Oral chemotherapy and reduced constraints
Several surveys1-2 conducted among patients treated with oral or with intravenous chemotherapy have shown that most patients clearly express their preference for oral treatment. The reasons given by respondents are: avoiding repeated injections and trips to the hospital thanks to home treatment, and enjoying greater comfort in their everyday life.
1 Liu G, Franssen E, Fitch MI, Warner E and al. Patient preference for oral versus intravenous palliative chemotherapy. J Clin Oncol 1997; 15: 100-5
2 Jensen LH et al. Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC. Lung Cancer 2008.
Chemotherapy requires several treatment cycles. With intravenous chemotherapy, this means that the patient must have repeated intravenous injections at the hospital. When use of oral chemotherapy is possible, the patient can avoid repeated intravenous injections and the accompanying risk of infection at the site of injection.
Intravenous chemotherapies require many trips to the hospital and sometimes long waits at the hospital. Whenever oral chemotherapy can be considered, being treated at home makes it possible for the patient to avoid repeated trips to the hospital, and therefore to considerably reduce the time spent on the administration of the treatment.
However, consultations with the oncologist and medical exams must still take place as often as they do with intravenous treatment.
As with intravenous chemotherapies, the patient must inform the doctor of all medications he takes or receives when oral chemotherapy is started. Based on the review of all ongoing treatments received by the patient, the doctor will decide whether there are major incompatibilities between the different treatments. In most cases, long-term therapies can be associated with oral chemotherapy without risk of interference.
When they are first placed on the market, oral chemotherapy drugs are often sold in hospital pharmacies; later, in some countries, they become available in city pharmacies. Your doctor will tell you where you can obtain each chemotherapy drug.
There are different oral chemotherapy treatments. Some require taking many tablets, while others require taking a smaller number of tablets. Similarly, some oral chemotherapy treatments have to be taken every day or even twice a day and others less often, such as once a week, for example.
This point is essential. Oral chemotherapy is not minor treatment. Like intravenous treatment, it must be subject to rigorous follow-up: the tablets must be taken in exact quantities and on the days recommended by the doctor. Changing treatment schedules, or increasing or decreasing the number of tablets taken can have very serious consequences (such as decreasing treatment efficacy or increasing side effects that can then become serious).
In addition, the schedule established for taking the drugs is very important and must be respected.
A calendar or a small notebook where patients treated with oral chemotherapy can mark the dates when they take the drugs is useful for insuring good continuous treatment, and for knowing when they have to start a new chemotherapy cycle. Oncologists have “patient booklets” for persons undergoing treatment, to help them follow treatment more easily.
Because there can be drug interaction, it is important to advise your doctor of all treatments you are presently receiving. This allows the doctor to adapt the treatment.
Oral chemotherapy allows patients to follow their treatment at home and to maintain their daily routines. Patients’ schedules are usually not disturbed (particularly by trips to the hospital), and most activities can be continued.
Oral chemotherapies are less constraining because they allow the patient to be treated at home. However, certain treatments require particular care: they must be kept refrigerated until the patient takes them, in order to maintain maximum drug effectiveness. Other oral treatments must be stored in a dry place, away from heat and humidity. When you purchase the drugs, your pharmacist will tell you how they should be stored.
No specific foods are systematically contraindicated for patients treated with oral chemotherapy. However, certain foods that can irritate the digestive system or slow down transit should be consumed in moderation. If necessary, your doctor will give you the relevant information concerning foods that might best be avoided. For example, grapefruit consumption should be limited because of its interaction with certain drugs and the risk of interfering with their effectiveness.
Patients taking oral chemotherapy can drink alcohol provided they do so in moderation and with the agreement of their doctor. There is no interference between alcohol and most oral chemotherapy drugs if the patients involved do not consume alcohol excessively. Your oncologist will tell you if your state of health and the treatment you receive allows you to drink alcohol.
Oral chemotherapy treatments, like intravenous chemotherapies, do not reduce the effectiveness of oral contraceptives, if the latter are taken regularly and never forgotten. In any case, it is best to inform your doctor of all medications you are taking, including an oral contraceptive, in order to benefit from his advice. In fact, the disease itself or other drugs you take can constitute a contraindication to certain oral contraceptives. In addition, with some rare exceptions, all chemotherapies must be associated with effective contraception, whether chemical or mechanical, given the risks for mother and child in case of pregnancy during this type of treatment. Once again, your doctor will give you more information if needed.
In persons who expose themselves to the sun, some chemotherapy treatments, either oral or intravenous, can cause a photosensitisation reaction, with redness, swelling and itching appearing on the areas exposed. Your doctor will tell you if the chemotherapy prescribed in your case is compatible with sun exposure or not.
Contrary to intravenous chemotherapies that require particular and constraining arrangements at vacation time, oral chemotherapy treatments give patients great autonomy. This freedom applies not only to their everyday lives, but also to their vacations. In fact, when treated with oral chemotherapy, patients can take their treatment with them on vacation, or they can buy it at the place of their vacation.
But it is very important that these oral chemotherapy treatments be followed rigorously as recommended by the doctor; the medication must be taken on the scheduled dates, and the number of tablets must be strictly respected. Some treatments require storage in the refrigerator, which means that persons taking oral chemotherapy drugs must have access to a refrigerator. In any case, the doctor supervising your treatment must give his agreement before you take a vacation or go on a trip.
Several surveys1-2 conducted among patients treated with oral or with intravenous chemotherapy have shown that most patients clearly express their preference for oral treatment. The reasons given by respondents are: avoiding repeated injections and trips to the hospital thanks to home treatment, and enjoying greater comfort in their everyday life.
1 Liu G, Franssen E, Fitch MI, Warner E and al. Patient preference for oral versus intravenous palliative chemotherapy. J Clin Oncol 1997; 15: 100-5
2 Jensen LH et al. Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC. Lung Cancer 2008.
Chemotherapy requires several treatment cycles. With intravenous chemotherapy, this means that the patient must have repeated intravenous injections at the hospital. When use of oral chemotherapy is possible, the patient can avoid repeated intravenous injections and the accompanying risk of infection at the site of injection.
Intravenous chemotherapies require many trips to the hospital and sometimes long waits at the hospital. Whenever oral chemotherapy can be considered, being treated at home makes it possible for the patient to avoid repeated trips to the hospital, and therefore to considerably reduce the time spent on the administration of the treatment.
However, consultations with the oncologist and medical exams must still take place as often as they do with intravenous treatment.
As with intravenous chemotherapies, the patient must inform the doctor of all medications he takes or receives when oral chemotherapy is started. Based on the review of all ongoing treatments received by the patient, the doctor will decide whether there are major incompatibilities between the different treatments. In most cases, long-term therapies can be associated with oral chemotherapy without risk of interference.
When they are first placed on the market, oral chemotherapy drugs are often sold in hospital pharmacies; later, in some countries, they become available in city pharmacies. Your doctor will tell you where you can obtain each chemotherapy drug.
There are different oral chemotherapy treatments. Some require taking many tablets, while others require taking a smaller number of tablets. Similarly, some oral chemotherapy treatments have to be taken every day or even twice a day and others less often, such as once a week, for example.
This point is essential. Oral chemotherapy is not minor treatment. Like intravenous treatment, it must be subject to rigorous follow-up: the tablets must be taken in exact quantities and on the days recommended by the doctor. Changing treatment schedules, or increasing or decreasing the number of tablets taken can have very serious consequences (such as decreasing treatment efficacy or increasing side effects that can then become serious).
In addition, the schedule established for taking the drugs is very important and must be respected.
A calendar or a small notebook where patients treated with oral chemotherapy can mark the dates when they take the drugs is useful for insuring good continuous treatment, and for knowing when they have to start a new chemotherapy cycle. Oncologists have “patient booklets” for persons undergoing treatment, to help them follow treatment more easily.
Because there can be drug interaction, it is important to advise your doctor of all treatments you are presently receiving. This allows the doctor to adapt the treatment.
Oral chemotherapy allows patients to follow their treatment at home and to maintain their daily routines. Patients’ schedules are usually not disturbed (particularly by trips to the hospital), and most activities can be continued.
Oral chemotherapies are less constraining because they allow the patient to be treated at home. However, certain treatments require particular care: they must be kept refrigerated until the patient takes them, in order to maintain maximum drug effectiveness. Other oral treatments must be stored in a dry place, away from heat and humidity. When you purchase the drugs, your pharmacist will tell you how they should be stored.
No specific foods are systematically contraindicated for patients treated with oral chemotherapy. However, certain foods that can irritate the digestive system or slow down transit should be consumed in moderation. If necessary, your doctor will give you the relevant information concerning foods that might best be avoided. For example, grapefruit consumption should be limited because of its interaction with certain drugs and the risk of interfering with their effectiveness.
Patients taking oral chemotherapy can drink alcohol provided they do so in moderaation and with the agreement of their doctor. There is no interference between alcohol and most oral chemotherapy drugs if the patients involved do not consume alcohol excessively. Your oncologist will tell you if your state of health and the treatment you receive allows you to drink alcohol.
Oral chemotherapy treatments, like intravenous chemotherapies, do not reduce the effectiveness of oral contraceptives, if the latter are taken regularly and never forgotten. In any case, it is best to inform your doctor of all medications you are taking, including an oral contraceptive, in order to benefit from his advice. In fact, the disease itself or other drugs you take can constitute a contraindication to certain oral contraceptives. In addition, with some rare exceptions, all chemotherapies must be associated with effective contraception, whether chemical or mechanical, given the risks for mother and child in case of pregnancy during this type of treatment. Once again, your doctor will give you more information if needed.
In persons who expose themselves to the sun, some chemotherapy treatments, either oral or intravenous, can cause a photosensitisation reaction, with redness, swelling and itching appearing on the areas exposed. Your doctor will tell you if the chemotherapy prescribed in your case is compatible with sun exposure or not.
Contrary to intravenous chemotherapies that require particular and constraining arrangements at vacation time, oral chemotherapy treatments give patients great autonomy. This freedom applies not only to their everyday lives, but also to their vacations. In fact, when treated with oral chemotherapy, patients can take their treatment with them on vacation, or they can buy it at the place of their vacation.
But it is very important that these oral chemotherapy treatments be followed rigorously as recommended by the doctor; the medication must be taken on the scheduled dates, and the number of tablets must be strictly respected. Some treatments require storage in the refrigerator, which means that persons taking oral chemotherapy drugs must have access to a refrigerator. In any case, the doctor supervising your treatment must give his agreement before you take a vacation or go on a trip.