My Daily Dose of Oral Cancer Medications

A woman shares her thoughts on the number of oral medications she's taken to treat her metastatic breast cancer.

As I was reflecting on these last several years since being diagnosed with de novo metastatic breast cancer, I was curious to know just how many pills I have swallowed. It all started with tamoxifen, of which I took 255 pills. Next came Femara (letrozole). Femara was a short-lived treatment for me. I only took 31 pills. Ibrance (palbociclib) was next, and it is taken with breaks in between rather than daily. Unfortunately, it was another short-lived treatment, as I only did six cycles for a total of 105 pills before this treatment failed me. My next oral medication was Xeloda (capecitabine). Xeloda was increased or decreased depending on the severity of my side effects. I would take it for a week on and a week off. I did pretty well on Xeloda and ended up taking 1015 tablets. Afinitor (everolimus) and Aromasin (exemestane) came next and also were a long run. I took 856 Aromasin pills and 849 Afinitor pills.

My current treatment is Lynparza (olaparib) and I’m at 2,020 tablets so far and still counting. In between all of these pills, tablets and capsules was 60 infusions of various chemo cocktails. When you have metastatic breast cancer, you try to get the most mileage out of one treatment before moving on to the next.

There are only so many options, and when you are out of options, you are truly out of options – and we all know how that ends.

These numbers are mind-boggling when you really stop to look at them. In 88.5 months – or 2,693 days – I have reached a milestone by consuming a grand total of 5,131 life-extending pills. Jumping from one treatment to another due to disease progression, as is the case with metastatic disease, can be a challenge when it comes to organizing medication dosing schedules. Every treatment is different in its dosage, timing and frequency. My Sunday morning ritual has always been to load my plastic pill box that has the days of the week imprinted on each lid flap. With the chemo brain comes forgetfulness. Did I take my pills today? Did I take them at the right time? I know I’d be lost without my pill box.

I find it much easier to keep track of what I have taken by using my good old-fashioned pill box. In addition to the pill box, I’ve also discovered a great app called Medisafe. It’s free to download and simple to use. You enter the name of your medication, the dosage and frequency, and the app sends you a reminder on your phone at your designated time every 10 minutes or until you take your medication and mark that you’ve taken it. At the end of each week an email is generated with your weekly adherence. I’m always happy to see I’ve taken my pills with 100% adherence, chemo fog and all. Medisafe also has a medications interactions checker if you are unsure of mixing medications and can’t speak to a pharmacist or doctor.

That’s an awful lot of pills to swallow – 5,131. I didn’t even begin to count all the antibiotics I’ve taken for various reasons. I also didn’t count the year or so of blood thinners for a deep vein thrombosis (DVT) blood clot. I’m sure there are other pills I missed in my tally. I really don’t know how I would have kept track of it all without my pill box and app. While I’m grateful for all of these life-extending pills, I still think the most bitter pill to swallow is my mortality and running out of treatments. Even with a spoonful of sugar, it saddens me to know when my Lynparza fails I’m out of oral options. In the meantime, I continue to take my pills on time with a daily dose of hope for newer and better treatments to come.

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