Dr Ciara O’Hanlon Brown
Consultant Medical Oncologist, St James’s Hospital Dublin
Senior Oncology Pharmacist, St Luke’s Hospital Kilkenny
Clinical Nurse Specialist, University Hospital Limerick
New ways of administering breast cancer treatment can enhance women’s quality of life while alleviating hospital capacity issues.
For years, it was typical for breast cancer patients to sit for multiple hours in busy infusion suites to receive their treatment intravenously. This time-consuming treatment could be disruptive to the lives of patients, making it difficult for them to continue their normal daily routines. For some, it was exacerbated by the need to travel long distances to the nearest infusion clinic. Each treatment required significant time and attention from busy nurses, placing a heavy burden on the capacity of the hospital system
However, recent innovations in cancer care have led to a shift in how some treatments are administered, allowing patients to spend more time living their lives. These new methods of administration also benefit the healthcare system, through cost-saving and resource capacity in the oncology pathway.
Better treatment options available
Ciara O’Hanlon Brown, Consultant Oncologist in St James’s Hospital Dublin, says: “Breast cancer treatments have improved greatly in my 15 years working in this area. We are seeing better success with each treatment. Increasingly, patients are on less toxic treatments, which they are responding well to, and are living longer.
“We are increasingly giving oral treatments and some treatments given intravenously are administered subcutaneously (beneath the layers of the skin).” These treatments require patients to spend much less time in the infusion suite, sometimes reducing the time from hours to minutes.
She says this approach can ultimately improve quality of life for patients with breast cancer. “There was a time when a patient’s life was dictated by their treatment. We now have opportunities to fit treatment around their lives, families and work.”
It’s a sign of a revolution in cancerDr Ciara O’Hanlon Brown
treatment that we have patients on
effective treatments who are living well.
Administering treatment in a ‘patient-friendly’ way
Many cancer units are moving toward options which allow administration to be given closer to where patients live without them having to travel frequently to specialist hospitals. “Breast cancer treatments are every three weeks or so. Rather than patients taking a day or half a day out, we want to give them treatment closer to home, so they can go and see a nurse, have an easy injection or an oral treatment and go home. This has a huge impact on their quality of life,” says Dr O’Hanlon Brown. She adds that: “As we are treating patients earlier and for longer in their disease, we have more pressure on our capacity. Anything we can do to administer treatments more easily is a win-win.”
Maureen Kyne is a Clinical Nurse Cancer Specialist at University Hospital Limerick: “Some patients still need to come into our hospital to receive treatments if they require blood tests, for example. However, we have seen a reduction in the time patients spend in hospital, which now can be as little as 10 minutes. This was particularly important during Covid when we could treat breast cancer patients more quickly and focus our resources on day care.” Maureen adds: “By moving breast cancer treatment closer to where patients live, we are fulfilling the Irish Government’s SlainteCare ambition. This is a 10-year plan to put people at the centre of the health system by delivering primary and community health services so people can stay healthy in their homes and communities as long as possible. She adds: “We are finding patients are less sick, so are less likely to be admitted to hospital. In general, they are leading fuller lives, which was not the case even 10 years ago.”
Improved storage and efficiencies
Senior Oncologist Pharmacist Niamh Kelly is dispensing cancer treatments in Kilkenny with her nurse colleagues who prepare and administer the vials to eligible patients. “These new vials take about 10 minutes to prepare. We can also keep them in our fridge for up to 18 months,” she explains. “It has freed up time for ordering and preparing other therapies.”
Dr O’Hanlon Brown concludes: “It’s a sign of a revolution in cancer treatment that we have patients on effective treatments who are living well. Having the drugs administered in a simpler way means they can start to be rolled out in a non-hospital environment. They still have to be dispensed by a trained healthcare professional but, hopefully, we can roll it out locally.”
Contributors were not remunerated for their participation.