Although a number of common cancer therapies rely on infusion delivery systems and highly regulated medication protocols, more oral oncology drugs are being approved for patient care. In many respects, it is hoped that this development is likely to allow patients better access to drugs and to be able to follow treatment methods with greater convenience and consistency. However, the use of oral oncology drugs also means that there may be less overall monitoring of side effects by healthcare professionals.
There are a number of benefits that patients do see from access to oral oncology drugs. These include:
- Less stringent storage regulations
- Ability to take medications without nursing assistance
- Greater control over drug regimens
- Ability to attend to self treatment at home
- More cost effective
- Less in clinic or in hospital downtime for patients
While the use of oral oncology drugs can give patients a greater amount of responsibility in the process of their own treatment, these medications do also represent the possibility of a more variables and risks that can happen during the course of treatment. Although the use of oral medications reduces the need for constant healthcare staffing for their administration, this shift does still require that patients maintain regular physician visits and condition monitoring.
Some of the concerns that the use of oral oncology drugs do represent include:
- Safe handling
- Food and drug interactions
- Side effects and risk factor monitoring
- Overall dosage safety
- Private insurance coverage obstacles
Access Versus Adherence
For many patients, the greater development of oral oncology drugs will mean that there is better access to the necessary medications. This is especially important for patients who have limited mobility or cannot gain transportation to clinical care where traditional cancer drugs can be administered by way of IV therapies. The ability to self regulate for daily treatment regimens can give a number of patients a more convenient and simpler process.
The majority of oncology drugs, oral or otherwise, can cause a number of unpleasant normal side effects. This factor can become some cause for concern in relation to oral oncology drugs, since patients are responsible for keeping up with dosage. Along with side effects, cancer medications will frequently require a loading phase before patients begin to experience any positive outcomes. As a result, the use of oral oncology drugs can make it more likely that patients may discontinue treatments on their own, rather than adhering to protocols while under healthcare staff supervision.
Although this possibility is some cause for concern, it also outlines different aspects that patients may wish to consider when looking into oral oncology drugs over infusion treatments. If individuals feel that they are likely to require encouragement in keeping up with therapy, then the oral medications may not be the best choice. Conversely, patients who find that reducing the amount of hospital stays and clinical visits will improve their lifestyle may find that oral oncology drugs are an ideal solution.
Safety and Risks of Oral Oncology Drugs
While most cancer medications do have some amount of side effects, oral oncology drugs can also be of concern in regards to interactions with foods or other drugs. This makes the protocols for this type of therapy fairly strict to follow, although these rules also reduce the chance of any risk that patients may experience while taking them. Some of the more common interactions for oral oncology drugs include:
- Abiraterone – can react with certain proteins and protein receptors which may be further heightened through adjunct therapies. The medication cannot be taken with any food, and higher fat consumables increase the risk of interaction.
- Capecitabine – this medication does have adverse reactions if it is taken by patients who also take warfarin or phenytoin. The drug needs to be taken with a meal in order to reduce other normal side effects from the medicine.
- Dasatinib – will adversely interact with any type of antacid or acid suppressant in the system. This medication should not be taken with grapefruit, however, as the higher acid level in the food can lead to higher concentrations of the drug in the bloodstream.
- Erlotinib – this drug should not be taken with warfarin, any type of acid suppressant, and any type of CYP3A4 medications, as these can increase risk factors. This drug needs to be taken without any food, as other nutrients in the stomach can slow or reduce the chance of absorption into the blood.
- Imatinib – has extreme interactions with a number of protein inhibitors and must be taken with food, as it will cause severe gastric irritation.
- Lapatinib – also interacts strongly with a many protein inhibitors, and needs to be taken on an empty stomach. This drug can also build to extreme levels in the system if it is taken with grapefruit juice.
- Nilotinib – can interact with other cancer treatment therapies and should not be taken with any type of antacid. The medications should be taken without any food in order to ensure proper absorption and less side effects.
- Sorafenib – will interact with certain protein inhibitors and inducers and must be taken without foods.
- Temozolomide – this medication can cause strong side effects when taken with valproic acid, and should be taken on an empty stomach at night in order to reduce the impact of nausea and vomiting.
Based on the variety of interactions and the protocols for taken specific oral oncology drugs, care providers do have some concern over the patient’s ability to adhere to proper administration. Although oral medications do greatly reduce the need for nursing care, it may still require patient education and in home health services to ensure that individuals are properly monitored during treatment.
Insurance and Oral Oncology Drugs
While a number of private insurance carriers will cover some of the costs of oral oncology drugs, the out of pocket for these medications can still be high. A number of specialty pharmacies and even manufacturers also offer assistance programs for payment, but regular filling of these prescriptions can still be considered somewhat prohibitive. Medicare offers some assistance to patients that have Part D, although this type of therapy does not immediately qualify for coverage.