The majority of cancer therapies are administered in a hospital or clinic. Certain types of treatment, however, can be done at home. This is frequently the case with oral medications like pills, capsules, tablets, and liquids, as well as topical treatments like creams and lotions that are applied to the skin. Even intravenous (IV) or injectable medicines can sometimes be administered at home. Chemotherapy, targeted therapy, immunotherapy, and hormone therapy medications are examples of these treatments.
If you need IV or injectable treatments, a home care nurse or an IV therapy (infusion) nurse may come to your house to administer them. If you’re taking oral treatment pills, a nurse may visit to ensure that you’re set up with your medications, that you’re taking them as prescribed, that you’re aware of any potential adverse effects, and that you’re handling the meds safely. If a nurse visits you at home, they may stay for a time or teach you and your caregiver how to give and monitor home therapies.
It’s not always possible to get your cancer treatment at home. Sometimes it might not be safe, or in some cases, treatments might not be covered by health insurance if they’re given at home. If you’re not able to get your cancer treatment at home, but are having trouble making frequent visits to the office or clinic, talk to your cancer care team and health insurance company. There might be options to use some kinds of telehealth (telemedicine). You might also be able to get some home care services.
MANAGING CANCER TREATMENT AT HOME
Topical treatment or oral treatment:-
Oral therapy (pills, capsules, tablets, or liquids) is administered through the mouth. Topical treatment
(cream or lotions) is rubbed on the skin. Your doctor will prescribe the medicine if oral or topical treatment is part of your treatment strategy. You can get it from a regular pharmacy, a mail-order pharmacy, or your doctor directly. You should check with your insurance carrier to see if you’ll be covered and if there will be any out-of-pocket expenses associated with the therapy. Many of these medications are fairly costly.
You’ll need to take the medicine on a schedule, usually at the same time every day. It’s very important to follow the schedule exactly as you are taught. This will help the treatment drug remain in your body at the right dose all of the time. It will also help you to have the best treatment outcomes.
Tips for taking oral cancer treatments:-
- Before cutting or crushing a tablet or capsule that is excessively large, consult your cancer care team or pharmacist.
- Side effects might be lessened by changing the schedule a little bit, but your cancer care team needs to help you decide if changing the schedule is best.
- Keep all medicines out of the reach of others, especially children, pets, and other adults who might take them by mistake.
- Many oral cancer treatments are hazardous drugs and need to be handled with special care.
- Take the drug precisely as directed by your doctor.
- Use a pill sorter to assist you to remember if you have to take a lot of medicines every day at different times.
- Make sure you’re taking them at the proper time by checking with your cancer care team.
- Before cutting or crushing a tablet or capsule that is excessively large, consult your cancer care team or pharmacist.
Treatment by injection (under the skin or into a muscle):-
Injectable treatments are given through the skin with a needle. They might be given into a muscle (intramuscular or IM) or just under the skin (subcutaneous, subcu, or subq) in an arm, leg, hip, or belly. Sometimes these are given in a treatment center or clinic. But if you’re getting these at home, a home health nurse (infusion nurse) will come to your home to give the treatment and will probably teach you to give it yourself or teach a family member or caregiver to give it to you. There may be special care or precautions needed when handling the drug, depending on its type.
Treatment by intravenous (IV) drug:-
Intravenous (IV) therapies are administered into a vein using a catheter or needle. These are normally provided in a clinic or treatment center. If you receive them at home, a home health nurse (infusion nurse) will come to your home to give the treatment. A family member may be taught to give the medicine or to disconnect the lines once the infusion is complete. Depending on the type of medicine, particular attention or precautions may be required when handling it.
DRUG SAFETY AT HOME
Some cancer medications are hazardous chemicals, regardless of how they are administered to patients. Many of them are considered harmful drugs. Only the individual who is being treated should be exposed to them in these situations. The ingredients in these drugs stay in your body for hours to days after you take them, no matter how you take them. These medicines can be found in small levels in your urine, feces, vomit, and even perspiration.
Ask your cancer care team if the treatment you’ll be receiving at home is hazardous. If that’s the case, here are some “rules” to follow to keep everyone in your family safe and away from harmful chemicals:-
- Taking treatment drugs: Only the person who should take the drugs should touch them, even if they are in pill or capsule form. If someone else touches them, they should use disposable gloves. Be sure to wash hands with soap and water after taking treatment drugs.
- Spills: you will be given a special kit and shown how to use it if liquid treatment drugs are used in the home. This kit will help you safely clean up a spill. If a pill or capsule is dropped, use disposable gloves to pick it up.
- Throwing away treatment drugs: You will be given a special container to put treatment drugs and any needles, syringes, IV bags, and tubing into, instead of using the regular trash.
- Laundry: Wash your clothes, sheets, and towels in the regular laundry unless there is urine, feces, vomit, sweat, or any of the treatment drugs on them. If this happens, put on disposable gloves and wash these items in hot water separately from your other laundry. If you do not have a washer, put these items in a bag to wash separately later.
- Using the toilet: You can use the same toilet like the rest of the household while you are receiving treatment, with some extra safety rules. For at least 48 hours after your treatment ends (which means after your injection, or after the IV is finished), when you use the toilet, close the lid and flush the toilet twice after each use. Wash your hands well after use. If any urine or feces gets on your skin, wash your skin with soap and water. Keep children or pets from playing in or drinking from the toilet.
- Storing treatment drugs: Store drugs in a safe place away from children and pets, or from any adult who could be confused and accidentally take it. Do not store in the bathroom, because the moist air in the bathroom could affect the drugs.
WHAT CAREGIVERS CAN DO
(A) Learn how to assist the patient in staying on track so that they don’t miss a treatment or dose.
(B) Help patients in establishing an effective method for receiving treatment at home. If the patient is receiving oral or topical therapy, you can seek advice from the cancer care team or request that a home health nurse pay a visit or two to check on the patient’s setup and ensure that a good calendar or alarm system is in place to serve as dose reminders. If the treatment involves an IV or injection, you can assist by ensuring that visits are scheduled and learning what you can do at home to assist with the setup.
(C) Be sure you know what safety precautions might be needed.
(D) Know about the expected side effects and ask how they can be managed. Track any side effects that happen.
(E) Keep the cancer team’s office numbers (including emergency numbers) handy. If you have a home health nurse who helps with injections, keep their phone number nearby in case you have problems or questions.
Call the cancer team if the patient is-
- Notices itching, dizziness, shortness of breath, hives (raised itchy skin welts), or other symptoms of an allergic reaction after taking any medicine.
- Has a fever higher than the level taught to you by the cancer care team or home health nurse
- Has uncomfortable side effects, such as nausea, vomiting, diarrhea, or pain
- Can’t give themselves the shots or take the pills for any reason, or if they refuse to have the treatment given by someone else
- Is about to need a prescription refill
- Spills or loses medicine, or vomits a dose
- Learns that any person, other than themselves, have taken their medicine
- Misses a dose
- Has redness, warmth, swelling, drainage, or pain at any injection site