More and more oral chemotherapy drugs, pills or liquids that are taken by mouth, are being developed each year. For the leukemia or lymphoma patient, some of these drugs may include Gleevec, cyclophosphamide, or fludarabine.
In most cases, taking oral chemotherapy is a welcome change for patients. It is less expensive, may be just as effective, and does not require you to come into the hospital or cancer center for your treatments. On the other hand, you may feel less in touch with your healthcare providers, and overwhelmed by managing your own side effects. Taking oral chemotherapy can be a big responsibility!Before You Begin
Before you begin your treatment with oral chemotherapy, there are a number of questions you will need to ask your healthcare provider about the drugs you will be taking:
- Should I take this drug with food or on an empty stomach?
- What if I miss a dose?
- What if I vomit after taking a dose?
- Is it best to take this drug in the morning or at night?
- What side effects should I expect?
- Who should I contact if I have any concerns?
- What if I notice I have leftover pills/ not enough pills?
If possible, you should avoid touching any chemotherapy pills or liquid with your hands. This is true if you are giving your own medication, helping someone else take theirs, or if someone is helping you take yours.
As you already know, chemotherapy drugs are hazardous both to cancer cells and normal cells in the body. If you get some of the medication on your hands then touch your skin, or objects that others may touch, it is possible to expose yourself or other people unnecessarily to the chemicals it contains.
Try using the cap of the container that your medication comes in, a spoon, or a small cup to transfer the medication from the bottle to your mouth. Always wash your hands thoroughly after taking your dose, even if you don’t think you came into contact with it.
Also be sure to keep your medications in their original container in a safe location where it will not be taken accidentally by someone else, and where children or pets can not reach it.
What To Do
It is very important for you to take your oral chemotherapy exactly as your doctor or pharmacist describes, even if you are experiencing side effects. If you change the time between doses, skip a dose, or change the dose it may not be effective. Increasing the dose you are taking will not help it fight your cancer better, either.
You may need to take more than one medication, or take medication more than one time per day. Daily written schedules, diaries, or electronic timers can help you keep track of these easier. If you are having a really hard time, speak with your nurse or pharmacist and they can help you organize the schedule.
It is also a good idea to keep track of any side effects you are experiencing in a journal or diary. This will help you to note any trends, and to remember them better when you visit your doctor next.
When to Call the Doctor
You should contact your healthcare provider right away if you develop:
- Chest pain or difficulty breathing
- Fever with a temperature greater than 100F or 38C
- Flu-like symptoms
- Severe nausea, vomiting, or diarrhea
While it less urgent, you should also contact your healthcare provider if you develop:
- Increased pain
- Sudden skin changes
- Mouth ulcers/ oral mucositis
- Or if you are having difficulty coping or if you are unsure of any part of your treatment.
The Bottom Line
While oral chemotherapy can be very convenient, and allow you to take your cancer treatment from home or work, it does require a great deal of knowledge about the drugs you are taking. Be sure to follow all of the instructions given to you by your doctor or pharmacist, and ask questions if you are unsure of any part of your treatment.
Harrold, K. Effective Management of Adverse Events While on Oral Chemotherapy: Implications for Nursing Practice. European Journal of Cancer Care April 2010.(19).
Oakley, C. Johnson, J. Development of a patient-held diary for oral chemotherapy. Cancer Nursing Practice July 2008 7:6.
Winkeljohn, D. Adherence to Oral Cancer Therapies: Nursing Interventions. Clinical Journal of Oncology Nursing August 2010 14:4