Your healthcare team
Throughout your treatment, your primary doctor may introduce additional healthcare professionals as they are needed. These people all play an important role in your treatment, so talk to them openly and honestly. This "team" of healthcare professionals is often referred to as a multidisciplinary team, or MDT.
Here are some of the specialists you may see:
In addition, some supporting team members you may see include:
- Oncology nurse—specially trained to work with cancer patients, your oncology nurse provides general support to you and your family. You may be in touch with your oncology nurse on a regular basis so that he or she can keep track of your health and help in managing any side effects. Often, this nurse takes on the role of MDT coordinator
- MDT coordinator—this position is critical to a smoothly functioning MDT. The coordinator facilitates patient entry into the MDT system, maintains patient data, and ensures that assessments, interventions, and follow-up visits are scheduled and completed efficiently
- Nurse practitioner and physician assistant—both work closely with your doctors, performing physical examinations, helping ensure patient compliance with all therapy protocols, reporting adverse drug reactions, and helping manage side effects. Sometimes, these professionals work only in transplantation units
- Registered dietitian—certified to give nutritional advice to patients, a dietitian works with other healthcare team members to make sure patients are getting the nutrition they need
- Interventional radiology coordinator—assists team members with access to images and other data stored in a central repository
- Primary care physician—treats unrelated comorbidities and manages side effects. Likely to see patients during the post-treatment phase, following hospital discharge
Other healthcare professionals may join the MDT as needed. These include pathologists, palliative care physicians, social workers, psychologists, and financial counselors.
Personnel who can help you with financial issues include: office/practice managers and specialty pharmacy providers.
Any and all of the professionals listed above can play an important role in helping you face the challenges of cancer and deciding whether NEXAVAR is right for you.
What is NEXAVAR?
NEXAVAR is a prescription medicine used to treat:
- a type of liver cancer called hepatocellular carcinoma (HCC) that cannot be removed by surgery
- a type of kidney cancer called renal cell carcinoma (RCC)
- a type of thyroid cancer called differentiated thyroid carcinoma (DTC) that can no longer be treated with radioactive iodine and is progressing
It is not known if NEXAVAR is safe and effective in children.
Important Safety Information
Do not take NEXAVAR if you:
- are allergic to sorafenib or any of the other ingredients in NEXAVAR.
- have squamous cell lung cancer and receive carboplatin and paclitaxel.
Before taking NEXAVAR, tell your healthcare provider about all of your medical conditions, including if you:
- have heart problems including a condition called “congenital long QT syndrome”
- have chest pain
- have abnormal magnesium, potassium, or calcium blood levels
- have bleeding problems
- have high blood pressure
- plan to have any surgical procedures or have had recent surgery
- are pregnant or plan to become pregnant. NEXAVAR may harm your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with NEXAVAR.
For females who are able to become pregnant:
- Your healthcare provider should do a pregnancy test before you start treatment with NEXAVAR.
- Use effective birth control (contraception) during your treatment with NEXAVAR and for 6 months after the last dose of NEXAVAR.
For males with female partners who are able to become pregnant:
- Use effective birth control (contraception) during your treatment with NEXAVAR and for 3 months after the last dose of NEXAVAR.
- NEXAVAR may cause fertility problems in males. This may affect your ability to father a child. Talk to your healthcare provider if this is a concern for you.
- are breastfeeding or plan to breastfeed. It is not known if NEXAVAR passes into your breast milk. Do not breastfeed during treatment with NEXAVAR and for 2 weeks after receiving the last dose of NEXAVAR.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Especially tell your healthcare provider if you take the medicine warfarin.
What are the possible side effects of NEXAVAR?
NEXAVAR may cause serious side effects, including:
- decreased blood flow to the heart, heart attack and heart failure. Get emergency help right away if you get symptoms such as chest pain, shortness of breath, racing heartbeat, swelling in lower legs, feet and abdomen, feel lightheaded or faint, tiredness, nausea, vomiting, or sweat a lot.
- increased risk of bleeding. Bleeding is a common side effect of NEXAVAR that can be serious and can lead to death. Tell your healthcare provider right away if you have any signs of bleeding during treatment with NEXAVAR:
- vomiting blood or if your vomit looks like coffee-grounds
- red or black (looks like tar) stools
- coughing up blood or blood clots
- heavier than normal menstrual cycle
- unusual vaginal bleeding
- frequent nose bleeds
- high blood pressure. High blood pressure is a common side effect of NEXAVAR and can be serious. Your blood pressure should be checked every week during the first 6 weeks of starting NEXAVAR. Your blood pressure should be checked regularly and any high blood pressure should be treated during treatment with NEXAVAR.
- skin problems. A condition called hand-foot skin reactions and skin rash are common with NEXAVAR treatment and can be severe. NEXAVAR may also cause severe skin and mouth reactions that can be life threatening. Tell your healthcare provider if you have any of the following symptoms:
- skin rash
- skin redness
- pain or swelling
- blistering and peeling of your skin
- blistering and peeling on the inside of your mouth
- blisters on the palms of your hand or soles of your feet
- an opening in the wall of your stomach or intestines (gastrointestinal perforation). Tell your healthcare provider right away if you get fever, nausea, vomiting or severe stomach (abdominal) pain.
- possible wound healing problems. If you need to have a surgical procedure, tell your healthcare provider that you are taking NEXAVAR. NEXAVAR may need to be stopped until your wound heals after some types of surgery.
- changes in the electrical activity of your heart called QT prolongation. QT prolongation can cause irregular heartbeats that can be life threatening. Your healthcare provider may do tests during your treatment with NEXAVAR to check the levels of potassium, magnesium, and calcium in your blood, and check the electrical activity of your heart with an electrocardiogram (ECG). Tell your healthcare provider right away if you feel faint, lightheaded, dizzy or feel your heart beating irregularly or fast during your treatment with NEXAVAR.
- liver problems (drug-induced hepatitis). NEXAVAR may cause liver problems that may lead to liver failure and death. Your healthcare provider will do blood tests to check your liver function regularly during your treatment with NEXAVAR. Tell your healthcare provider right away if you develop any of the following symptoms:
- yellowing of your skin or the whites of your eyes
- dark "tea-colored" urine
- light-colored bowel movements (stools)
- worsening nausea or vomiting
- pain on the right side of your stomach area
- bleeding or bruising more easily than normal
- loss of appetite
- change in thyroid hormone levels. If you have differentiated thyroid cancer, you can have changes in your thyroid hormone levels during treatment with NEXAVAR. Your healthcare provider may need to change your dose of thyroid medicine during treatment with NEXAVAR. Your healthcare provider should check your thyroid hormone levels every month during treatment with NEXAVAR.
The most common side effects of NEXAVAR include:
- diarrhea (frequent or loose bowel movements)
- hair thinning or patchy hair loss
- weight loss
- loss of appetite
- stomach-area (abdomen) pain
- low blood calcium levels in people with differentiated thyroid cancer
Tell your doctor if you have any side effects that bother you or do not go away. These are not all the possible side effects of NEXAVAR. Ask your doctor or pharmacist for more information.
You are encouraged to report negative side effects or quality complaints of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For important risk and use information about NEXAVAR, please see the full Prescribing Information.