We might think that all anticancer treatment is to be always administered via needles, cannula, and drip sets. However, there are anti-cancer medicines that can be given via mouth. This can be simply called oral anticancer treatment.
It is important to know that oral anticancer treatment could be either oral chemotherapy or oral targeted therapy. Oral chemotherapy has been in usage for a long time. This is being given in many types of cancers including breast cancer, ovarian cancer, blood cancers, etc. Oral targeted therapy in comparison is a new modality of treatment, where these drugs act by inhibiting specific pathways at the molecular level responsible for cancer propagation. Chemotherapy is non-specific in cell killing whereas targeted drugs are very specific in cancer-killing.
Methotrexate, capecitabine, cyclophosphamide, etoposide are a few of the commonly used oral chemotherapy medications. They are potent and efficacious and one should not think that because they are oral- they are weaker than intravenous chemotherapy. Also, their side effect profile is similar to their injection counterparts.
The advantages are as follows :
- Convenience and ease of administration: as oral is easier and less painless than the administration of medication by injections.
- Fewer hospital visits, as oral medications can be taken at home
- No admission to hospital: so overall less cost to the patient.
- Easier dose modifications: Since oral treatment is administered in small daily doses, treatment can always be interrupted in case of side- effects. This is not the case with chemo injections where all the treatment is usually administered at once.
The disadvantages are as follows :
- Erratic oral absorption: you can't be sure how much drug has actually reached blood circulation as oral absorption of medications depends on lots of factors. For e.g. what food the patient has eaten, is patient on any antacid medication are the common ones.
Compliance is always an issue: aWhile chemo injections are administered in hospital, we become sure that patient has taken medication-. The same is not the case with oral chemotherapy, where we don't have a way to find out. Lots of patients end up stopping oral treatment with smallest of side-effects.
Barring few cancers, oral chemotherapy has been less commonly used and evidence regarding their usage in many cancers is not there.