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 the way they are administered. With oral chemotherapy, patients can take their medication at home or wherever they prefer, following a prescribed schedule. They may need to take pills daily, weekly, or several times a day for several weeks or months. Oral chemotherapy can be a more convenient option for some patients because it eliminates the need for frequent hospital or clinic visits. However, it also requires that patients be able to adhere to the medication schedule and manage any side effects on their own.

IV chemotherapy, on the other hand, is given in a healthcare setting, such as a hospital, clinic, or infusion center, by a healthcare professional. It may be given as a one-time injection or as a series of infusions over a period of weeks or months. IV chemotherapy allows for precise dosing and monitoring by healthcare professionals and may be necessary for some chemotherapy drugs that cannot be taken orally.

Both oral and IV chemotherapy can have similar side effects, including nausea, fatigue, hair loss, and increased risk of infection. However, the specific side effects and severity may vary depending on the individual and the drugs being used. It is important to discuss the potential benefits and risks of each type of chemotherapy with your healthcare provider to determine the best treatment option for your specific situation.

Is oral chemotherapy as effective as IV chemotherapy?

Yes, oral chemotherapy can be just as effective as IV chemotherapy for many types of cancer. The effectiveness of chemotherapy depends on a variety of factors, including the type and stage of cancer, the specific chemotherapy drugs used, and the individual patient’s response to treatment.

Some studies have shown that oral chemotherapy can be as effective as IV chemotherapy in treating certain types of cancer, including breast, lung, and colon cancers. In other cases, IV chemotherapy may be more effective, particularly for cancers that require higher doses of chemotherapy drugs or for patients who have difficulty taking oral medications consistently.

It is important to note that the effectiveness of chemotherapy can vary widely between individuals, and the best treatment option should be determined by a healthcare provider on a case-by-case basis. Factors such as the patient’s overall health, age, and other medical conditions may also be considered when deciding between oral and IV chemotherapy.

How long do you take oral chemotherapy?

The length of time a patient takes oral chemotherapy can vary depending on the type and stage of cancer being treated, the specific chemotherapy drugs used, and how well the patient responds to treatment. Some patients may take oral chemotherapy for several months or even years, while others may only need to take it for a few weeks.

The treatment plan for oral chemotherapy is usually developed by an oncologist or another healthcare provider specializing in cancer care. The schedule may involve taking chemotherapy drugs daily, weekly, or on a different schedule, depending on the specific treatment plan.

It is important for patients to follow their treatment plan closely and to take their medications exactly as prescribed. Missing doses or stopping treatment early can reduce the effectiveness of chemotherapy and may increase the risk of cancer recurrence.

Patients taking oral chemotherapy should also communicate regularly with their healthcare providers about any side effects or changes in their condition, as adjustments to the treatment plan may be necessary.

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.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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