Usually, chemotherapy is associated with cancer drugs given intravenously in a hospital or doctor’s office. This has been the traditional nonsurgical method of treating cancer.
Some versions of oral chemotherapy have been around for more than 60 years. But it’s due to recent advances in cancer treatments that oral chemotherapy pills have become more widely used.
In 2007, researchers estimated that 25 percent of all anticancer drugs under development were oral drugs, which come in the form of a liquid or a pill. But it’s important to know the difference between the various forms of oral medication prescribed to fight breast cancer, points out Dr. Hannah Luu, California-based oncologist and CEO and founder of OncoGambit, an online service that creates personalized cancer treatment plans. She outlines three categories of oral medications cancer patients may take as part of their treatment plan:
- chemotherapy pills
- antihormonal pills
- targeted therapy (precision medicine) pills
Each therapy works differently and serves a different purpose. Not every medication will be right for everyone. Which therapy is right for you will depend on various factors including the type of cancer you’re fighting, the severity of your case, and other health considerations.
What are breast cancer chemotherapy pills?
Not all traditional chemotherapy drugs come in an oral form. These chemotherapy medications, are commonly prescribed to fight breast cancer and are available as pills:
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- cyclophosphamide (Cytoxan)
- capecitabine (Xeloda)
- temozolamide (Temodar)
- etoposide
- topotecan (Hycamtin)
- methotrexate (Trexall)
- vinorelbine (Navelbine)
- idarubicin (Zavedos)
Sometimes oral chemotherapy is prescribed in combination with other medication, often intravenous (IV) drugs. Additionally, chemotherapy pills work like IV chemotherapy to kill all fast-growing cells. As such, you’ll experience similar side effects as well as similar results.
“The efficacy of chemotherapy pills ... are similar to the traditional intravenous therapy, with research showing that the overall survival with oral chemotherapy is the same as patients would have with traditional intravenous chemotherapy,” says Dr. Luu.
How do you take chemotherapy pills?
Unlike traditional chemotherapy treatment given at a clinic or hospital, chemotherapy pills are taken at home. Your doctors will provide you with clear instructions on how to take your medication and when. They’ll also tell you whether you should take the pills with food and how long or before after eating. It’s very important to follow these instructions exactly. In some cases, you may even need to wear gloves when handling your chemotherapy pills.
You should also ask your doctor whether it’s safe to use a pill organizer. Chemotherapy pills should be considered hazardous, according to Mayo Clinic. So you need to keep them in the container they came in and can’t store them with other medications or supplements. You should also avoid crushing, breaking, or chewing oral chemotherapy pills.
The American Cancer Society provides a few other key safety tips for taking this type of medication:
Tell your healthcare team if you miss a dose or are late taking it. Your doctor will advise when to take your next dose and if any changes need to be made.
Adds Dr. Luu: “Chemotherapy pills have the potential to cause the same serious toxicities as intravenous chemotherapy. If used incorrectly, they can potentially have fatal outcomes. It’s important for patients to be aware of their treatment plan and take their chemotherapy drugs accordingly. It’s even more important that the patient doesn’t take the missed pills with the next dose.”
Don’t make any changes to your doses unless your doctor explicitly tells you to. Even if you begin to feel better, your body needs the chemo to continue to fight the growth of cancer cells. Your doctor will request blood tests and other scans to monitor changes in the cancer and make any necessary adjustments to your treatment plan.
Make sure chemo pills are always out of reach of children and animals. Ask your healthcare team how to get rid of extra doses, as it isn’t safe to keep these pills around if you aren’t taking them. You may be asked to take the unused medication back to a pharmacy or to another facility where it can be destroyed and thrown away safely.
If for some reason you can’t take your medication or you feel sick after taking a dose, call your healthcare team for further advice.
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What are the side effects?
Side effects for breast cancer oral chemotherapy drugs are similar to those for traditional chemotherapy. They include:
- nausea
- vomiting
- hair loss
- low blood counts
- mouth sores
- diarrhea
- tingling or numbness in your hands and feet
- fatigue
- menstrual changes
What side effects you’ll experience will depend on the pills you’re taking, so it’s very important to talk to your doctor about what to expect beforehand. And because you won’t be seeing your healthcare team as frequently, it’s especially necessary to tell them about what side effects you’re experiencing. That way they can make any necessary adjustments to your doses and help you find relief from the side effects.
What are the pros and cons of oral chemotherapy?
One of the primary benefits of breast cancer chemotherapy pills is their convenience. You can take them at home. You don’t have to allot extra time for traveling to and from the clinic and receiving treatment. Also, because oral chemotherapy is significantly less invasive than traditional chemotherapy, which involves IVs that are painful for some, it’s a more comfortable option.
Oral chemotherapy also allows doctors to create more tailored and flexible dosing plans compared to traditional chemo treatment.
Although convenience and flexibility are major perks of this type of cancer treatment, it may not be the right option for you. Taking the medication on a strict schedule and in the correct doses is a lot of responsibility that you may not be comfortable with. A missed or incorrect dose can have serious implications, so you should talk to your cancer team about this and weigh the pros and cons of breast cancer chemotherapy pills.
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The other major consideration is the out-of-pocket cost difference between oral chemotherapy and IV drugs. Because some insurance providers consider oral chemotherapy drugs as a pharmacy benefit, they don’t reimburse for the cost as they do for traditional chemotherapy. This can put the financial burden on you for medications you need to fight cancer.
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