The use of oral anticancer medications, while not new, has increased greatly in recent years. This increase is set to continue, with around 25% of all anticancer drugs in development being oral preparations (Bedell [10], Szetela and Gibson [241]). This shift to oral anticancer medications has implications for nurses, who will focus less on drug administration and more on educating and monitoring patients (Kav et al. [120], Szetela and Gibson [241]).

There are considerable advantages to administering anticancer medications via the oral route. The primary benefit is one of patient preference. The majority of patients (90%) would prefer to take oral anticancer medications as long as there was no reduced efficacy (Aisner [3], Barefoot et al. [8], Sharma and Saltz [233]). Patients prefer oral anticancer medication because of its ease and convenience; it allows them to take their medication in the comfort of their own home and is often associated with fewer or shorter hospital appointments (Barefoot et al. [8], Bedell [10], Winkeljohn [272]). Oral anticancer therapy is non‐invasive, eliminating the need for IV access (Sharma and Saltz [233], Wilkes [268]).

Some evidence suggests that oral anticancer therapy is more cost‐effective. Although the cost of new oral medications may be high, the staff and equipment costs of IV administration can be greater. Therefore, the overall costs of administering oral anticancer therapy may be less (Holmberg and Zanni [101]). Oral anticancer medications are also often considered to be less toxic than those needing other routes of administration (Holmberg and Zanni [101], Wilkes [268]). However, this view is not universally accepted (Birner et al. [14], Sharma and Saltz [233]). Use of the oral route can be beneficial when chronic exposure to a drug is important, for example cell cycle‐specific drugs (Scurr [227]).

There are several disadvantages associated with giving anticancer medications orally. Oral formulations are not suitable for all patients. Although most oral anticancer drugs are absorbed well if the gastrointestinal tract is functioning normally, many factors affecting cancer patients can alter absorption, making the oral route unreliable (Findlay et al. [76], O'Neill and Twelves [185]). These include primary tumour, gastrointestinal (GI) surgery and concomitant medications. Side‐effects of anticancer treatment such as diarrhoea or nausea and vomiting can also affect absorption (Goodin [87], Scurr [227], Sharma and Saltz [233], Wilkes [268]).

Some patients may experience difficulty swallowing, which makes taking tablets or capsules problematic. Crushing or dissolving oral anticancer medications could result in changes to the tablets’ disposition and effectiveness, and advice should be sought from an oncology pharmacist.

Patients usually self‐administer at home which can result in less monitoring and support from healthcare professionals (Kav et al. [120]). This can lead to poor adherence and under‐reporting of side‐effects (Barefoot et al. [8]). Patient adherence to anticancer treatment is important to maximize the chance of achieving the goals of therapy. However, there is a greater chance of patient non‐adherence with oral anticancer medications than with parenteral therapy which tends to be administered under direct supervision in a healthcare setting. Fear of side‐effects can lead patients to stop taking or reduce their dose of oral anticancer medications.

Conversely, patients may feel that their oral chemotherapy is not effective enough and increase their doses (Findlay et al. [76], Ruddy et al. [213]). They may continue taking oral anticancer medications despite toxicity because they feel the treatment is helping and do not want it stopped (Szetela and Gibson [241]). Other factors that can affect adherence are the complexity of the treatment regimen, number and type of concomitant medications, cognitive impairment, treatment of asymptomatic disease, lack of insight into disease seriousness, lack of confidence in treatment and poor patient–provider relationships (Barefoot et al. [8], Hartigan [94], Holmberg and Zanni [101], Viele [261], Wilkes [268], Winkeljohn [272]).