Understanding Your Drugs Is Important
Before beginning oral chemotherapy, talk with your doctor or nurse to learn how this medicine will affect your body. You should know:
- The name of the medicine
- How the medicine works
- When to take the oral chemotherapy
- Dose, frequency, and when the prescription will need to be refilled
- Best time of day to take the drug
- Whether to take the drug before or after a meal or snack.
- Whether any other drugs, supplements, or vitamins you are taking may interfere with the anti-cancer drug.
- What to do if you miss a dose
- Who to call if you have questions.
Check with your local pharmacy to find out whether your oral chemotherapy can be filled there, or if it must be ordered by mail. Oral chemotherapy can be costly, so it is also important to find out about insurance coverage.
When Should I Call My Doctor Or Oncologist
- You have a fever of 100.5Â°F or higher or chills.
- You have bleeding from your gums.
- You have nausea or vomiting and cannot take your chemo.
- You vomit after you take your oral chemo.
- You miss a dose of chemo.
- You have sores or white spots in your mouth.
- You have constipation or diarrhea for more than 1 day.
- You feel depressed.
What Are The Advantages Of Oral Chemotherapy
Unlike the traditional IV infusion chemotherapy given in a clinic, oral chemotherapy is a drug taken in tablet, capsule, or liquid form. It has the same benefits and risks as chemotherapy given by infusion.
Oral chemotherapy may be easier than taking a trip to the clinic, but the pills are just as strong as intravenous forms of chemotherapy.
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Keeping Safe At Home With Chemotherapy
As more and more chemotherapy is given in outpatient clinics and at home, it is extremely important that caregivers and patients understand the risks and hazards that household members may be exposed to. Chemotherapy can be given via a portable infusion pump or in pill form. In both cases it is possible for cancer drugs to unintentionally come in contact with caregivers. When chemotherapy is given in any form, the body must then get rid of it after its done its job. This means that the drugs leave the body in a patients stool and urine. It can also be present in emesis.
Traces of chemotherapy drug may be found in and on toilets, in disposable diapers or any clothing or laundry that a person has soiled after having a treatment. Cleaning the bathroom or handling body wastes or soiled laundry can expose you to these chemotherapy drugs. If you are handling infusion pumps or equipment, flushing intravenous lines or handling chemotherapy drugs in any form, traces of the drug can be present and can be absorbed through the skin.
If you or a family member is currently receiving chemotherapy, whether in the clinic or at home, it is strongly recommended that precautions be followed in order to keep household members safe:
Receiving chemotherapy as an outpatient is much more common than in the past and its much more convenient than getting treatment in a hospital. However, simple precautions need to be taken to make sure everyone at home stays safe.
How Much Does Oral Chemotherapy Cost
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 $180â2,600 per month on cancer care. This amount is known as the âout-of-pocketâ 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.
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What To Know About Paying For Oral Chemotherapy
Most oncology practices help you figure out your health coverage and how youll pay for your treatment.
If you have health insurance, theres 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 youll have a much higher copay.
Make sure you understand your coverage so youre 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
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 shouldnt assume it is.
Each drug acts differently, so read the instructions and warnings that come with your prescription. Its a good idea to double-check with a doctor or pharmacist. Be sure to mention any other medications you take in addition to chemotherapy.
Raw Or Undercooked Foods
Avoid eating raw or undercooked:
This also includes unpasteurized milk or cheese.
If you need to handle these items, wash your hands thoroughly after doing so. Also be sure to clean any surfaces they may have come into contact with, such as cutting boards or countertops.
To prevent food poisoning, always cook foods to at least the minimum internal temperature, which can vary by food item. You can use a food thermometer to check the internal temperature of your food.
Harmful germs can also be present on raw fruits and vegetables. Because of this, always rinse them thoroughly before eating. Avoid eating raw produce that can be difficult to wash well, such as:
- leafy greens like lettuce or spinach
- berries like raspberries and strawberries
- alfalfa or bean sprouts
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Cancer Drug Therapy Safety At Home
What you and your caregivers need to know
The medications used in cancer treatment especially chemotherapy and immunotherapy drugs are very powerful. If you are handling or receiving these drugs, you must take precautions to keep everyone in your home safe.
These drugs are broken down by the liver and kidneys and most of them are excreted in the urine. While your body is processing the drugs, they can remain in your body fluids for a few days. Your caregivers can absorb the drugs through their skin if they touch these fluids.
Short-term exposure to some of these drugs can cause skin rashes, nausea, vomiting, belly pain, cough, dizziness, eye irritation, hair loss, headache, mouth/throat/nose sores and allergic reactions. Long-term exposure has been associated with developing a second cancer, infertility and birth defects.
The precautions you will need to take depend on a number of factors, including the drug type and dose, how you receive the medication and your personal health. Talk to your doctor or pharmacist to learn what precautions are appropriate for you.
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 personâs treatment schedule depends on the specific chemotherapy agent and the type of cancer.
Chemotherapy treatment typically lasts 3â6 months. However, it may be shorter or longer. An individual usually has between four and eight cycles of treatment, each lasting 3â4 weeks.
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Key Points About Chemotherapy Safety At Home
- Always read medicine labels and follow dosing instructions carefully.
- Know how to safely store, handle, and give your child chemotherapy to keep you and your family safe during your childs treatment.
- Chemo medicines stay in your childs body and body fluids for 48 hours after they take them. Follow safety guidelines as instructed.
When To Get Urgent Medical Advice
While the side effects of chemotherapy can be distressing, most are not serious.
Infections can be very serious if not treated immediately. Contact your care team immediately if you have any symptoms of an infection, these include:
- a temperature of above 37.5C or below 36C
- your skin feels warm to touch, or you feel hot and shivery
- breathing difficulties
- flu-like symptoms, such as muscle aches and pain
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How To Handle Leftover Or Soiled Medications
- Do not flush chemotherapy medications down the toilet or toss in the garbage .
- Store your chemotherapy drugs in a safe place until you can return them. Roswell Park Comprehensive Cancer Center has drug disposal containers available on the 1st floor of the main hospital, near the ATM. New York State has Take Back programs for the collection of household drugs. Go to the NY Department of Conservation website and click on Find a free collection site near you.
- If you need to dispose your medication urgently and you cannot get to a drop off location, mix whole pills in water and add salt, dirt, ashes or cat litter. Do not hide them in food. Place mixture in a bag, box or plastic tub that you can seal. Secure the container with strong tape and place in your trash bin as close to trash collection day as possible.
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Whats The Difference Between Oral Chemotherapy And Iv Chemotherapy
The main difference between oral chemotherapy and IV chemotherapy is in the way its administered.
To receive IV chemotherapy, youll usually go to an infusion center at a hospital, cancer center or another outpatient facility. You may have to get some bloodwork done before each round of treatment. A health care provider administers the drug through an IV or port, though some chemotherapy is given by injection.
Oral chemotherapy comes in a pill or liquid gel form. You take it at home, by mouth, making sure to follow safety precautions as directed. Oral chemotherapy is sometimes taken daily, whereas IV chemotherapy is usually given once every few weeks.
When trying to understand the difference between oral chemotherapy and IV chemotherapy, patients also frequently ask:
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Is There Any Risk To Family And Friends
You may worry about the safety of family and friends while you are having chemotherapy. There is little risk to visitors because they arent likely to come into contact with any chemotherapy drugs or body fluids.
The safety measures listed below are recommended for people who are providing care or have other close contact with you during the recovery period at home. If you have questions, talk to your treatment team or call Cancer Council 13 11 20.
Cost Of Oral Chemotherapy
Getting access to oral chemotherapy drugs may be somewhat complicated, depending on your prescription drug insurance coverage.
IV chemotherapy drugs have been part of cancer treatment for a long time, and the health insurance system is set up to process and approve these prescriptions relatively quickly and easily. An established system is in place that allows pharmacies to get pre-certification from the insurance company. They then fill the prescription, knowing theyll very likely be reimbursed by the insurance company. The patient doesnt usually have to be involved in this process.
Many oral chemotherapy drugs, however, arent part of this system yet. The pharmacy may not give you the drug unless you have confirmation that the insurance company has already approved it. If not, youre required to pay the pharmacy directly when you pick up the prescription. Most people are unable to pay cash for drugs that may cost between $6,000 – $12,000 per month.
We help our patients at CTCA with this process through our CTCA/Rx oncology pharmacy. Our pharmacy communicates with your insurance provider to get the authorizations you need to receive your medication, including oral chemotherapy drugs. Our pharmacy staff will also work with patient assistance programs to try to help you find financial support for your medications if your insurance denies coverage.
Check with the nonprofits related to your specific type of cancer, too.
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What Should I Do If I Accidentally Spill Or Splash My Medication Or Body Waste
If your medication or bodily fluid spill or splashes, follow the guidelines in this section. For a quick reference, read the resource Follow the 4 Cs if Your Chemo Leaks or Spills.
Make a spill kit
You should be ready to clean up medication spills while youre taking or giving chemotherapy at home. Make a spill kit that has the supplies below. Keep the kit where you can easily reach it.
- 2 pairs of disposable gloves
- Paper towels or an absorbent towel that can be thrown away
- Dish soap or laundry detergent
- 2 plastic bags that seal
What to do if your medication spills or splashes
What to do if your medication gets in your eyes or on your skin
If your medication gets on your skin, wash the area with soap and water. Call your healthcare provider if you have any redness, pain, or burning on your skin.
If your medication splashes in your eyes, rinse them with running water right away. Keep the water flowing over your open eyes for 10 to 15 minutes. Call your healthcare provider to ask for more instructions.
Adherence: Carefully Following Instructions
Taking a pill to treat your cancer may sound easier than it is. Non-adherence, or not taking the drug correctly and on time, may have serious consequences, including the inability to treat your cancer and/or harm caused to yourself or others. Patients who choose to self-administer their chemotherapy must be committed to doing so correctly, and need to be organized enough to follow through on that commitment.
Chemotherapy drugs may be toxic and must be stored and handled very carefully. They must be kept away from children. You may have to wear gloves when handling them. You must be able to follow all safety precautions.
You also need to take oral chemotherapy drugs according to precise instructions. Some need to be taken at a certain time every day, with or without food. Others may need to be taken on a rotating schedule, similar to that of an infusion schedule, depending on your treatment regimen. Its even more challenging if, like many patients, youre juggling multiple medications, especially if the schedule differs daily and/or weekly.
The ability to do this is crucial, however. Not taking chemotherapy drugs correctly could increase their toxicity, which is very dangerous, or it could decrease the absorption, which means youre not getting the right amount to treat your cancer. Missed doses mean the drugs cant adequately fight cancer.
Even with the best of intentions, it may be difficult to properly adhere to an oral treatment regimen.
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S You Can Take To Protect Workers
No single approach can protect all workers in healthcare workplaces against all hazardous drugs. These steps, however, can lessen the chance that hazardous drugs will do harm:
- Clearly label all hazardous drugs so workers will know to carefully handle them.
- Do not use automated counting machines for hazardous drugs. The machines can produce powder and contaminate the work area.
- Use liquid formulations when possible to avoid crushing tablets or opening capsules.
- When possible, avoid cutting, crushing, or otherwise manipulating pills or capsules. This might produce powder that can contaminate a workplace and may expose workers.
- When manipulating hazardous drugs, use effective engineering controls and personal protective equipment.
- Use effective engineering controls and personal protective equipment when you compound a hazardous drug.
- Consider relevant factors when determining appropriate hazard control strategies. For example, administering unopened, intact tablets and capsules may have lower risk of exposure than preparing syringes or IV bags of injectable drugs.
How Do I Safely Handle Oral Chemotherapy Medications
- Dont crush, break, or open any pills unless your healthcare provider tells you to.
- If you need to split or open pills, wear a facemask that covers your nose and mouth.
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