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Are at-home cancer treatments effective?

Some cancers can be treated with oral chemotherapy, which consists of pills a patient takes at home. Now, a new study shows it doesn't always go as planned.

RALEIGH, N.C. — Chemotherapy is a lifesaving treatment for many cancer patients. It’s given intravenously over a period of many hours. But many might not know that some cancers can be treated with oral chemotherapy, which consists of pills a patient takes at home. Now, a new study from Duke University shows that despite the benefits for patients, home treatment doesn’t always go as prescribed.

Deborah Tippett is a retired professor, world traveler and ballroom dancer, and for the second time in 13 years, she’s battling cancer.

“Doctors found, in a routine exam, a little abnormality which they decided to test,” Tippett said.

When Tippett had lymphoma years ago, treatment meant trips to a clinic and IV chemo. 

“Sometimes, it would be 10 hours by the time I met with the doctor had my blood work, had the treatment," Tippett explained.

This time, Tippett’s doctor had a lab test her tumor for genetic mutations and found an oral anti-cancer treatment that could work for her ovarian cancer. Duke University GYN oncologist Brittany Davidson, M.D., studies cancer patients and how they fare with this home treatment. 

“Several of my partners said, ‘Well, it's not going to be a problem. These patients have cancer, so, of course, they're going to take their treatment," Dr. Davidson said.

But, in a survey of 100 cancer patients taking oral anti-cancer treatment, Dr. Davidson found that 50% of patients took their medication exactly as prescribed — the right amount, at the exact time, under the correct conditions. 25% missed at least one dose in a week, and another 25% missed more than one dose.

“This tells us that adherence is still a problem,” Dr. Davidson explained. 

Earlier research suggested that side effects, patient support at home, and finances can all impact home treatment. Tippett and Dr. Davidson worked with the pharmaceutical company so she could afford her drug, Mekinist, and Tippett builds her day around medication time so that she never misses a dose. 

These days, Tippett is back on her toes, feeling more like herself again. 

“I'm just grateful to be living in a time where I could have all these options,” she said. 

Dr. Davidson said there’s no research that shows what happens when patients are occasionally late or miss an oral dose. If patients miss many doses, the treatment might not work as effectively, and if doses are too close together, the side effects might be more severe.

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