Government advisers yesterday cleared the way for more patients with advanced forms of common cancers to treat themselves at home rather than have chemotherapy in hospitals.
"Smart pill" alternatives to conventional treatments are licensed for use in Britain, but the endorsement given by the national institute for clinical excellence (Nice) in the fight against breast and bowel disease is likely to mean a massive increase in their use.
The new recommendations on their usage throughout England and Wales were welcomed because they offered patients the chance of more control over their treatment and fewer hospital visits.
This should give NHS staff more time to combat other cancers. Advice from the institute said the decision to use the drugs should be made jointly by patients and doctors so that choices of treatment and potential side-effects were understood.
Capecitabine, better known by its brand name, Xeloda, works by stopping cancer cells dividing. Most patients say they would prefer oral treatment to an infusion of drugs through drips, but the Nice approval is not unqualified. For advanced breast cancer the institute recommends it as a single agent, or with another drug brand named Taxotere, when other treatments have failed or are unsuitable.
Xeloda, made by Roche, and another oral drug, Uftarol, made by Bristol Myers Squibb, have also been recommended as options for frontline treatments for advanced bowel cancer.
About 40,000 cases of breast cancer are diagnosed each year in Britain. Between 30% and 40% might develop into advanced disease. Around 13,000 women die annually. Bowel, or colorectal, cancer claims 17,000 lives a year and is diagnosed in 33,000 people.
Bruce Sizer, bowel cancer specialist and consultant clinical oncologist at Essex Rivers Healthcare NHS trust, said: "Oral treatment makes chemotherapy schedules simpler, cuts hospital time and therefore costs, and provides patients with the convenience of treatment at home."
The approval for wider use of the drugs coincided with an appeal by scientists for men with prostate and testicular cancer to help them find the hereditary genes thought responsible for increasing the risk of contracting the diseases.
They are seeking men who have three or more relatives who developed prostate cancer before they were 70 or two or more family members with testicular cancer.
Six possible prostate cancer genes have been identified, as well as a promising candidate for a gene that influences the risk of developing testicular cancer. Professor Colin Cooper of the Institute of Cancer Research in London said about 15% of prostate cancers and up to 30% of testicular cancer might be due to inherited predisposition.
Discovery of the genes responsible could help screen for people at high risk and provide targets for new and more effective drugs.
