Current Canadian experience with capecitabine: partnering with patients to optimize therapy

Capecitabine (Xeloda) is the first oral chemotherapeutic agent to be used in Canada for the treatment of metastatic breast cancer and metastatic colorectal cancer. The home-based administration of this drug, coupled with the importance of prompt side-effect management, presents unique challenges to oncology nurses and gives them an expanded role in optimizing therapeutic outcomes. Fulfillment of this role involves partnering with patients to help them become educated active participants in their own treatment, and to ensure that side effects are prevented, recognized, and managed adeptly. Although well tolerated, capecitabine, as with all chemotherapy, can require interventions and dose modification. Hand-foot syndrome, the most common dose-limiting toxicity, requires particular attention. Drawing from published articles and interviews with Canadian oncology care providers, this article reviews the development and safety profile of capecitabine. Best practices in side-effect management are discussed, with a particular focus on managing hand-foot syndrome and building patient partnerships.