What You Need to Know About Taking Oral Cancer Therapies

More and more chemotherapy drugs, pills, or liquids that are taken by mouth (orally) are being developed each year. For leukemia or lymphoma patients, some of these drugs may include Gleevec (imatinib), Cytoxan (cyclophosphamide), Venclexta (venetoclax), and Imbruvica (ibrutinib).

Medication Through Cancer
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In most cases, taking oral chemotherapy is a welcome change for patients. It is often less expensive, in the case of older drugs (though newer drugs can be quite a bit more expensive), and may be just as effective. It also 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, or not enough pills?

Safety First

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 and 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 they will not be found or taken accidentally by someone else, and where children and pets cannot reach them.

What to Do

It is very important for you to take your oral chemotherapy exactly as your healthcare provider or pharmacist prescribes, even if you are experiencing side effects. If you change the time between doses, skip a dose, or change the dose, the medication may not be effective. Increasing the dose you are taking will not help 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 more easily. If you are having a really hard time, speak with your nurse or pharmacist: they can help you organize your medication 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 healthcare provider next.

When to Call the Healthcare Provider

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 the following concerns or symptoms are less urgent, you should also contact your healthcare provider if you are having difficulty coping, if you are unsure of any part of your treatment, or if you develop:

  • Increased pain
  • Sudden skin changes
  • Constipation
  • Mouth ulcers (oral mucositis)

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 healthcare provider or pharmacist, and ask questions if you are unsure about any part of your treatment.

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  • 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.

By Karen Raymaakers
Karen Raymaakers RN, CON(C) is a certified oncology nurse that has worked with leukemia and lymphoma patients for over a decade.