When Will I Start Chemotherapy And Targeted Therapy
In general, chemotherapy and HER2-targeted therapies are more likely to be given prior to surgery. Youll receive these treatments in cycles, with each period of treatment followed by a period of rest to let your body recover.
Chemotherapy begins on the first day of the cycle. Cycles can last anywhere from about two to four weeks, depending on the combination of drugs.
Chemotherapy generally lasts about three to six months. The total length of chemotherapy treatment may vary depending on the stage of breast cancer and a number of other factors.
Herceptin is usually given every three weeks for one year , initially in combination with chemotherapy and then on its own after chemotherapy is complete.
Disadvantages Of Oral Chemotherapy
One of the biggest disadvantages of oral chemotherapy is the fact that its not administered in a hospital or hospital-like setting, or by a healthcare professional. This means that users may run the risk of forgetting to take their medication or doing so incorrectly.
According to an older 2012 study , the longer a persons oral chemotherapy treatment lasts, the more likely a person is to eventually discontinue use of the drug without the guidance of their doctor. This can lead to treatment being less effective, worsening side effects, and high dosages if pills are taken closely together.
One other disadvantage of oral chemotherapy is that the pills can be extremely dangerous. According to the
Before starting chemotherapy, youll have an opportunity to consult with a doctor. This is a good time to ask questions and discuss your concerns.
Where You Have Chemotherapy
You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so its a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.
You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.
For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.
Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.
Clare Disney : Hello, my name is Clare and this is a cancer day unit.
So when you arrive and youve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. Were going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
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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:
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.
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Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
How You Have Chemotherapy
You may have chemotherapy directly into your bloodstream through a drip . Some chemotherapy drugs are tablets or capsules that you swallow, such as capecitabine.
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
If you don’t have a central line, you might have treatment through a thin short tube . The cannula goes into a vein in your arm each time you have treatment
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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.
Quit Smoking Before Oral Cavity And Oropharyngeal Cancer Treatment
If you smoke, you should quit. Smoking during chemotherapy treatment can cause more side effects and can cause the chemo drugs to not work as well. It can give you a higher chance of getting an infection and is linked to worse outcomes. Smoking after treatment can also increase the risk of the cancer coming back and of getting another new cancer. Quitting smoking is the best way to improve your chances of survival. It is never too late to quit. For help, see How To Quit Using Tobacco.
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Duration And Frequency Of Oral Chemo
Just as traditional chemotherapy is done in a cycle, varying from receiving treatment once a week to once every three weeks, often oral chemotherapy is also done in cycles, explains Oluchi C. Oke, M.D., assistant professor at the University of Texas MD Anderson Cancer Center in The Woodlands, TX.
You may, for example, have two weeks where you take medications daily and then one week off, she notes. Then youd repeat the cycle. Some cycles, however, are continuous, she says. A lot of them are either 21-day cycles or 28-day cycles. Ultimately, every patients planboth with oral chemo and traditional chemois different based on their unique disease and needs.
Making A Decision: A Few Final Thoughts
Before you make a decision, take some time to think about it. Talk to your family and/or caregivers about the pros and cons.
If you havent yet, ask your doctor questions about oral chemotherapy, such as:
- How long will I be on this drug?
- Where do I store it?
- How often do I take it?
- What if I forget to take it?
- What are the potential side effects?
- Are you going to give me anything ahead of time to deal with potential side effects?
- Who do I call if I have a question?
No matter which decision you make, if you find its not working out for you for some reason, go back to your doctor and have a conversation. You may be able to switch to the other method. Or ask, What can we do instead? Cancer treatment drugs continue to improve, and we have more options to choose from than ever before.
If you have questions about oral chemotherapy, or if youd like to talk with someone at CTCA about your cancer treatment options, or chat online with a member of our team.
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Menstrual Changes And Fertility Issues
For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and could be permanent. If this happens, there is an increased risk of heart disease, bone loss, and osteoporosis. There are medicines that can treat or help prevent bone loss.
Even if your periods stop while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you have not gone through menopause before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best for you. When women have finished treatment , they can safely go on to have children, but it’s not safe to get pregnant while being treated.
If you think you might want to have children after being treated for breast cancer, talk with your doctor soon after being diagnosed and before you start treatment. For some women, adding medicines, like monthly injections with a luteinizing hormone-releasing hormone analog, along with chemo, can help them have a successful pregnancy after cancer treatment. To learn more, see Female Fertility and Cancer.
What If I Have Side Effects
You will see your doctor regularly while you are having treatment. Before each dose of chemotherapy you will have a blood test and a consultation with your medical oncologist to review your treatment. You will be able to discuss any side effects you have experienced and to ask questions. If necessary, the treatment can be adjusted for the next cycle.
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Common Chemotherapy Drugs For Breast Cancer
Chemotherapy drugs used to treat early breast cancer include:
Who May Not Be A Good Candidate For Oral Chemotherapy
Not everyone is a good candidate for oral chemotherapy. If you know youll struggle to take your medication correctly, for example, avoid oral therapy and choose another treatment option.
Patients who are experiencing nausea, vomiting and/or who have difficulty swallowing are going to have a difficult time physically taking oral medications.
Some drug interactions may prohibit you from taking oral chemotherapy because certain drugs increase or decrease the absorption of other drugs. That could lead to toxicities, or it could cause the chemotherapy to not have as good of a result as it should.
If oral chemotherapy isnt a good option for you, but you have serious obstacles getting to an infusion center, ask your doctor about alternatives. For example, our CTCA Atlanta hospital is piloting our Oncology Clinic at Home program. This program allows certain patients who qualify to receive some chemotherapy or immunotherapy infusions or injections at home. Treatment is administered by licensed nurses who are trained in chemotherapy administration.
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What Is The Difference Between Oral And Iv Chemotherapy
Most cancer treatment includes chemotherapy, a process that delivers strong drugs to your body to kill cancerous cells. You receive these drugs at regular intervals and for a specified length of time.
Your doctor at UHC Cancer Center may recommend oral or IV chemotherapy based on your specific type of cancer, its progression, and your personal preferences. Both have equal strength and deliver similar results.
Drug Interactions And Supplements
Coumadin and other blood thinners are drugs that interact with Xeloda. Its important to note that some nutritional supplements may also work as blood thinners, and you should talk to your oncology team before taking them.
In those 80 years old or older, Xeloda may cause more diarrhea, nausea, and vomiting than in younger people.
Hand-foot syndrome can occur with Xeloda. It often starts with darkening of the palms of the hands and soles of the feet. As it progresses, it can become more like a sunburn. There are several things you can do to help prevent this including keeping your hands and feet cool, wearing good shoes, and not going barefoot.
Xeloda can cause , which means you may get a sunburn more easily. Consider the following precautions to help protect your skin:
- Avoid sun exposure if possible
- Use a good sunscreen
- Cover up using UV clothes, hats, or an umbrella
Since Xeloda can make you more susceptible to infections, its best to avoid situations that might put you at risk, such as crowded places and visiting ill friends.
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Will I Ever Feel Normal Again After Breast Cancer
In many ways, it will be a lot like the life you had before, but in other ways, it will be very different. Call it your new normal. From your relationships with your family and your spouse to eating habits and exercise, breast cancer will change your life in ways that last well after treatment ends.
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Will I Need Chemotherapy
Not everyone with early breast cancer will be recommended chemotherapy. Whether or not it is recommended for you will depend on your individual situation. Factors the doctors consider include the pathology of your breast cancer the risk of the cancer coming back or spreading to other parts of the body your general health and your preferences. Your medical oncologist will discuss whether chemotherapy is the right treatment for you and which combinations of medications are most appropriate.
Some aspects of your type of breast cancer can influence whether chemotherapy is recommended for you. Your surgeon or medical oncologist may talk to you about genomic tests. Genomic tests can help predict the likelihood of an individual cancer recurring and can provide information to help you decide whether you may benefit from chemotherapy or some other breast cancer treatments.
Your doctor may talk to you about genomic tests currently available, including:
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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.
The potentially significant disadvantages of oral chemotherapy, however, are associated with a patients ability to take their medication properly and with cost or access to the medication itself.
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Are You Ready To Start Your Oral Or Topical Chemo
Here are some things you may want to talk to your cancer care team about when starting oral or topical chemo:
- Whats the name of the chemo? Is there more than one name for the same drug?
- How do I use it or take it?
- When should I use it or take it?
- Is it safe to take it with other drugs, food, vitamins, herbs, supplements, skin lotions, or other treatments I use?
- What should I do if I miss a dose?
- How should I store it?
- Is there a special way it needs to be handled to protect me and others?
- What do you expect it to do?
- What are the likely side effects? What should I do if I have side effects?
- How can I get in touch with you if I have trouble late at night or on the weekend?
- How long will I need to take the chemo?
- Will my insurance pay for my chemo? If not, how much will it cost? How will I pay for it?
- Will my other health problems stop me from being able to take the chemo the way I should? Is there a chance my other health problems could make me forget to take my chemo?
- Will you be calling me to find out how Im doing with the chemo?
- How often will you need to see me in person?
For oral chemo, be sure to also ask about certain questions about the pills, such as:
- What if I have trouble swallowing or keeping down the pills?
- Can they be opened, broken, or crushed?
- Can I mix it with food or liquid to take it?
Before starting chemo, talk to your doctor or nurse about any concerns or questions you have. Get answers to all of your questions about chemo before you start taking it.
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