Oral chemotherapy kills or weakens cancer cells. It comes in the form of a pill, liquid, or tablet that a person swallows or places under the tongue to dissolve. As with other prescription medications, people can take oral chemotherapy drugs at home.

Most people receive chemotherapy intravenously, which means directly into a vein. Although IV chemo is effective, it can also be painful due to the insertion of needles and IV ports. The individual also has to go to a hospital or clinic for treatment, which may be inconvenient.

Oral chemotherapy can help a person feel as though they have more control over their treatment. However, it can still cause side effects.

This article looks at the advantages and disadvantages of oral chemotherapy and the potential costs.

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Chemotherapy kills or slows the growth of cancer cells. In some cases, it can eliminate cancer. In others, it prolongs life by slowing down the progression of the disease.

The administration of traditional chemotherapy is through a needle into a vein. This IV treatment usually takes place in a hospital or clinic.

Oral chemotherapy is chemotherapy that a person can swallow or dissolve under the tongue, meaning that there is no need for needles or an IV line. Some examples of oral chemotherapy medications include:

  • cyclophosphamide (Cytoxan)
  • etoposide (VePesid)
  • capecitabine (Xeloda)
  • methotrexate (Trexall)
  • temozolomide (Temodar)

The exact treatment a person receives will depend on various factors, including their condition and overall health. However, some of the basics of what to expect include:

Dosage and schedule

The dosage a person needs will depend on a number of factors, such as the type of cancer requiring treatment. Incorrect dosing can cause severe side effects, so it is essential to take the drug as a doctor instructs.

It is also critical to take oral chemotherapy drugs according to the exact schedule that the doctor recommends. The medication may be less effective if a person misses a dose, takes two doses too close together, or takes other drugs alongside the chemo.

People should obtain clear dosing instructions from the prescribing doctor, including what to do if they miss a pill or accidentally take too many. Keeping a medication diary or using a reminder app can help people remember to take their drugs.

Special handling and storage

Oral chemotherapy pills are hazardous. A person must take special precautions when handling them, such as wearing gloves.

The medication may also require storage at specific temperatures. A person will also need to keep it:

  • in the original container
  • away from other medications
  • in a cool, dry place away from heat, sunlight, or moisture
  • in a secure place out of the reach of pets or children

If a person needs to store their chemotherapy medication in the refrigerator, they should place the pill bottle inside an additional airtight container and away from food. It is essential that all containers have clear labeling, so there is no risk of confusion.

Chemotherapy is potent, killing healthy cells as well as cancerous cells. This can result in side effects.

Both oral and IV chemotherapy may cause side effects, with common ones including:

  • hair loss
  • skin changes
  • sores in the mouth
  • easy bruising
  • fatigue
  • infection or flu-like symptoms
  • nausea, vomiting, or diarrhea

The type and severity of side effects vary among individuals, and interactions between chemotherapy medications and other drugs or supplements may make them worse.

It is important to talk with a doctor about alcohol consumption and the use of dietary and herbal supplements before beginning chemotherapy. The doctor can help the person avoid interactions and the resulting side effects.

People taking oral chemotherapy should also try to keep a log of all the side effects that they experience. If someone often feels very sick, they may be unable to take their medications. A person experiencing vomiting may also not be able to keep the medication down.

In such cases, it is important to speak with the prescribing doctor as soon as possible so that they can change the treatment plan, if necessary.

Many people prefer oral chemotherapy to IV chemotherapy because it involves fewer trips to a hospital or clinic. Instead, people can undergo treatment in the comfort of their own home.

Other benefits of at-home treatment may include:

  • fewer child care issues
  • less disruption to daily activities
  • less time off work
  • lower travel expenses
  • more privacy

Some people also dislike going to a clinic for treatment because it makes them feel anxious. Others may have a needle phobia, bruise easily, or have difficult-to-access veins. For these individuals, oral chemotherapy may be a less uncomfortable and stressful option.

Although oral chemotherapy has many advantages, there are also some disadvantages.

Medical professionals administer IV chemotherapy in a healthcare setting to ensure that the individual gets the correct dose at the appropriate time. Being in a healthcare setting also means that medical staff can respond quickly if the person has an adverse reaction to their treatment.

When someone has oral chemotherapy, they are in their own home. Should they experience an adverse reaction, it may take longer to receive medical attention.

Another issue with oral chemotherapy is that the individual or their family is responsible for proper drug administration, and they may make mistakes. For example, an older 2012 review notes that possible problems of oral chemotherapy include:

  • making dosing errors
  • being unable to adhere to the treatment plan
  • overadhering to the treatment, such as by taking too much medication
  • experiencing drug interactions

However, the researchers say that medical centers can reduce the chance of this happening by providing patient education, regular follow-up appointments, and other safeguards.

Another disadvantage of oral chemotherapy is that a person must remember to order new prescriptions on time. It is sometimes necessary to order the medication many days or weeks in advance. People who do not keep up with the ordering process may miss doses, which will affect their treatment.

Oral chemotherapy is also hazardous and requires careful handling. Some drugs are so potent that people need to wear gloves to handle them. People with young children and pets must be careful to store their drugs out of reach and dispose of any leftover pills safely.

Yes, oral chemotherapy can potentially make cancer go into remission. Remission is when the cancer signs and symptoms disappear. It can be temporary or permanent.

Partial remission means that the signs and symptoms have decreased, while complete remission means that they have disappeared.

The survival rates and chance of remission will vary depending on the type and stage of the cancer. However, in some cases, oral chemotherapy might be more effective than IV chemotherapy.

For example, in a 2019 study involving 402 people with metastatic breast cancer, oral paclitaxel and encequidar produced better responses than the IV version of paclitaxel.

A person can ask their cancer care team about the effectiveness of oral chemotherapy compared with that of IV chemotherapy for their specific case.

How long can a person take oral chemotherapy for?

Chemotherapy treatment often happens in cycles. This means that after a treatment period, a person will have a period of no treatment to allow their body to rest and recover from the effects of the chemotherapy.

A person’s treatment schedule depends on the specific chemotherapy agent and the type of cancer.

Chemotherapy treatment typically lasts 3–6 months. However, it may be shorter or longer. An individual usually has between four and eight cycles of treatment, each lasting 3–4 weeks.

The cost of oral chemotherapy treatment varies widely depending on the duration, dosage, and type of drug. Insurance coverage also affects the price.

A 2021 review reports that adults with cancer in the United States spend $180–2,600 per month on cancer care. This amount is known as the “out-of-pocket” cost, which is the portion of treatment that insurance companies do not cover.

The American Cancer Society notes that oral chemotherapy often involves higher out-of-pocket costs than IV chemotherapy. Some insurers may not cover certain types of drugs, and the drugs themselves may be more expensive.

A person with health insurance should call their plan provider to find out what it covers. They should speak with their cancer care team about this coverage before an oncologist issues a prescription.

Oral chemotherapy works in a similar way to IV chemotherapy, killing cancerous cells to eliminate them or slow them down. It can be a good option for people who cannot or do not want to make trips to the hospital for IV chemotherapy.

However, oral chemotherapy is not available for all types and stages of cancer. Even when it is available, it might not be the best choice for everyone. People can ask a doctor if oral treatment is an option for them and find out the details about its effectiveness and side effects.