All You Need to Know About Oral Chemotherapy

Oral chemotherapy is chemo that is taken by mouth in tablet, capsule, or liquid form.  It can be as strong and effective as more traditional chemotherapy that is injected or infused into the body but is taken in the comfort of home. Its use is becoming more prevalent, though there is a lot to understand about what makes it unique.

A good way to understand oral chemotherapy better is to look at it through a lens of benefits and risks.  There are both good and bad things about oral chemotherapy, but because it is a strong medication used in the treatment of cancer, those ‘bad things’ have serious risks involved, meaning patients need to be certain they are informed and educated about the proper use and storage of oral home-based chemotherapy.

Benefits of Oral Chemotherapy

• Taking oral chemotherapy is convenient for the patient and provides more flexibility 

• Oral chemotherapy is less invasive to the patient

• There are generally fewer interactions with hospitals and clinics with oral chemotherapy

• It is an easy process to get life-saving treatment to patients

Risks of Oral Chemotherapy

• There is little to no medical supervision for oral chemo, as it is taken at home

• Not following the instructions for its use can impact its effectiveness

• The cost of oral chemo more often falls to the patient than clinic based, or hospital administered chemotherapy

• If vomiting occurs in response to the oral chemo, that leads to reduced drug absorption and confusion about what to do in that situation, with no medical staff there to help

• The patient is put in a position of more responsibility at a time they may not be feeling their best

Even with all the above risks, an oncologist may determine (and often do) that oral chemotherapy is the treatment that is best suited for their patient. Srilata Gundala, MD, hematologist/oncologist and founder of Hope & Healing Care Centers in Lombard and Hinsdale, Illinois works with each of her patients on individual treatment plans, some of which utilize home-based oral chemotherapies, “Oral chemotherapies can be a preferred and very effective treatment modality. If they are prescribed as part of the treatment plan, it is always with the patient’s best interest and their full awareness and understanding of how to safely administer their medication independently at home.”

If you and your treatment team have determined that oral chemotherapy will be a part of your chemo regimen, here are some things to consider as you begin your home-based treatment:

• Have all the names and contact info for your treatment team ready and easily accessible before you begin taking oral chemo

• Maker certain you have all your medications and any necessary supplies ready and accessible and know both the trade and generic names of your prescribed oral chemotherapy medication

• Understand how to store your oral chemotherapy – never in a bathroom (too much moisture) or on a windowsill (too much sunlight) and set up a station that is away from any children or pets in your home

• Keep your oral chemotherapy away from your other medications and in its original packaging – never place it in your pill box with other meds

• Keep a diary where you can record your daily records of use and any side effects. Remember to bring this diary with you on your next doctor visit

• Enlist the help of a friend or family member to regularly review your oral chemo setup and your medication diary, to ensure you are doing everything properly

• Use your smart phone, computer, or watch to set alarms to help you remember when to take your oral chemo – it is very important to always maintain your treatment schedule

• Always wash your hands before and after handling the medication. Ask your doctor or pharmacist if you need to avoid handling the medication with your bare hands and have appropriate gloves in stock, if needed

• Double and triple check that you are taking the right medication at the right time, every time

• If you do forget or miss a dose, or vomit shortly after taking the oral chemo, contact your doctor’s office ASAP for guidance 

• Ask if the oral chemo prescribed to you can be opened, broken, or crushed to be mixed with food or liquid to make it easier for you, if needed

• Be proactive and notify your treatment team of any side effects or symptoms early, so they can be better controlled

• Learn about how to safely dispose of any unused oral chemo, which often requires it be returned to the pharmacy where you got it. These are hazardous drugs that should not be put down the sink, toilet, or thrown in the garbage.

The Dana-Farber Cancer Institute in Boston has compiled a useful webpage for anyone prescribed oral chemotherapy. Their philosophy about oral chemotherapy is, “It’s not just any pill,” and they are right. For many, though, it is an ideal kind of treatment that will help many manage their cancer in as comfortable a setting as is possible — home.  You can find that informative page HERE.  And read about being an empowered cancer patient, something anyone taking oral chemotherapy should be, HERE.

Written By: Sheila Quirke, MSW

Reviewed By: Srilata Gundala, MD