Today, thanks to progress in cancer treatments, there are many types of chemotherapy (chemo) that can be taken as a liquid, tablet, or capsule. Oral chemo is any drug you are taking by mouth to treat your cancer. Oral chemo does not need to be injected into the body. Chemo taken by mouth is as strong as the other forms and works just as well. One of the best ways you can help fight your cancer is by taking your chemo exactly as your doctor or nurse tells you to.

Some chemo drugs are never taken by mouth because the stomach can't absorb them. Others may cause harm when swallowed. In fact, most chemo drugs are injected through an IV (intravenous) line into a person's vein. The chemo you take by mouth is easier, because it often can be taken at home. You don't need to go into a hospital or clinic for every treatment.

Sometimes chemo is given in cycles. This cuts down on the harm to healthy cells and allows the drugs to kill more cancer cells. Your doctor will decide if you need to get your treatment every day, every week, every few weeks, or every month.

Are you ready to start your oral chemo?

Here are some things about oral chemo that you may want to talk about with your doctor or nurse:

• What is the name of the chemo? Is there more than one name for the same drug? 
• What do you expect it to do? How might it make me feel? 
• Are the directions for taking the drugs easy to follow? 
• How are my chemo drugs taken? 
• What if I have trouble swallowing and keeping down the pills? Can they be opened, broken, or crushed?
• When should I take it? 
• Is it safe to take it with other drugs, food, vitamins, herbs, supplements, or other treatments you use? 
• What should I do if I miss a dose? 
• How should I store it? 
• What are the likely side effects? How should I report them if I have them? How can I get in touch with you if I have trouble late at night or over the weekend? 
• How long will I need to take the oral chemo? 
• Will my insurance pay for oral chemo? 
• Will my other health problems stop me from being able to follow your instructions? Is there a chance my other health problems could make me forget to take my oral chemo? 
• Will you be calling me to find out how I am doing with the chemo? How often will you need to see me in the office?

Before starting oral chemo, discuss any concerns or questions you have with your doctor or nurse. Get answers to all of your questions about oral chemo before you start taking it.

How do I take my oral chemo?

You should have exact instructions on how much and when to take your chemo. Take it all just the way your doctor or nurse has told you to. Be sure to tell your doctor or nurse about any problems you have taking your chemo. For instance, if you are throwing up or feel sick to your stomach, you may feel too sick to take your chemo. Or, if you are throwing up, you may not be able to keep your chemo down and may throw up your treatment dose. Your doctor needs to know about any problems so he or she can tell you about whether or not you need changes in your treatment plan.

Oral chemo doses are set up so that you will have constant levels of the drugs in your body to kill the cancer cells. Not taking your chemo as it needs to be taken can affect how well the treatment works, and it can even allow the cancer to grow. Sometimes changes may be needed, but do not make any changes unless your doctor tells you to do so. Even after you start feeling better you may still have cancer cells in your body that must be kept under control with chemo.

Will I still need to see my doctor?

Even though you will be able to take your oral chemo at home, you will still need to see your health care team. They will watch for changes in the cancer and see how you are doing with your chemo plan. Blood tests and scans will be done to see how your body and the cancer respond to the chemo. If you miss a dose or are late with one, tell your doctor or nurse about it. Your doctor needs to know about this when looking at your response to the treatment. It may also help the doctor decide whether to change the dose or timing of the medicine.

What can I expect from oral chemo?

The side effects of any form of chemo vary from drug to drug and from person to person. Your doctor or nurse may not be able to predict what side effects you will have. Some oral chemo drugs can upset your stomach (nausea) or cause you to throw up (vomit). They can cause loose or watery bowel movements (diarrhea), hair loss, mouth sores, skin changes, low blood counts, and other possible side effects. This is because oral chemo is a systemic treatment just like the IV form of chemo. That means it goes through your whole body to kill cancer cells wherever they might be. But when it does that, it also can harm healthy, normal cells and cause side effects.

Make sure you know what side effects to look for before you start chemo. Also ask if there are any side effects that you should call the doctor or nurse about right away.

Telling your doctor or nurse about side effects as soon as they happen can help make sure that the problem does not become dangerous to you. Your doctor may have to change the dose you are taking or give you other drugs to help you feel better. If you are in doubt about a side effect and can't get in touch with your doctor, don't take your chemo until you get further advice.

Taking chemo at home gives you more freedom to carry on with your daily life without the trouble of frequent treatment visits. Although you may not be seeing your doctor and nurses very often, be sure to call them with any questions or concerns you might have. The success of oral chemo depends a lot on you—it is important to take the right dose of the drug, on schedule, exactly as you were told. Your team is there to help you do this—they want you to succeed.

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-ACS-2345 or visit www.cancer.org.

Revised: 03/05/2008