Chemotherapy options

Chemotherapy is a type of cancer treatment. These powerful drugs work by disrupting the activity of cancer cells to prevent them from growing and multiplying.

Chemotherapy can help:

  • Shrink tumors.
  • Keep cancer from spreading (metastasizing) to other parts of your body.
  • Destroy cancer cells left in your body after surgery or other treatments.

You may have chemotherapy as your primary cancer treatment or in combination with other cancer therapies. Your doctor considers the cancer type and stage — as well as your overall health — when deciding how to treat you.

What Are the Different Types of Chemotherapy?

Some people think getting chemotherapy means many visits to an infusion center. This type of chemotherapy is intravenous (IV) chemotherapy. But there are other ways to deliver these drugs.

You may have:

  • Oral chemotherapy: You swallow chemotherapy drugs in capsule, pill, or liquid form. You may take these medications every day for several weeks.
  • Topical chemotherapy: You apply a cream that contains a chemotherapy drug. You rub this cream into your skin, where it works to disrupt skin cancer cells.

Other types of chemotherapy include injections and chemotherapy delivered to your abdomen (intraperitoneal chemotherapy).

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Treating Cancer With Oral Chemotherapy

You may wonder if oral chemotherapy drugs are as powerful as drugs you would get at an infusion center. They are. Oral chemotherapies work in the same ways that IV chemotherapy drugs do.

Your doctor will talk with you about whether oral chemotherapy is right for you. You may have this type of chemotherapy if you have:

  • Breast cancer
  • Colon cancer
  • Leukemia
  • Lymphoma
  • Multiple myeloma
  • Prostate cancer
  • Kidney cancer
  • Rectal cancer

Oral chemotherapies can cause similar side effects as IV chemotherapies do. You may experience:

  • Nausea and vomiting.
  • Hair loss.
  • Fatigue.
  • Diarrhea and constipation.
  • Brain fog.

Benefits of oral chemotherapy

You can take oral chemotherapy at home, so you won’t need to go to an infusion center for treatment. You won’t need to take time off work to receive the drugs — or find transportation to a treatment center.

Besides privacy, other advantages of oral chemotherapy are that you won’t have to have as many needle sticks as you would with IV chemotherapy. You also won’t need to have a port placed in your chest to deliver treatment.

Managing oral chemotherapy

Oral chemotherapy may seem like less hassle because you can take your treatments at home. But managing your own chemotherapy treatment is a big responsibility.

It’s important that you follow your doctor’s directions exactly. You must:

  • Take only the amount of chemotherapy prescribed.
  • Take all doses as your doctor instructs, such as with or without food.
  • Not miss a scheduled dose.

Taking your medication on schedule helps make sure your oral chemotherapy treatment is as effective as possible in fighting cancer. Not following your doctor’s instructions about how to take your medication could have a bad effect on your body (toxicity).

Oral chemotherapy isn’t right for everyone. You may not be able to take these drugs if:

  • You take other medications that could interact with chemotherapy drugs.
  • You have trouble swallowing medications.

Another important consideration when taking oral chemotherapy is cost. Check with your insurance company or pharmacist to make sure your insurance plan covers the cost of these medications.

Questions to Ask Your Doctor About Oral Chemotherapy

If your doctor prescribes oral chemotherapy, make sure you have all the information you need to protect your health. Things you should ask include questions about:

How to take oral chemotherapy

Make sure you understand exactly how you should take your medication. Ask:

  • What time should I take chemotherapy?
  • Should I take it every day?
  • Should I take this medication with food? Are there any foods or drinks I shouldn’t have with it?
  • Can I take vitamins, supplements, or other medications while taking chemotherapy?
  • Can I drink alcohol?
  • Do I have to swallow pills whole, or can I crush them and add them to liquid?
  • When should I stop taking this medication?

How to store oral chemotherapy

Talk to your doctor about how to store your medication to protect its effectiveness and keep others safe. Ask:

  • Where should I store this medication? Does it need to stay cold or dry?
  • Can I touch pills or liquids with my hands, or should I wear gloves?
  • Is this medication dangerous to pets or other people in my home?
  • If I change medications, what do I do with any leftover pills or liquid?

How to manage your oral chemotherapy regimen

Taking chemotherapy at home means you must manage your own treatment. Ask:

  • What should I do if I forget to take my medication?
  • Will anyone check in with me about how I’m feeling? Who should I call if I don’t feel well?
  • Are there any side effects I should watch for?
  • If I don’t like taking this medication or can’t manage it, can I switch to another type of chemotherapy?

Treating Cancer With Topical Chemotherapy

Doctors may prescribe topical chemotherapy for certain types of skin cancers. These include actinic keratoses, and basal cell carcinomas and squamous cell carcinomas that haven’t spread. The most common topical chemotherapy is a drug called 5-fluorouracil (5-FU).

You’ll rub a cream or ointment that contains the chemotherapy drug into your skin. Your doctor will tell you how often you should apply it. The drug helps destroy cancer cells on the surface of the skin and in the outermost layers.

Benefits and side effects of topical chemotherapy

Topical chemotherapy doesn’t enter your bloodstream. You won’t experience the same side effects that you might with oral or other chemotherapies. But your skin might become red or sensitive where you apply the drug.

Questions to Ask Your Doctor About Topical Chemotherapy

Talk with your doctor about how to use and store topical chemotherapy. Ask:

  • How much medication should I use?
  • How often should I apply it?
  • Do I need to wear gloves when I apply topical chemotherapy?
  • Where should I store my medication?
  • What should I do if I forget to apply it?
  • Should I expect any side effects?
  • When should I call you?
  • What should I do if other people touch my medication?

Is Oral or Topical Chemotherapy Right for You?

Some people find that taking chemotherapy at home can feel lonely. You won’t have a medical team around and you won’t meet other people who are experiencing cancer. Talk to your care team if you have any concerns about taking these chemotherapies.

American Society of Clinical Oncology, What Is Chemotherapy?, https://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/what-chemotherapy

American Cancer Society, Getting Oral or Topical Chemotherapy, https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/oral-chemotherapy.html

National Cancer Institute, Support for People with Cancer: Chemotherapy and You, https://www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf

U.S. Pharmacist, Challenges to Oral Chemotherapy Adherence, https://www.uspharmacist.com/article/challenges-to-oral-chemotherapy-adherence

Macmillan Cancer Support, Chemotherapy Cream or Immunotherapy Cream to Treat Skin Cancer, https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/chemotherapy-cream-for-skin-cancer

American Cancer Society, Local Treatments Other Than Surgery for Basal and Squamous Cell Skin Cancers, https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/other-than-surgery.html

MedlinePlus, Fluorouracil Topical, https://medlineplus.gov/druginfo/meds/a605010.html

National Cancer Institute, Chemotherapy to Treat Cancer, https://www.cancer.gov/about-cancer/treatment/types/chemotherapy

About UPMC Hillman Cancer Center

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