Drugs Q & A

What’s The Difference Between Oral Vs IV Chemotherapy?

Chemotherapy refers to the use of drugs to destroy cancer cells. It usually works by keeping the cancer cells from growing, dividing, and making more cells. Because cancer cells usually grow and divide faster than normal cells, chemotherapy has more of an effect on cancer cells. However, the drugs used for chemotherapy are powerful, and they can still cause damage to healthy cells. This damage causes the side effects that are linked with chemotherapy.

Intravenous (IV) chemotherapy is a cancer treatment that injects chemotherapy medicine directly into a patient’s vein thereby instantly entering the bloodstream. IV chemotherapy is the most common form of chemotherapy and is typically performed during a series of sessions over the course of weeks; each session may range from a few minutes to a few hours.

Oral chemotherapy is a type of cancer treating drug that is taken in the form of a daily pill or liquid, allowing for less frequent medical appointments. Over the past 20 years, more than 50 new oral anticancer medications (OAMs) have become available to treat many different cancers, including lung, leukemia, colorectal, kidney, and prostate.

Cancer treatment is always evolving, with new techniques regularly being approved. Oral chemotherapy is a relatively recent development that makes treatment more convenient for eligible patients by allowing them to take medication at home.

What’s the difference between oral chemotherapy and IV chemotherapy?

The main difference between oral chemotherapy and IV chemotherapy is in the way it’s administered. To receive IV chemotherapy, you’ll 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 (not always) given once every few weeks.

Is oral chemotherapy as effective as IV chemotherapy?

Yes, the potential results are the same no matter which method you choose. The purpose of chemotherapy is to kill cancer cells. It has the potential to reduce the size of tumors, control disease progression and, in some cases, may lead to cancer regression.

Chemotherapy may be used before and/or after another treatment, such as surgery, or alone as the primary treatment method. It’s sometimes used in combination with other treatments, such as radiation therapy or immunotherapy.

How long do you take oral chemotherapy?

Chemotherapy in either form is usually given in cycles over a period of a few weeks at a time, but this may vary depending on the specifics of your treatment plan. If you have advanced cancer and chemotherapy is being used to slow the progression of cancer or to relieve its symptoms, it may be used for longer periods of time if you’re tolerating it well and it improves your quality of life.

What are the side effects of oral chemotherapy?

The possible side effects of oral chemotherapy are the same as those of traditional chemotherapy, and may include fatigue, nausea, diarrhea, constipation or hair loss.

The potential side effects you may experience depend on the type of chemotherapy drug you’re taking and how often you’re taking it. Not everyone experiences the same ones or in the same way. Patients are sometimes surprised to find out that not all chemotherapies cause hair loss, for example, or that men and women may experience different side effects of chemotherapy.

What are the advantages of oral chemotherapy?

The primary advantage of oral chemotherapy is the convenience of being able to take it at home. You (and your caregiver, if someone accompanies you) don’t have to go to an infusion center for treatment.

For some patients, this means not having to take time off work for treatment appointments. Those who live some distance from their treatment center don’t have to deal with the time and stress of frequent travel. Others simply prefer to reduce disruptions to their regular schedule.

Maintaining a normal routine as much as possible provides a psychological benefit to some patients. Being able to take oral chemotherapy at home helps them maintain a sense of normalcy.

Oral chemotherapy may reduce the number of blood draws you have to undergo—a benefit to patients who are averse to needles. You may also avoid having to get a port-a-cath, which appeals to some patients.

When oral chemotherapy is taken daily, it also may change the way you experience side effects of treatment. Some patients find their side effects are less severe, but more constant, than with IV chemotherapy.

What are the disadvantages of oral chemotherapy?

While the oral administration of chemotherapy has the advantage of convenience and flexibility, it comes with a few potential disadvantages.

By choosing oral chemotherapy, you may miss out on the personal connections and support that develop spontaneously in an infusion center. Some patients are surprised to find that they look forward to the time they spend there. Nurses and other members of the care team are generally positive and upbeat. Some patients benefit from talking with them on a regular basis. Patients may form relationships with other patients as well, supporting one another through treatment.

The potentially significant disadvantages of oral chemotherapy, however, are associated with a patient’s ability to take their medication properly and with cost or access to the medication itself.

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. It’s even more challenging if, like many patients, you’re 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 you’re not getting the right amount to treat your cancer. Missed doses mean the drugs can’t adequately fight cancer.

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