Few patients know about the possibility of using chemotherapy at home. Is this method of treatment as safe and effective as chemotherapy used in a hospital? We asked Dr. Leszek Kraj, MD, who treats colorectal cancer patients with home chemotherapy.
What are the factors that determine the incidence of colorectal cancer?
There are many factors that may contribute to the occurrence of colorectal cancer, they are divided into modifiable and non-modifiable. The former are most often associated with the family history of this neoplasm, but also with age or gender. Modifiable factors, i.e. factors influenced by the presence and presence of the patient, constitute a much larger group. Among them are environmental factors as well as lifestyle factors.
Therefore, about bowel cancer, we can say that the patient has a significant influence on whether he develops this cancer or not. The risk of developing the disease can be reduced through the use of primary prevention, which is lifestyle modification. Also through the use of secondary prophylaxis, which should be carried out by detection (colonoscopy, stool examination for occult blood) and removal of early neoplastic lesions (polyps).
Colorectal cancer takes a long time to develop. It arises from benign polyps and therefore often patients do not notice neoplastic changes. What are the symptoms of this cancer that should worry us?
Early changes are most often detected during the implementation of research in the field of a screening program. However, it should be emphasized that this is a program aimed at healthy patients who do not have symptoms that could indicate the development of a neoplastic disease.
Symptoms that should arouse anxiety and prompt the patient to consult a specialist are bowel movements disturbances in the form of constipation, diarrhea, and rectal bleeding. It should be emphasized, however, that bleeding is most often detected on the basis of a fecal occult blood test and is difficult to see with the naked eye. Another symptom that may be a sign of bleeding is iron deficiency anemia, which occurs especially in men.
What is home chemotherapy?
The basic method of treating most cancers is radical – surgical treatment, as is the case with colorectal cancer. In many cases, however, especially when the disease is advanced or the tumor is located in a hard-to-reach place, it is necessary to use chemotherapy, i.e. systemic treatment.
Most of us associate classic chemotherapy with difficult, debilitating treatment. Patients who need it for days, months or even years spend in chemotherapy wards where they receive treatment. For several years now, for our cancer patients large intestine there is chemotherapy available that can be used in their homes. It is, of course, safe and as effective as the one administered in a hospital setting, a method of anti-cancer treatment. The procedure of administering chemotherapy at home begins with putting the so-called port, it allows the safe administration of the drug. This is a standard procedure that is not painful and does not adversely affect the patient’s quality of life. The patient then receives the first part of the drug in the daytime chemotherapy ward. During this time, we monitor the patient for side effects. If nothing is wrong, the patient receives the next parts of the chemotherapy cycle in the form of an infusor, which he already takes at home. On the last day of the cycle, we meet with the patient to disconnect the infusor. Home chemotherapy is especially convenient during the COVID-19 pandemic, when access to chemotherapy units is significantly limited. We also offer it to patients who do not tolerate hospital stay very well, but also to all other patients who want to be treated at home.
Are patients willing to use this form of treatment? Does the lack of knowledge in this aspect mean that they approach such a solution with a great distance?
When we tell them about such a solution, patients need reliable information from us that will allow them to make the best decision for them. My experience shows that patients who receive information and support from their attending physician decide to be treated with home chemotherapy, and what’s more, after a few cycles, they say that they are very satisfied with this method of treatment, often they cannot imagine being treated in a hospital setting.
So educating the patient and his family about home chemotherapy is crucial?
A patient who receives chemotherapy at home must be very vigilant and careful, and his relatives must also know what to pay attention to, how to behave in certain situations. This information should always be passed on to the patient and his family by the treating physician. In our hospital, patients who receive home chemotherapy can call us at any time of the day or night. Whenever something disturbing happens, doctors and all medical staff offer them their knowledge and help. This support is very important to patients and they need it very much.
Speaking of education, it is also worth mentioning another aspect of it, that it is necessary to inform patients about the possibility of starting treatment at home. Although this method is becoming more and more popular among doctors, not all of them inform their patients about the possibility of using it. However, it is very important that every cancer patient knows what treatment options are available and that they can consciously, in consultation with a specialist, decide how they will be treated.
Patient’s comment
I fell ill with colorectal cancer in 2018. At that time, few gave me a chance to live such a long life with cancer. After surgery, I went to a clinic in Warsaw, where I started chemotherapy. The first cycles of treatment, and there were over 80 of them, I received in hospital. In the clinic, I was looked after very well, but the treatment involved many journeys, me and my relatives were already very tired. When the COVID-19 pandemic struck and the chemotherapy unit in the clinic where I was receiving treatment was closed overnight, my doctor offered me a home treatment. Today I know that it was the best solution for me. I feel safe while receiving the drug, I know that at any time, if something disturbing happens, I can contact my doctor. Fortunately, there has been no such need so far. Since I have been receiving the drug at home, the quality of my life has changed as well, I spend much more time at home with my relatives.
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