Amid lockdown, is chemotherapy and cancer care at home the way forward?

The rapid spread of SARS-CoV-2, combined with an unprecedented, near-complete global lockdown, has prompted cancer patients to seek healthcare at home. This has provided a window for healthcare companies to offer home services.




For a Gurgaon-based breast cancer patient, the lockdown has been a difficult time. Fearing hospital-led infections, she has been undergoing chemotherapy at home. A stage four metastatic breast cancer patient, aged 50-plus, she has been undergoing treatment for three-and-a-half years. She said, “Before the lockdown, I was going to the hospital for chemotherapy cycle and treatment every 21 days. But now, undertaking one at one.”

The sentiment is echoed in the case of a Delhi-based 79-year-old, who was detected with stage three breast cancer in early 2019. “She was in hospital care but after the pandemic and subsequent lockdown, we decided to look after her at home as per the oncologist’s advice,” mentioned a family member. The family was initially concerned about the risk of infection with “nurses and physicians” visiting the home, “but the qualified and educated professional treatment has made us feel better about taking such a service”. For two months now, the bedridden patient has been administered the essential IV drugs at home as part of chemo care.

With the lockdown restrictions amid the novel coronavirus pandemic, there has been rising concern among cancer patients whose immune systems make them susceptible to the respiratory viral infection. They are increasingly raising queries and even opting for chemotherapy at home among other oncology services for multiple type of cancers including breast cancer, blood cancers, multiple myeloma and ovary cancer.

Their concerns are not unfounded as a March 2020 report of Cancer Care Delivery Challenges Amidst Coronavirus Disease – 19 (COVID-19) Outbreak published in Asian Pacific Journal of Cancer Prevention stated how cancer patients are more susceptible to coronavirus as they are in an ‘immunosuppressive state because of the malignancy and anticancer treatment’. The report went on to highlight that ‘Oncology communities must ensure that cancer patients should spend more time at home and less time out in the community’.

Agreed Dr Manish Singhal, senior consultant, medical oncology, Apollo Hospital, “While it is not a preferred mode of treatment, it is an arrangement between the patient, oncologist and the healthcare provider/medical company to maintain the schedule of chemo sessions.”

“Desperate times call for desperate measures. While there is a risk involved in tertiary anti-cancer therapy at home, it is to be monitored effectively. Also, since at least two or more sessions are first completed in the hospital, such treatment can be provided at home if the oncologist is on board with the course of treatment that includes administering anti-cancer drugs,” Dr Singhal told indianexpress.com. He informed that he has done 25 such infusions in the past few months with the help of Apollo HomeHealth Care, hinting at an “unprecedented” demand for such tertiary care.

That is perhaps why Portea Medical, a consumer healthcare brand, recently launched chemotherapy at home services in metro cities of Delhi, Bengaluru, Mumbai, Chennai and Kolkata to help cancer patients and survivors to avoid the risk of hospital-acquired infections by recuperating at home, said Dr Vishal Sehgal, MD, Portea Medical.

“Today, medical care is at an advanced level and both hospital and home-based care is possible. If there have been no adverse reactions after the initial sessions of chemotherapy in the hospital and if the oncologist approves with a detailed protocol formulated by  them, only then such a service is provided,” Dr Sehgal said.

While international brand HealthCare atHOME has been providing such a service for the past six years in India, it is now that the demand has seen a steep rise. “As OPDs are closed and patients don’t want to visit them for fear of contracting COVID, home chemotherapy and other oncology services have become a lifesaver,” said Dr Gaurav Thukral, executive vice-president and chief operating officer, HealthCare atHOME, India.

“The concept is slowly growing in India and we are trying to replicate the same model here. To build the confidence of doctors, we get them interviewed and train our existing experienced nurses. We keep them updated remotely via technology at every step of care delivery,” he said.

What happens in such at-home patient care settings?

As part of the home-based service, a trained and certified chemotherapy nurse is appointed for the session, which is supervised by a full-time doctor provided by the healthcare company. Besides administering medications like pills and injections, and IV chemotherapy or antibiotics, therapies administered via patch or suppository, the nurse reviews the health history, keeps a record and tracks pathological, laboratory and imaging studies, assesses and monitors emotional and physical status and carries out regular communication with the oncologist on a patient’s behalf.

“It is a very comfortable and smooth experience. I faced no issues at all. They have been very supportive. The oncologist has also been in constant touch with me,” according to a patient. She added that her procedure is done in a “different room where I don’t allow my family members and anyone else to come; only the doctor and the nurse who attend to me are there with me throughout”.

Cancer patients require specialised care, attention, and monitoring as they undergo recovery at home. In such a situation, having an oncology nurse by your side ensures a proper monitoring of one’s needs and offers the care required for a speedy recovery. From assisting them in daily activities to mitigating stress during complications arising out of pain, nausea, etc, home-care assistants help prevent unnecessary distress from symptoms and make the patient feel as comfortable as possible,” remarked Dr Thukral. He added, “High standards of hygiene and infection-control at par with that of hospitals is followed.”

How convinced are doctors with it?

While several oncologists like Dr Singhal are on board with the concept, there are still others like Dr Shyam Aggarwal, senior consultant, medical oncologist, Sir Gangaram Hospital, Delhi, who holds that “it amounts to jeopardising one’s life”. “What if an adverse reaction takes place? Jeopardising the life of a patient is a risk not worth taking. Administering a drug at home is definitely very different and opens up the possibility of something going wrong manifold. The risk, therefore, lies with the treating oncologist,” said Dr Aggarwal, who has more than three decades of clinical experience.

However, given the “improvement in the quality of care for cancer patients through a patient-centered approach”, patients’ needs rather than prognosis is seen as a way of improving the quality of care, pointed out Dr Thukral. “The delivery of oncology care at home is increasingly seen as a way of improving the quality of care and as a cost-effective alternative in recent times,” he said.

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Christina Milian Talks Starting a Baby Line, Homeschooling amid Pandemic and Her Newborn Son


Four months after giving birth to her second child, Christina Milian says "life is good."

The actress and singer, 38, welcomed son Isaiah in January with her boyfriend, Matt Pokora. Isaiah joined 10-year-old big sister Violet Madison, whom Milian shares with ex-husband The-Dream.

Milian tells PEOPLE in a new interview that despite the ongoing coronavirus global health crisis, she is grateful to be able to spend quality time with her family.

"I'm super happy. I have a really happy baby," she says. "And honestly, with all this stuff going on, it kind of was a blessing in disguise to be able to spend so much time together, and to not be forced to rush right back to work. It's been nice to just be home and be with my daughter and have this bonding experience."

"Hopefully this is a once-in-a-lifetime thing that's happening [and] not something that will happen often," Milian adds of the pandemic. "But whatever the case may be, I'm an optimistic person — I look at the positivity in it all."

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Christina Milian "Felt the Love" During Baby Shower for Son on the Way: "I Had Such a Great Time"

Milian has been keeping busy since having Isaiah, recently debuting a baby line with Your Babiie titled AM:PM by Christina Milian.

The collection, which includes a range of strollers, high chairs and diaper bags, is meant to "really stand out" and appeal to "modern moms," Milian says.

"I wanted to provide a really cool and kind of stylish baby gear line because everything else is pretty basic," she tells PEOPLE. "I just wanted to do something different."

The Bring It On: Fight to the Finish star has also been helping to homeschool her daughter Violet while schools remain closed amid the pandemic.

"I thought it would go better than what it is," she says, laughing. "I'm actually having a great time working with her and going over her school stuff."

"I think the parents all think we're doing a good enough job, but then you almost take it personally if she's not getting straight As because you're like, 'Wait, hold on, I'm helping do all of this,' " Milian adds.

Christina Milian Is "Mom of the Year" for Setting Up Meeting Between Daughter and Cardi B

Milian says that Violet's personality "really shines" when the mom of two films for her Facebook Watch series, What Happens at Home with Christina Milian.

"She's just a light bulb — when she turns on, she turns on. She's so funny," Milian raves. "She's got a lot of facial expressions and hand motions and things that sometimes I'm like, 'Where did this character come from?' "

"But I love that she can really express herself and has fun, and doesn't feel uncomfortable," she adds.

As information about the coronavirus pandemic rapidly changes, PEOPLE is committed to providing the most recent data in our coverage. Some of the information in this story may have changed after publication. For the latest on COVID-19, readers are encouraged to use online resources from CDC, WHO, and local public health departments. PEOPLE has partnered with GoFundMe to raise money for the COVID-19 Relief Fund, a GoFundMe.org fundraiser to support everything from frontline responders to families in need, as well as organizations helping communities. For more information or to donate, click here.

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Pregnant Hilaria Baldwin Takes 'Baths Morning and Night' to Help with Feeling 'Overwhelmed'

Hilaria Baldwin might be a busy mom of four, juggling parenting and homeschooling her children amid the coronavirus pandemic as they continue to social distance together, but she still finds the time for self-care.

In a video for Verizon Media/Yahoo's "Reset Your Mindset" virtual event, the fitness instructor and Mom Brain podcast co-host, 36, reveals a few of the ways she is "spending 'me time' " during the crisis.

"I close myself off in my bathroom and I love to exercise and do breath work," she says. "I take baths morning and night — that really, really helps me."

Of course, sometimes she is joined by her "little people" — sons Romeo Alejandro David, 2, Leonardo Ángel Charles, 3½, and Rafael Thomas, 5 next month, plus daughter Carmen Gabriela, 6½ — but she doesn't mind, and just appreciates "the warm water on [her] skin."

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Pregnant Hilaria Baldwin on "Nonstop" Day While Social Distancing with 4 Kids amid Coronavirus

Hilaria, who is sheltering in place with husband Alec Baldwin and their kids while pregnant with their fifth child together, says that when she's having a tough time mentally, "I always think about how much worse it could be."

"How much worse it could be all of a sudden makes my situation seem not as bad, and with that, it pulls me up a little bit," shares The Living Clearly Method author, "and allows me to have a lightness and a strength to be able to attack my problem."

But she certainly has her moments when she just needs to let it out, too. "I cried the other morning, and it was over a bunch of really silly little things," Hilaria recalls. "And I don't typically do that, and my kids were [taken aback]."

"I wasn't freaking out on them — I just had tears," she clarifies, laughing. "There were just tears because I was so overwhelmed."

Hilaria — who suffered a miscarriage last April and another at four months along in November, while expecting a baby girl — recently chatted with PEOPLE about how she and her family are looking at the big picture amid the global health crisis.

"Alec and I were complaining about it a week or so ago and Carmen was asking about it and I said, 'Carmen, nobody wants to be doing this right now. It's frustrating for us all to have to stop our normal lives,' " she said in late March. "And she's like, 'I don't know what you guys are talking about, I love this. I love spending time with you. All I want to do is spend time with Mommy and Daddy and my brothers.' "

"And it kind of stopped us in our tracks and our mouths were open and we were like, 'Okay, let's go with that mentality, because that sounds so much better than complaining, which is what we've been doing!' " Hilaria added.

As information about the coronavirus pandemic rapidly changes, PEOPLE is committed to providing the most recent data in our coverage. Some of the information in this story may have changed after publication. For the latest on COVID-19, readers are encouraged to use online resources from CDC, WHO, and local public health departments. PEOPLE has partnered with GoFundMe to raise money for the COVID-19 Relief Fund, a GoFundMe.org fundraiser to support everything from frontline responders to families in need, as well as organizations helping communities. For more information or to donate, click here.

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Kristin Cavallari: I'm Going 'Stir-Crazy' Parenting 3 Kids Amid Pandemic

A new normal. Kristin Cavallari is struggling to adjust to parenting three young children amid the coronavirus quarantine.

The Very Cavallari star, 33, opened up about the unexpected challenges she’s facing with her sons, Camden, 7, and Jaxon, 6, and 4-year-old daughter Saylor — whom she shares with her estranged husband, Jay Cutler — in an Instagram Live conversation with her stylist Dani Michelle on Saturday, May 16.

“I’m at my friend Justin’s house right now. We’ve been together for the entire quarantine time, literally from day 1,” Cavallari explained, referring to her pal Justin Anderson, with whom she and Cutler, 37, spent three weeks on vacation in the Bahamas in April.

“With my kids, it’s, like, ‘All right, what should we do today?’ We’ve maxed out every creative idea,” the Hills alum said. “I used to wake up at 5 a.m. every morning, work out and then I would get my kids ready for school, take them to school and go to the office. I haven’t set an alarm since all of this has been going on. It’s going to be really hard for me to get back into it. I don’t know that I can go back to that 5 a.m. lifestyle.”

Cavallari noted that she now has a later start to her mornings due to the quarantine and sharing a bed with her children.

“Because of my kids, I get up from anywhere between 6:30 and 8. I don’t normally let my kids sleep with me, but I’ve been rotating my kid for the last week,” she said. “It’s cute but those are the moments that will never be the same, we’ll never get those back. So in that sense, I’ve been trying to really enjoy that time with my kids.”

The Uncommon James designer has also undertaken the “tough” job of homeschooling — a feat that has been particularly difficult for her youngest son.

“I will tell you, the no school thing is tough,” Cavallari said. “With the boys, Jaxon will not listen to me. He refuses to do work. I’m like, ‘I can’t fight with you about doing schoolwork.’ It’s too hard.”

She added, “My kids are young so that’s nice. My boys are 7 and 6 so it’s not the end of the world if they’re not sitting here doing schoolwork every day but everyone’s going a little stir crazy because we really can’t go anywhere.”

Cavallari and the retired NFL quarterback announced their separation in April after seven years of marriage. Us Weekly confirmed on May 1 that the former couple settled on a custody agreement for their children, with each parent receiving 182.5 days a year.

After their split, Cutler penned a sweet Mother’s Day tribute to Cavallari on May 10.

“Happy Mother’s day to all the moms. These 3 little ones picked a good one,” Cutler wrote alongside a photo of Camden, Jaxon and Saylor via Instagram.

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Coronavirus: Big tobacco sees an opportunity in the pandemic

Over the last few months, as COVID-19 has spread around the world, big tobacco has exploited the pandemic to push its branding and products. The industry never misses a trick when it comes to exploiting the chaos of international crises, including wars. The current pandemic is no exception.

The strategy is to use the pandemic to try and shift their image from vilified industry to trusted health partner. The tactics they have employed to achieve this are shameless, even for an industry as controversial as tobacco. There are examples of tobacco companies offering assistance in the form of ventilators, gels, PPE and even cash. They are even involved in trying to develop a vaccine. While there is no doubt that these have been gratefully received by authorities struggling with a chronic lack of resources, the industry has been up to other tricks, too. And one British FTSE 100 company is proving particularly adept.

In March, as many governments began to lock down their populations, British American Tobacco (BAT) began co-opting universal health messages. These were then placed on branded face masks, which were subsequently handed out to social media influencers for free.

Instagram remains one of the key marketing platforms for the industry. In 2019, BAT paid Instagram influencers to promote glo, its heated tobacco device, among other products. One of the hashtags used was #todayiwill.

BAT’s Instagram campaign ran into trouble, though. In December 2019, in a landmark decision, the UK Advertising Standards Authority, ruled against BAT and three other firms for promoting an e-cigarette, Vype, on Instagram, after a complaint by ASH, Campaign for Tobacco-Free Kids and STOP, of which the University of Bath is a partner. Later that month, under pressure to act, Facebook and Instagram announced that “branded content that promotes goods such as vaping, tobacco products and weapons will not be allowed”.

Undaunted, BAT appeared to use the social media platform as a COVID-19 marketing tool, especially in countries where oversight was likely to be less stringent. BAT simply changed the #todayiwill hashtag to #todayIwillstayhome, to reflect the messaging from governments for people to stay at home. Evidence uncovered by the Campaign for Tobacco-Free Kids, which has been tracking BAT’s activities, found that in Kazakhstan among other countries, BAT provided influencers with “today I will stay home” glo masks. Other hashtags used included #glomask.

The company used other COVID-19 hashtags, too. An influencer appeared on one BAT Vype account in Spain, using #frenalacurva, the Spanish for “flatten the curve”. BAT employed similar tactics in Latin America and Europe. This meant if you were searching on Instagram for these government messages, you would come across BAT’s subliminal marketing.

Days before the glo-branded masks started appearing on social media and right in the middle of the pandemic, BAT launched a glossy rebranding exercise unveiling a new slogan “For a Better Tomorrow”. The company replaced its old tired leaf logo with bright rainbow colours.

‘New adults’, new market

BAT’s board told investors that its redefined mission was now “stimulating the senses of a new adult generation”. This essentially means entrapping a new generation of young people into nicotine addiction, from vaping, heated tobacco products to cigarettes.

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Pink Calls Coronavirus Battle with Son Jameson 'Most Physically and Emotionally Challenging Experience'

Pink is opening up about her experience battling the coronavirus alongside her 3-year-old son, Jameson.

Ahead of the Mother’s Day holiday on Sunday, the singer, 40, wrote an essay for NBC News reflecting on the current coronavirus pandemic and what it means for mothers around the world.

“Mother’s Day is this weekend and I have been reflecting on the wonderful, yet challenging gift of time that life in COVID-19 quarantine has meant for me and my children,” she begins in the essay. “To be a mom, a teacher, a cook, a confidant, and a badass dream chaser all at once is no small feat. Mamas everywhere, you are doing amazing.”

The mom of two also details how parents are currently “defining a new normal” for their children, adding that “the virus knows no boundaries” and parts of the world may be just beginning to feel its effects.


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Pink, who revealed in early April that she and her son battled the coronavirus, also reflects her own experience with the respiratory illness in her essay.

“Battling COVID-19 along with my 3-year-old son was the most physically and emotionally challenging experience I have gone through as a mother,” Pink writes. “Weeks after receiving our test results, my son was still ill and feverish. It was a terrifying time, not knowing what might come next.”

The star adds, “But our story is not unique; there are mothers all over America, and the world, that are facing this same uncertainty every single day. Not every family, especially those living on reservations, or in refugee camps, slums, or favelas, are able to practice social distancing. In many parts of the world it can take hours just to access water, and even then, soap may be an impossible luxury.”

Shortly after revealing her and Jameson’s diagnosis on Instagram, Pink said that although they were both feeling better, the young toddler “had the worst of it.”

“Jameson has been really, really sick,” she said during an Instagram Live chat with her friend and author Jen Pastiloff on April 4. “I’ve kept a journal of his symptoms for the past three weeks and mine as well. He still, three weeks later, has a 100 temperature. It’s been a rollercoaster for both of us, but Carey and Willow have been perfectly fine.”

In her essay, published on Saturday, the “Beautiful Trauma” singer also urges fans to “put ourselves in the shoes of moms around the globe and consider doing what we can to help keep their babies safe.”

“How can we partake in ensuring their access to the basic human rights that so many of us are afforded each and every day?” she asks.

As information about the coronavirus pandemic rapidly changes, PEOPLE is committed to providing the most recent data in our coverage. Some of the information in this story may have changed after publication. For the latest on COVID-19, readers are encouraged to use online resources from CDC, WHO, and local public health departments. PEOPLE has partnered with GoFundMe to raise money for the COVID-19 Relief Fund, a GoFundMe.org fundraiser to support everything from frontline responders to families in need, as well as organizations helping communities. For more information or to donate, click here.

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