Patients with colorectal cancer now have another treatment option after surgery. The US Food and Drug Administration has approved the pill Xeloda (capecitabine) as adjuvant chemotherapy for people with disease that has spread to the lymph nodes (stage III or Dukes' stage C). Adjuvant therapy is given after surgery to help keep the cancer from coming back.

The action was based on results from a clinical trial of nearly 2,000 patients that showed the pill was just as effective as chemotherapy with 5-fluoracil/leucovorin, the standard treatment.

Xeloda promises to be easier for patients to take, however. Because it is a pill, patients can take it at home with only occasional visits to the doctor. Standard chemotherapy is given into a vein and patients must visit a clinic dozens of times over the course of many weeks to be treated.

Xeloda works by changing into 5-fluoracil when inside the body. The two drugs cause about the same amount of side effects overall. But people who take Xeloda tend to have fewer problems with mouth sores and low counts of white blood cells, and more problems with tingling, numbness, pain, and other strange sensations in their hands and feet. Xeloda can also cause diarrhea, vomiting, and nausea.

The drug is already approved for patients with breast cancer or colorectal cancer that has spread to other parts of the body. Manufacturer Roche said it is testing Xeloda in combination with other chemotherapy drugs and targeted agents to try to make it even more effective. Xeloda is more expensive, however. The cost of a 6-month course will be around $10,000. This is much higher than the cost of 5-fluorouracil and leucovorin, but Xeloda is covered under Medicare.