Chemotherapy backpack allows cancer patients to have treatment outside hospital

When cancer patients need chemotherapy they can spend hours, days, or even weeks undergoing the treatment in hospital.

But WalesOnline reports this could soon be a thing of the past thanks to a new ambulatory chemotherapy service at the University Hospital of Wales (UHW) in Cardiff.

The innovative project will allow eligible patients with certain types of blood cancer to take their chemotherapy outside hospital grounds in a bag or backpack.

It means that rather than having to stay on a ward people can remain in the comfort of their own home, or even go to the shops, while the drug fights the disease.

Bethan Ingram, a Teenage Cancer Trust senior nurse, was the nurse lead for the team responsible for setting up the service and believes it will greatly reduce the emotional impact on people living with cancer.

She said “Having this treatment is hard wherever you choose to have it.

“But it can make such a difference being in your own bed, eating when you want or making a cup of tea whenever you fancy it. That can all be very empowering for the patient and improve their wellbeing and quality of life. I think this has the potential to transform cancer care and how it is delivered.”

According to the latest figures, the number of people being diagnosed with blood cancers is rising in Wales and the rest of the UK.

This is putting increased pressure on key hospital services, reducing the number of beds available and putting the NHS workforce under huge strain.

In recent years the Welsh Government and health boards have aimed to introduce new models of care which allow patients to remain in their own homes when suitable.

Bethan Ingram said “Ultimately any time a patient spends in hospital is too long.

“Other parts of the country, and indeed the world, have been looking at different models of delivering therapies which normalises the process for people. For us the number one priority is improving the experience for patients and what better way to do that than to keep them at home?”

The ambulatory service was launched two years ago to initially help cancer patients who were undergoing autologous stem cell transplants.

This involves a patient’s own healthy blood forming stem cells being collected in advance, while they are in remission, and then returned to them at a later stage.

The transplants allow patients to have higher doses of chemotherapy, providing some with a better chance of a cure or long-term control of their disease.

It was found these patients could have these infusion treatments carried out away from the hospital grounds at home under regular supervision.

Now, thanks to £163,000 in funding from Macmillan Cancer Support, Macmillan haematology ambulatory care pharmacist Siobhan Smith has been brought into the team so that the chemotherapy aspect of treatment can be broadened and tailored to different types of the disease.

Siobhan Smith said in the near future it could become commonplace to see cancer patients walking around in public with their chemotherapy backpacks strapped around them.

She said “We need to ensure that the chemotherapy can be carried around outside the hospital safely and will still work as well as if given in hospital.

“With support from hospital pharmacy clinical and technical services colleagues, and in collaboration with colleagues in Cardiff University School of Pharmacy and Pharmaceutical Sciences, I have coordinated research studies to check that it remains safe and doesn’t degrade over the time the patient has it in the backpack.

“From the time it goes on to the time it comes off we have to ensure that it is not affected by temperature or any other conditions it is exposed to wherever the patient goes.

“Alongside this we also make sure that patients are educated and supported in managing their medicines at home.”

Richard Pugh, head of services for Macmillan Cancer Support in Wales, said “Cancer is not always life-threatening, but it is life-changing and we hope this innovative service supports people with blood cancer to retain some normality during their chemotherapy.

“The ambulatory chemotherapy service means eligible people being treated for blood cancer can go home or stay nearby at night rather than needing to stay in isolation, while knowing they still have 24-7 specialist support available if needed.

“We’re proud to be funding the Macmillan pharmacist at this brilliant service with money from our supporters and to be working in partnership with Cardiff and the Vale University Health Board.”

Ambulatory care nurse Gwawr Hughes manages the service on a day to day basis, liaising with staff, patients and their families to ensure it runs as smoothly as possible. She said so far thirty patients have used the ambulatory service.

She said “As a whole the feedback has been really positive.

“Patients no longer have the restrictions they had as an inpatient in the hospital. They can have a lie-in in the morning and use their own bathrooms – it’s just simple things that can make a huge difference.

“But it’s not for everyone. It’s up to the patients at the end of the day. They will never be forced to do this.

“And their carers play a huge in this too as it can be a bit daunting for them but they are supported as much as the patients.”

The haematological cancer service at UHW supports patients with different types of blood cancer including acute lymphoid leukaemia, acute myeloid leukaemia, and non-Hodgkin’s lymphoma. These blood cancers combined make up 15% of all cancer cases in Wales.

Bethan Ingram said patients and their families are educated in how to use the equipment at home but she stressed that NHS staff will be on hand twenty four hours a day to offer specialist medical support.

She said the service will allow people to carry on with their daily lives as much as they can.

She said “If you’re told that you’re going to be in hospital for up to four weeks it’s a very challenging thing to be faced with.

“So even if you can shorten that by a week or two weeks, or for some people the whole thing, it’s really important.

“We feel very committed to sharing this across Wales so that other hospitals can help support people in this way.”

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