Oral chemotherapy is a drug, normally in pill form, used to help kill or weaken cancer cells. The drug can be taken at home, versus in a hospital setting.

Chemotherapy is a treatment that’s designed to destroy cancer cells, no matter where they are in your body.

When you think about chemotherapy, you may envision needles, intravenous (IV) administration of drugs, and long hours in a doctor’s office or clinic. But many chemotherapy drugs come in oral form, either as a liquid you can drink or a tablet you can swallow.

Most people with cancer need more than one type of treatment. Other treatments may include surgery, radiation therapy, and immunotherapy. You can take chemotherapy before, during, or after other treatments.

How much chemotherapy you need depends on the type of cancer you have, how far it has spread, and other health factors.

For oral chemotherapy drugs to work efficiently, you follow dosage instructions from a doctor or healthcare professional. If you take pills incorrectly, too close together, miss one entirely, or don’t take the correct dosage, the. medication may not work properly.

Make sure the dosage instructions from a doctor are clear and that you’ve received instructions on what to do if you’ve missed a pill or taken the medication improperly.

Oral chemotherapy pills may have certain requirements for storage regarding temperature. It’s important to make sure to keep your medication stored at the temperature recommended.

Also, make sure to keep your medication in a dry place. Certain areas, such as the bathroom, may be damp and cause the medication to break down. Also, keep oral chemotherapy pills sealed and away from children’s reach.

You and a doctor must consider many factors when deciding on oral versus traditional chemotherapy. This is how they compare with each other on some key points:

Oral chemotherapyTraditional chemotherapy
ConvenienceYou can take it at home in a matter of seconds, so there’s less disruption to your life.It requires a visit to a doctor’s office or clinic for a treatment that may take hours. Over time, this can become burdensome.
ComfortIt’s less invasive and causes little to no physical discomfort when you take it.Getting IV medications can be uncomfortable or even painful. It can take several hours and may increase your anxiety levels.
ComplianceYou have to keep track of dosing and administration, making sure to take it exactly as directed, usually several times per day.Your healthcare team takes care of dosing and administration.
CostYour health insurance plan might list it as a pharmacy benefit instead of a medical benefit. This could increase out-of-pocket costs.Major medical benefits usually cover it.

Not all chemotherapy drugs have an oral version, so it’s not always an option.

One of the biggest disadvantages of oral chemotherapy is the fact that it’s not administered in a hospital or hospital-like setting, or by a healthcare professional. This means that users may run the risk of forgetting to take their medication or doing so incorrectly.

According to an older 2012 study, the longer a person’s oral chemotherapy treatment lasts, the more likely a person is to eventually discontinue use of the drug without the guidance of their doctor. This can lead to treatment being less effective, worsening side effects, and high dosages if pills are taken closely together.

One other disadvantage of oral chemotherapy is that the pills can be extremely dangerous. According to the American Cancer Society, oral chemotherapy pills may need to be handled in a very specific way, sometimes even administered with gloves on.

As chemotherapy kills cancer cells, it can damage some of your healthy cells as well. Side effects of oral treatments are similar to those of traditional ones. They vary depending on the particular drug.

Some of the most common side effects of oral chemotherapy are:

  • trouble sleeping
  • fatigue
  • general weakness
  • nausea
  • vomiting
  • a loss of appetite
  • diarrhea
  • weight loss
  • hair loss
  • finger and toenail changes
  • mouth sores
  • bleeding gums
  • skin changes
  • low blood counts
  • neuropathy, or nerve damage
  • lack of a menstrual period
  • fertility problems
  • vulnerability to infection and illness because of a compromised immune system

Less common but serious side effects include kidney damage and a weakened heart.

Not all chemotherapy drugs are available in oral form. Currently, there are dozens of oral cancer therapy drugs that treat a variety of cancers, including the following:

Drug (generic name)Cancer type
capecitabinebreast, colorectal
cyclophosphamidebreast, ovarian, lymphoma, leukemia, multiple myeloma
etoposidesmall-cell lung cancer

Doctors often prescribe chemotherapy drugs in combination.

Before starting chemotherapy, you’ll have an opportunity to consult with a doctor. This is a good time to ask questions and discuss your concerns.

Keep in mind

  • Keep in mind that your immune system isn’t at its best, so you’re at a higher risk of infection and illness. Try to avoid people who have contagious conditions.
  • Your body is working hard, which means you need a good night’s sleep. If you’re fatigued, a few rest periods during the day can help.
  • Even though your appetite may be low, don’t stop eating. Having a nutritious diet will help you heal and keep your strength.
  • Getting a little exercise each day will help you feel better.
  • It’s OK to ask for and accept help with chores and tasks.
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What to ask a doctor before starting oral chemotherapy

Here are some questions you may want to ask a doctor:

  • What’s each drug expected to do?
  • Exactly how should I take this medication? (You may be provided with a diary to keep track of times and doses.)
  • Can the pills be broken or crushed? Do they need to be taken with a meal?
  • Are there any particular foods I should avoid while taking this medication?
  • What should I do if I miss a dose?
  • What happens if I throw up after taking it?
  • How should I handle and store the drug?
  • What side effects can I expect from this drug, and what should I do if I have them? What are the warning signs of serious problems?
  • How often should I check in with your practice? When will I need blood tests or scans?
  • How long will I need to take it?
  • How will we know it’s working?

What to know about leftover oral chemotherapy drugs

You might be left with unused drugs when you finish treatment or if your treatment plan changes. These are powerful drugs, so you should never flush them down the toilet or sink. You also shouldn’t put them in the trash.

Check with your pharmacist or doctor’s office. Many will take them off your hands or let you know how to dispose of them properly.

Oral chemotherapy can be as powerful and effective as traditional chemotherapy.

When it comes to oral therapy, following directions and not skipping doses is key. It takes commitment to track your medications and take them on time and in the right dose. It also takes a lot of communication between you and your oncologist.

How effective your therapy is depends on:

  • the type of cancer
  • how far cancer has spread
  • other treatments
  • your age
  • your overall health
  • how well your body responds to therapy
  • the severity of your side effects

Talk with a doctor about what you can expect from oral chemotherapy.

Most oncology practices help you figure out your health coverage and how you’ll pay for your treatment.

If you have health insurance, there’s a good chance that traditional chemotherapy is covered under major medical benefits. Depending on your policy, oral chemotherapy may fall under pharmacy benefits, which could mean you’ll have a much higher copay.

Make sure you understand your coverage so you’re not blindsided by bills. If you do have high out-of-pocket costs, these services may be able to help you:

Many substances have the potential to interact with your chemotherapy medications. This includes:

  • over-the-counter or other prescription medications
  • herbal supplements
  • certain foods
  • alcohol

Some can affect the potency of your medication and others can cause dangerous side effects. With many medications, an occasional alcoholic beverage is harmless, but you shouldn’t assume it is.

Each drug acts differently, so read the instructions and warnings that come with your prescription. It’s a good idea to double-check with a doctor or pharmacist. Be sure to mention any other medications you take in addition to chemotherapy.

Even though you’re taking a quick pill instead of an IV drip that takes hours, these are very powerful drugs that can affect you in many ways.

You can share experiences and tips with others by joining an online or in-person cancer support group. Ask a doctor or visit the American Cancer Society for more information.