A unique Alberta study is offering the promise of a bit more independence for some cancer patients and potential relief for a strained health-care system.
Two dozen volunteers with myeloma, a type of blood cancer, are trained by oncology nurses to give themselves a chemotherapy treatment, called bortezomib, at home.
It's administered by injecting a needle under the skin, similar to the way diabetics take insulin. But it's traditionally been given in the hospital.
"I'm 79, pushing 80, and I don't want to waste my time driving back and forth. This is a great gig, you know," said Denis Edwards, one of the study participants in Calgary.
"It was easy from the first."
It used to take him an entire morning to go to the Tom Baker Cancer Centre for his bortezomib injections. Now, twice a month, rather than a trip to the hospital, he injects himself using a pre-filled syringe, with a little help from his wife, Bonnie.
"No one likes to be in a hospital. If they're really ill, fine, fine. But if the time can be cut, that's all the better," said Edwards, who still has to go in once a month for another treatment, given by IV infusion, and a nurse gives him a third dose of bortezomib at that time.
"It's a relief. It's a big relief."
One-of-a-kind pilot in Canada
The idea for the at-home treatment program came from patients themselves, according to Dr. Jason Tay, a hematologist at the Tom Baker Cancer Centre, who is leading the University of Calgary and Alberta Health Services study.
"It seems so simple. [They asked] 'why can't I give this to myself at home if I'm willing, wanting and capable of doing so?' And that's a really good question that we weren't able to answer or have the platform to allow this to happen for many of our patients," he said.
The pilot, which began two years ago and is funded by the Alberta Cancer Foundation, is the only one of its kind in Canada, according to Tay.
He noted many hospitals in the United Kingdom began offering at-home treatments earlier in the pandemic in an effort to relieve pressure on hospitals and keep vulnerable cancer patients safe.
"Many patients appreciate the opportunity to look after themselves at home, and they find that they don't have to travel as much — and this is a big deal, especially over the winter months," he said.
It can have a positive emotional impact as well, according to Tay, when people aren't constantly reminded of their illness.
"Any sense of normalcy, back in the community and not coming in, that makes a huge difference on their psycho-emotional health."
While it appears to be working well for patients so far, Tay sees potential benefits for strained hospitals, too.
"Having the opportunity to have a release valve for the system makes a lot of sense. So if patients do not have to come to a treatment chair at a particular centre, that means someone else can also benefit from that timely care."
Eighteen patients being treated at the Tom Baker Cancer Centre in Calgary and six from the Cross Cancer Institute in Edmonton are involved in the pilot feasibility study.
If this practice proves safe and effective, it could be offered more widely in the future, according to Tay.
"My ultimate hope — the win-win situation — is that our administrative system in the cancer centre finds this of value to the system and the patients, and they will allow us to do this routinely for patients who are willing and wanting."