Overmedication with cancer and other conditions

Great discussion topic, Maureen. I cross-posted the thread in the other cancer groups too. I'd like to bring @hopeful33250 @allisonsnow @cindylb @travelgirl @nogginquest into this discussion about the "tangle of medications" one can get into living and aging with cancer.

With respect to medication interactions, I think pharmacists, especially oncology pharmacists, are a key person in your cancer care team. They have oversight over all the drugs you take, regardless of which specialty prescribed them. And they know about interactions. Maureen - how do you coordinate prescriptions as prescribed by different doctors? Does your GP work with you to discuss interactions, etc? My uncle was recently transferred to a geriatrician, who reduced his medications by about a third - medications he no longer needed, but no one had the oversight "position" in managing his care.

This is outstanding information. Thank you for sharing! Iam passing this valuable information with others outside Cancer Connect.

@alpaca @colleenyoung This is absolutely an important discussion.
Drs over medicated my grandma. She almost died from.the situation .
It is important to go over all medications, vitamins and supplements you tske. Update this list whenever you have a check up.
All prescriptions are important.including eye drops. I have prescription eye drops didnt even dawn on me to tell the dr.
Colleen's sdvice to speak with a pharmacist is an excellent idea.

Maureen, good topic! I have been fortunate that I don't have to take a lot of prescription meds (also allergic to everything, so doubly good). But, my poor husband who is starting his cancer journey.....finally diagnosed as Stage 3a Lung cancer has several other conditions as he comes into the cancer treatment. He generally handles meds well but at present he is taking seven meds. COPD drugs, drugs for benign essential tremor, serious foot pain and neuropathy, a heartburn drug for Barrett's Esophagus and the new drug for Supra Ventricular Tacyacardia (a heart rhythm problem). Many of his drugs cause sleepiness or fatigue and dizziness. Soon we'll start treatment for the cancer and that will add more drugs I'm sure. I manage his drugs and ask each and every time a new drug is prescribed how it might interact with the others. I've actually gotten a couple changed so that 'mix' is safer and we always focus on the least powerful drug and amount to start. I also read those inserts you get with drugs and also look them up online to make sure they aren't causing interactions that will cause more serious issues. There does sometimes seem to be a 'cascade' effect with drugs. You take one drug to solve one problem which then requires another drug to counteract the original drug. Whenever possible I try to substitute a natural substance for a drug. I have done a great deal of research on 'natural' supplements and foods that can help support the body, making it as healthy as possible to sustain the treatments we all have to consider with serious illness.
I was prescribed, but was unable to take, aromatase inhibitor type drugs for my breast cancer due to serious side effects......but with really concentrated effort and lots of higher power intervention (I think) I was able to virtually eliminate all the estrogen in my body. I was concerned about the AI drugs because they can cause other problems like osteoporosis, carpal tunnel, depression, etc. I was shocked to hear one oncologist suggest that I would just start on drugs for those conditions to counteract the effects of the AI drugs. But, the AI drugs slow down or stop the cancer so I completely understand and support taking those drugs as needed. I am fortunate I have a new oncologist who supports a 'whole person' theory on cancer and makes recommendations on diet, lifestyle and alternatives to traditional drugs. It can't always be the answer but it's sometimes an option. Before I take a drug or before my husband takes a drug, I ask lots of questions about alternatives, do research and only then do we move forward.

I also had a pharmacist go over my husband's drug list at one point...very good idea travelgirl........!

At the moment I get meds from my GP and the pharmacy next door. I take a lot of meds to manage the aftereffects of cancer treatment but seem to tolerate them very well. But I have friends (we're in our early 70s now) and fellow head and neck cancer patients who really suffer from over-medication - or just getting the balance right.

This is so interesting that I am overwhelmed. I read the inserts and Google the drugs too. As I said above, I am not having a problem with my own medications at the moment but see others in my local head and neck cancer group and in my age group really struggling with this. Thank you for sharing these very good ideas!

Hello All:

This is a good topic of discussion. At this time, I take no meds for cancer. The medical treatment for NETs is mainly used for symptom control or if there are METs. As I have no symptoms and do not appear to have METs, I have only used surgery to treat the NETs. However, since I don't know what the future will bring, I'm looking forward to reading more posts about this topic.

Teresa

Very interesting and useful thread there! Thanks @alpaca aka Maureen 🙂 In my wife's case she was on a constantly changing stream of medications as they struggled with the constantly altering effects of her tumor. Initially it was a tough balancing act between her neuro-oncologist at Mayo, her GP at home, and our pharmacist. Early on our pharmacist was a huge help until our local pharmacy was sold to a chain and it was never the same pharmacist twice. I cringe when I think back to how much time I wasted re-educating pharmacist after pharmacist on who my wife was, what her condition was, and why she was on the cocktail she was on at that specific time. Grr!

Then there was the issue of doctor vs doctor, which put Kramer vs. Kramer to shame! Finally after a grueling 'duel', where I felt as if I were some bizarre type of Second, the neuro-oncologist finally convenience our GP to get out of the mediations loop (other than to be informed of any changes in meds or dosages). One professional ego took a hit and the relationship never recovered, but it was for the good of my wife so I was happy to give up the relationship I had with the same GP.

My wife was on a medicinal cocktail of 32 doses a day. Keeping them straight required a spreadsheet to keep track of the time of day and doses. Luckily, once my wife went into home hospice, her nurse transferred all her meds to another smaller pharmacy with a more stable staff and who delivered. They worked together hand-in-glove. At this point her meds were often changing daily so it was crucial for there to be solid, knowledgeable communications between all the medical pros! This was also critical when we had to go from pill-tablet-capsule form to all liquids for her meds since the liquid form often caused them to act differently, on a different timeline, absorption rate, etc. Unfortunately for future patients in our area, this pharmacy was also swallowed by a national chain and no longer offers the same level of service.

With all the progress in technology I would think information sharing would be simpler regarding patients, their medications, and the providers involved. Hopefully this will improve quickly, but give the conflicting forces of the profit motive, I have my doubts.

Strength, courage, and peace to all.

Mayo requires that you update your list of prescriptions they have on file each time you go to your doctor there. I have several different doctors at Mayo in addition to my hematologist who prescribed various drugs for the side effects of chemo therapy. I would hope that a Mayo pharmacist would go over these drugs periodically to alleviate any problems. In addition to the cancer drugs, I also have medications for blood pressure, hypothyroidism, GERD, COPD, asthma, cholesterol, pain from torn rotator cuff, etc. I have no idea if there are adverse interactions from any of these medications. Does anyone know whether the Mayo Pharmacy Department reviews these lists of medications?