Getting Cancer Treatment at Home

Most cancer treatments are given in a hospital or clinic. But certain types of treatment can be taken at home. This is usually the case for oral treatments, such as pills, capsules, tablets, and liquids, or topical treatments that are rubbed on the skin. Sometimes even intravenous (IV) or injectable treatments can be given at home. These treatments might be types of chemotherapy, targeted therapy, immunotherapy, or hormone therapy drugs.

If you're getting IV or injectable treatments, a home care nurse or IV therapy (infusion) nurse might come to your home to give your treatment. If you're taking oral treatment drugs, a nurse might come to be sure you are set up with your medicines, taking them as prescribed, know what side effects to watch for, and are handling the drugs safely. If a nurse is coming to your home, they might continue to come for a while, or they might teach you and your caregiver how to give or monitor home treatments.

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

Oral treatment (pills, capsules, tablets, or liquids) or topical treatment (creams or lotions)

Oral treatment is given by mouth. Topical treatment is rubbed on the skin. If oral or topical treatment is part of your treatment plan, the medicine will be prescribed to you by your doctor. You might get it at a regular pharmacy, through a mail-order pharmacy, or directly from your doctor. You might need to verify with your insurance company that you'll have coverage and if you'll have out-of-pocket costs with the treatment. Many of these drugs are quite expensive.

You'll need to take the medicine on a schedule, usually the same times 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:

• Take the medicine exactly as you have been told to do.
• If you have to take many pills each day and at different times of the day, use a pill sorter to help you remember.
• Check with your cancer care team to be sure you're taking them at the right time.
• If a pill or capsule is too big, talk to your cancer care team or pharmacist before cutting or crushing it.
• 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.

You can find more hints for taking these and learn more about safety precautions in Getting Oral or Topical Chemotherapy.

Treatment by intravenous (IV) drug

Intravenous (IV) treatments are given through a catheter or needle into a vein. These are usually 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. Sometimes a family member is taught to give the medicine or to disconnect the lines when it's done infusing. There may be special care or precautions needed when handling the drug, depending on its type. You can read more in Equipment Used During Cancer Treatment: Tubes, Lines, Ports, and Catheters and learn about safety precautions in Getting Intravenous or Injectable Chemotherapy.

Treatment by injection (under the skin or into a muscle)

Injectable treatment 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 the 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. You can read more about safety precautions in Getting Intravenous or Injectable Chemotherapy.

Drug safety at home

Some cancer drugs are dangerous chemicals, no matter how they are given to the patient. Many are classified as hazardous drugs. In these cases, it's important that only the person being treated should be exposed to them. No matter how you take these drugs, the chemicals remain in your body for hours to days after you take them. Small amounts of these drugs are in your urine, feces, vomit, and even your sweat.

Ask your cancer care team if the treatment you'll be taking at home is hazardous. If it is, here are some "rules" to follow to keep everyone in your household safe and keep them from being exposed to these chemicals:

• Laundry: Wash your clothes, sheets, and towels in the regular laundry unless there is urine, feces, vomit, sweat, or any of the treatment drug 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 as 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.
• 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. 

What caregivers can do

• Learn what you need to do to help the patient stay on track so they don't miss a treatment or dose.
• Help the patient set up a good system for getting treatment at home. If the patient is getting an oral or topical treatment, you can get tips from the cancer care team or ask if a home health nurse can make a visit or two to check on the patient's set up, and make sure a good calendar or alarm system is in place as dose reminders. If it's an IV or injectable treatment, you can help by making sure visits are set up and find out what you can do to help with the set up at home.
• Be sure you know what safety precautions might be needed.
• Know about the expected side effects and ask how they can be managed. Track any side effects that happen.
• 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 about to need a prescription refill
• Spills or loses medicine, or vomits a dose
• Learns that any person, other than themselves, has taken their medicine
• Misses a dose
• Has redness, warmth, swelling, drainage, or pain at any injection site
• 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
• Notices itching, dizziness, shortness of breath, hives (raised itchy skin welts), or other signs of an allergic reaction after a taking any medicine. If this happens, call emergency medical services (911) before calling the cancer team.