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Day Care Concept

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Improving quality of life for cancer patients with outpatient day-care

Family support is of utmost importance to cancer patients, and we understand our patients’ needs. Being the first cancer institute of its kind to integrate highly specialised, personalised and comprehensive cancer diagnosis, treatment and wellness in Hong Kong, our day-care concept allows our patients to spend more time with their families and fight against cancer together.

 

Private Daytime Oncology Centres are developing at a rapid pace in the United States and other developed countries. Previous studies have even proven that services provided by day-care medical centres are more effective than hospital treatments in improving patient quality of life. As day-care medical centres focus on particular groups of patients in particular and provide more specialised services which permits them higher efficiency at a lower budget.

 

With rapid development in the pharmaceutical field, certain injections can be administered within a short period of time. The time taken for administering chemotherapy infusions has been significantly shortened from several hours to slightly over an hour, while immunotherapy treatments can be completed in as little as 45 minutes. Some targeted therapies are available in the form of tablets, eliminating the need for patients to be hospitalised when receiving their treatment.

 

Day-care medical centres provide a more relaxed setting for patients to receive their treatment. Patients receive care from dedicated medical staff who are experienced in the administration of chemotherapy. Together with the shorter treatment times enabled by the new types of chemotherapy, the daily routines of patients may experience only slight disruption, allowing them to enjoy more free time for faster recovery and an easier time dealing with the side-effects of chemotherapy. Furthermore, there are now even more insurance policies that cover outpatient day-care. Not only may patients enjoy the convenience of day-care services, but can also avoid the burden of medical expenses from their being insured.

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Outpatient care and home therapy

New types of suspended chemotherapy infusions allow for a significantly simplified administration process. Patients can now receive their treatment in day-care medical centres or even with home therapy plans, depending on their preference and circumstances. In some setups, patients may carry an infusion device that provides them with their chemotherapy continuously; whereby they only need to visit the clinic for the initial setting up of the device and may engage in other activities as usual during their infusion process, without the need to remain in the clinic or stay at home. While the initial setup may take up to a day, subsequent setups are simpler and require much less time. Afterwards, each continuous infusion process typically takes approximately 48 hours to complete. As new types of infusion chemotherapy offer more flexibility than ever before, patients can now get on with their usual outdoor activities with less disruption. Most patients only need bring along their ambulatory infusion pump (AMP) and have follow-up consultations regularly to keep track of their condition. Patients may feel fatigued easily after undergoing chemotherapy. They may also experience side-effects such as nausea, diarrhoea, and constipation for the first few hours following treatment; some of these side-effects may last for several hours. Instead of requiring patients to commute between the clinic and home, having home therapy can save them valuable time to allocate to their rest and recovery. In addition, patients are usually given medications to alleviate the discomfort caused by the side-effects from chemotherapy.

 

Before commencing with any chemotherapy treatments, doctors will hold consultation sessions and explain the chemotherapy procedure, as well as clearly explain the outcome, side-effects, and associated precautions to the patient. Common types of side-effects for chemotherapy include:

Exhaustion

Patients may experience tiredness, sleepiness, sadness, anxiety, a decline in attention span and appetite. Even with sufficient sleep, patients may still feel sleepy during the day. However, patients should never take sleeping pills that have not been specifically prescribed by the doctors, as sleeping pills may cause unintended drug reactions with the chemotherapy drugs, leading to potentially lethal consequences.

An upset stomach

Within hours after commencing chemotherapy, patients may feel nauseous for some time. As opposed to a normal diet, it is recommended that patients eat multiple light meals instead. Patients are also advised to consume food that they find particularly appetizing to help overcome the lack of appetite that chemotherapy may bring.

Constipation and diarrhoea

If patients suffer from constipation frequently, they should notify their doctor and see if a change in medicine or dose level is required. Patients that have diarrhoea to the extent that they become dehydrated should seek medical attention immediately. As soon as symptoms have alleviated, try to resume a healthy and balanced diet.

Nerve and muscle numbness

Some chemotherapy drugs are known to cause numbed nerves and muscles, especially in the fingers and toes and may also lead to muscle weakness in the lower limbs. However, these symptoms can usually be avoided by slight alterations to the treatment plan. Patients are advised to alert medical staff should they feel any numbness in their nerves or muscles.

Blood-related issues

  1. Inflammation
    When undergoing chemotherapy, skin wounds may inflame easily. Cold and flu are also harder to cure. If you catch a cold or have any other sickness during the therapy process, consult a doctor as soon as possible to avoid any interference with your rehabilitation process.
  2. Bleeding and bruising
    Because patients undergoing chemotherapy have a relatively low platelet count, the speed of blood clotting slows down and more time is needed to stop bleeding in the cases of wounds; which can take up to 10 minutes. Patients should take extra care when cutting nails or shaving to avoid cutting themselves.
  3. Anaemia
    Anaemia can be caused by a low red blood cell count. As a result, patients may feel fatigued or have pale skin.

Other long-term side-effects

Potential side-effects also include mouth sores, scalp hair loss, itchy or peeling skin, cognitive changes, declined fertility, etc.

Immunotherapy

Immunotherapy drugs are protein-based antibodies that combat cancer by either launching direct attacks on cancer cells or by assisting the restoration of immune system function. Compared to drugs based on chemical substances used in chemotherapies and targeted therapies, immunotherapy causes fewer and milder side-effects. Immunotherapy is also less likely to lead to drug resistance and so gives long-lasting and effective results. Immunotherapy drugs are generally injected intravenously every two to three weeks, with each session taking approximately one hour. The effectiveness of immunotherapy is research proven and it has been demonstrated that by using immunotherapy as a second-line treatment for lung cancer patients, patients attained a higher one-year survival rate than with just chemotherapy alone.

 

Currently, The Food and Drug Administration (FDA) of the United States has approved numerous immunotherapy drugs. The approved drugs can be used to treat lung cancer, melanoma, renal cell carcinomas, as well as head and neck cancers. Immunotherapy drugs are also registered in Hong Kong and are applicable to patients dealing with melanoma and lung cancer. Before undergoing immunotherapy treatments, patients may undergo PDL-1 tests to predict and evaluate the effectiveness of their immunotherapy. This allows patients to receive treatment sooner and savings wasting time and money on unsuitable or less efficient plans.

Targeted Therapies

Targeted therapies gained popularity in the late 90s. In addition to intravenous therapy, certain types targeted therapy medications can now be taken orally.

 

Targeted therapies can tackle cancers that are caused by specific types of cell mutation and target specific molecular targets and blocks the growth of cancer cells.

 

Compared to traditional chemotherapies, targeted therapies are more effective and patients suffer fewer side-effects. However, clinical experience suggests that drug resistance may develop when some targeted therapy drugs are used for around 9 to 10 months, as such it is best incorporated with other such treatment methods such as chemotherapy or radiation therapy (radiotherapy) for optimum results.

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