A closeup photo of two white capsules being shaken from a pill bottle in one hand into the other.

What is Oral Chemotherapy? Things to Know Before Starting Treatment

  • Updated: February 26, 2020

    Oral chemotherapy is a type of cancer treating drug that is taken in the form of a daily pill or liquid, allowing for less frequent medical appointments.

    Over the past 20 years, more than 50 new oral anticancer medications (OAMs) have become available to treat many different cancers, including lung, leukemia, colorectal, kidney, and prostate.

    Cancer treatment is always evolving, with new techniques regularly being approved. Oral chemotherapy is a relatively recent development that makes treatment more convenient for eligible patients by allowing them to take medication at home.

    Here are some important things to know when beginning a course of oral chemotherapy:

    • Oral chemotherapy is just as effective as intravenous (IV) chemotherapy. OAMs work as well as cancer drugs that are administered intravenously over a period of hours in a medical office. The medication is just as strong and therefore, the same safeguards need to be applied.
    • Patients taking OAMs may experience side effects, just as they would with traditional chemotherapy. Unfortunately, just as oral chemotherapy achieves the same effectiveness as IV chemotherapy, it can cause the same types of side effects. Every patient is different and every drug is different, but some common side effects from OAMs include nausea and vomiting, rash, diarrhea, low blood counts, and fatigue. Doctors discuss possible side effects when prescribing OAMs and should alert patients to any symptoms that would require immediate medical attention.
    • Doctor appointments are still necessary. Patients taking OAMs can avoid the very frequent visits to a doctor’s office that IV chemotherapy requires, but regular appointments with an oncologist are still necessary. Patients taking OAMs will need regular scans or blood tests to make sure the medication is working and is safe.  
    • OAMs must be taken, stored, and handled cautiously. It is important to follow all directions from the prescribing provider. These will include how often to take the medication and how much to take.
      • Find out what time of day to take your OAM and be consistent; adhering to the regimen and not skipping doses is critical; patients who need a break should speak to the doctor./li>
      • Pay attention to storage guidelines. Generally OAMs will be stored in a cool, dry location, away from light. But this depends on the drug.
      • Keep OAMs away from children and pets.
      • Return remaining pills or liquid to the provider for safe disposal. DO NOT throw away OAMs at home.
    • Providers and patients should expect that getting OAMs may require some extra time and advocacy effort.

    A 2018 study by several Fox Chase Cancer Center physicians showed that both providers and patients face barriers to starting oral chemotherapy when it comes to insurance. This is largely due to the fact that insurers cover OAMs as a prescription drug benefit, whereas IV chemotherapy is covered as a medical procedure. The distinction can lead to delays from the time an OAM is prescribed until the patient receives the medication. These delays can last days or even weeks. The researchers found that the process was labor intensive, taking an average of two weeks and five phone calls for a patient to start a drug.

    Additionally, the study found that out-of-pocket costs could vary and required a lot of staff support to mitigate these costs through financial assistance. Many medical centers like Fox Chase offer financial counselors and insurance advocates to help patients and providers navigate this process.

    Being treated for cancer in the comfort of home is a big convenience for patients. But it’s important to remember that OAMs are powerful drugs and should be taken with the same care as traditional chemotherapy given in a hospital setting.

    Learn more about chemotherapy treatment at Fox Chase.

    Learn more about the services provided by our financial counselors and insurance advocates.