Outpatient cancer therapy: pharmacies help

Many patients take their medication at home. Pharmacists can help them with this

Well advised: Monika Hampel, specialist pharmacist for clinical pharmacy and oncology from Wesseling

© W & B / Selina Pfrüner

It actually sounds very simple: the cancer patient receives a prescription from the oncologist, which he redeems in the pharmacy. And instead of hanging on the drip in the practice, he takes pills at home.

In addition to the obvious advantages, there are also risks: Oral cancer drugs are highly effective drugs with sometimes significant side effects (see below). "Patients save time, but have to develop more personal responsibility," emphasizes Professor Frank Gieseler, specialist in hematology and internal oncology at the University Medical Center Schleswig-Holstein.

In order for the medication to work properly, the patient must follow the doctor's instructions exactly. "And since those affected have less contact with the treating doctor, the support from pharmacies is all the more important."

Skin problems

Side effects are usually an indication that the drug is working, but they can be very stressful. "However, nausea and hair loss are much less common with oral cancer therapy than with infusion solutions," says oncologist Gieseler.

In contrast, skin problems such as itching and dryness, which also occur with chronic inflammatory skin diseases, are much more common with oral cytostatics. "Pharmacists can support patients with dermopharmaceutical skin care tailored to their needs," says Gieseler.

Thorough oral hygiene

In order to avoid painful inflammation of the oral mucosa, Monika Hampel, specialist pharmacist for clinical pharmacy and oncology from Wesseling, recommends thorough oral hygiene with mild toothpaste, a soft toothbrush and non-irritating mouth rinsing solutions. "Drinking a lot is at least as important."

Therapy is often made more difficult by complicated intake instructions. "A database of the German Society for Oncological Pharmacy (DGOP) helps pharmacists create individual therapy plans," says expert Hampel.

Diet for nausea

Simple nutrition tips often help with nausea: "Food that is difficult to digest, heavily spiced and with an intense smell is not very suitable," says pharmacist Hampel. Instead, the patient should spread out several small meals throughout the day and grab some fruit and snacks in between.

For more severe symptoms, the doctor usually prescribes so-called antiemetics. "No cancer patient today has to endure nausea," emphasizes oncologist Gieseler. In addition, this can often lead to severe weight loss, which further weakens the patient.

Balanced nutrition

In order to avoid heavy weight loss, it is advisable to drink food that is rich in energy and nutrients. "However, cancer patients should not resort to dietary supplements without medical advice," emphasizes Hampel. "These have no definite benefit and can even be harmful." A balanced diet is also very important with cancer.

Many pharmacists keep themselves up to date about the complicated cytostatic therapy through regular training courses at the DGOP.

Chronically tired

Many cancer patients find so-called fatigue to be particularly stressful: chronic tiredness that is associated with depressive moods. "Unfortunately, there is not much you can do about it," regrets Gieseler.

Monika Hampel advises those affected to regularly take a walk despite being tired: "Moving out in the fresh air often makes them much better."

When feeling depressed, many patients resort to over-the-counter St. John's wort preparations. But these weaken the effect of some cytostatics. Such interactions are always possible when cancer patients take other drugs.

"The pharmacist should check the medication and draw attention to problematic combinations," says Gieseler. "When it comes to oral cancer therapy, doctors and pharmacists have to work closely together."