the center of the person’s cancer care that can be consulted to find out whether oral chemotherapy would be more effective than IV chemotherapy for the person’s situation.
What is the maximum duration for taking oral chemotherapy?
Many patients deal with cancer in cycles; a treatment period followed by a break for the body to recover from the effects of chemotherapy.
A patient’s treatment schedule is determined by the specific chemotherapy agent and the type of cancer being treated.
The treatment of cancer through chemotherapy is typically 3 to 6 months. In some cases, it may shorten or extend beyond this window. In most cases, a person undergoes four to eight treatment cycles, and each cycle lasts between 3 to 4 weeks.
What is the price range of oral chemotherapy?
The price range of oral chemotherapy treatment is wide due to the duration, dosage, type of drug, and insurance coverage or lack thereof.
As of 2021, adult cancer patients in America were reported to spend around 180to180to2600 a month on cancer care, which is referred to as the out-of-pocket cost. This is the portion of treatment that insurance companies do not cover.
According to the American Cancer Society, oral chemotherapy may involve higher out-of-pocket expenses compared to intravenous chemotherapy. Certain insurers may exclude reimbursing some drugs, which may be costlier and violate the insurance coverage.
A person with health insurance should call their plan provider to inquire on coverage eligibility. Coverage terms should be discussed with the cancer care team prior to seeking an oncologist prescription in order to maximize coverage eligibility.
Conclusion
Similar to IV chemotherapy, oral chemotherapy utilizes cancerous cell-destroying mechanisms to either eradicate or inhibit cell growth. Moreover, it may be a suitable treatment for patients that do not want, or cannot, visit the hospital for IV chemotherapy. However, not every type or stage of cancer is eligible for oral chemotherapy, and even if some patients are, it may not be the best option for all of them Best medical oncologist in Gurgaon, Dr. Pooja Babbar, is well placed to guide patients with cancer on whether oral treatment is suitable, and its efficacy and associated risks.
