Caring Currents

Cancer Patients and Caregivers Hail New Anti-Nausea Patch

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When the FDA announced on Monday that it had approved the first anti-nausea medication available as a patch, cancer patients and those of us who are caring for them reacted with perhaps more excitement than the news seems to deserve. Why?  Not only because it offers us a new -- and much-needed -- option, but because it's further proof that the research community is finally taking seriously one of the most debilitating side effects of cancer treatment.

Nausea, I'm sorry to say, is a bigger deal than most people not living in "Cancer World" realize. Until you see firsthand how completely constant, unremitting nausea (and the consequent lack of appetite) can undermine a person's quality of life, you can't have a full appreciation for the power of this particular side effect to sideline a normally high-energy, effective person.

The patch, known by the brand name Sancuso, uses granisetron, an anti-emetic already in wide use in pill form both as brand name Kytril and as a generic. Like several other popular anti-nausea drugs, such as ondansetron (Zofran) and dolasetron (Anzemet), granisetron works by blocking serotonin receptors in the brain, which in turn reduce the vomiting reflex.

The reason Sancuso is different is that the patch allows the drug to be absorbed through the skin, so it can help patients with swallowing problems or those who have difficulty keeping their medications down. The patch is manufactured by a Scottish company, Prostrakan, and is expected to launch in the U.S. by the end of the year.

The Sancuso patch isn't actually the most exciting recent breakthrough in anti-nausea meds, however: That award goes to aprepitant (brand name Emend), which came on the market in 2003 and which just won FDA approval for an injectable form in January of this year.

Emend works by a completely different mechanism than other anti-nausea meds, blocking the chemical that transmits nausea and vomiting signals to the brain. It's usually used in combination with Zofran or Kytril and other antiemetics for a two- or three-pronged (with dexamethasone) approach. The problem is that Emend -- at well over $300 for a three-pill regimen given before and after each chemo treatment --  is insanely expensive, and it isn't covered by all insurers because alternate, less expensive (though less effective) drugs are available.

With a percentage of cancer patients so afflicted by nausea it leads them to quit chemo, it's high time we had more weapons in our arsenal to fight it. And high time they all became available to all paients, regardless of cost and insurance.

Image courtesy of Flickr user Olgite used under Creative Common Attribution License.