How at-home chemotherapy sessions helped a woman battle cancer a second time. Yes, it’s possible

Cancer usually hits you in two ways. First, it makes you uncertain about making it through. Second, it worries you sick about managing the resources to sustain the treatment. For Kanchan Pande, there was a third. Should she venture out amid the lockdown for treatment and risk exposure at a hospital? Today, as she gets a chemotherapy session done at her home, lying on her own bed with her husband and son around her, she knows she has won half the battle.
At 60, Kanchan has defeated a second bout of cancer with a little bit of hand-holding her doctor and paramedic, who showed her how a cheaper alternative could give hope to patients.
THE DIAGNOSIS THAT WENT WRONG ABOUT A RELAPSE
“I was diagnosed with breast cancer in 2010 after which I had the tumour removed. I was in fine fettle for the next 10 years. But it resurfaced in 2020, right in the middle of the pandemic. I was worried about managing my treatment and exposing myself to possible infection,” says Kanchan. According to Balaji Pande, her husband, there was also a delay in diagnosis. She started feeling familiar symptoms in October but the doctors said she was healthy.

“But as her discomfort continued, we visited the doctor again a couple of months later and early last year got the PET Scan test done. The results revealed that the cancer had relapsed,” says Balaji.
“We visited a senior oncolog at a private hospital in southeast Delhi and he suggested chemotherapy sessions on March 8, 2021,” says Kanchan, a resident of Sarita Vihar. After several tests, doctors ruled out surgery and suggested only chemotherapy sessions. She remained there for two days.
Kanchan with her husband Balaji Pande. (Express Photo)
But the family, which had already borne the burden of heavy expenses in 2010, had another problem coming. A decade had pushed up treatment costs and both father and son were left with huge bills. During her chemotherapy, a number of injections, including an injection called Perjeta, was infused in the drip. Perjeta alone costs around Rs 2.50 lakh and is a monoclonal antibody used in combination with Trastuzumab and Docetaxel for the treatment of metastatic HER2-positive breast cancer. Kanchan was given strong doses of these drugs and was kept under observation. On March 10, the Pande family came back as the second cycle of chemotherapy session had to be done after 21 days.
HOW THEY RATIONALISED THE BILLS
Both Balaji, a researcher, and Kanchan, a social worker, have retired from their jobs and been living on Balaji’s pension. Clearly that was not enough to afford the cancer medicines and they had to spend lakhs out of their savings. “We then shifted to another branch of the same hospital in Noida where there were some tax concessions and the hospital charges were lesser compared to the Delhi branch,” says Balaji, who used to work at a research institute in Odisha.
The couple’s son, who was then studying in the US, came back and attended to his ailing mother. “He used to take his mother for chemo sessions and I used to take care of the house,” Balaji says. Kanchan says these ran for 10 hours initially and were then reduced to five hours. She did four cycles, each 21 days apart.
Kanchan with her husband and son. (Express Photo)
This was the time when the Delta variant-led Covid pandemic was on the rampage and another lockdown had been imposed. For Kanchan, the risk just got amplified. “The hospital where I was getting my chemo sessions done did not have a COVID ward and we were very sceptical as we had to meet several people in the hospital. Not just this. The expenses were rising and our insurance company refused to pay for the chemotherapy after it changed its terms and conditions,” she says.
WHAT THE INSURANCE COMPANIES DO NOT TELL YOU
“We had a Rs 5 lakh insurance with a government company, which had cleared the amount when Kanchan got admitted in 2010. When we renewed the insurance with an entitlement of Rs 5 lakh, they didn’t tell us that rules were different for cancer survivors. They took the money and issued a policy. Then they flatly refused to pay us more than Rs 50,000,” claims Balaji.
“Four drugs were being used in my chemo sessions, each of which was highly expensive. One medicine costs Rs 2.55 lakh in hospitals but if you buy it on your own, it costs Rs 2.10 lakh. Another medicine costs Rs 24,000 in hospital while outside, it is available for 12,000. There is a huge difference in prices. Another medicine, which was being given for my bones, cost us Rs 1,600 in hospital but Rs 600 outside. Besides these, there were other hospital charges and out-of-pocket expenses as well,” says Kanchan, highlighting the cost burden for cancer therapies in private facilities. There was a time when the family considered dropping therapy altogether.
AT-HOME CHEMO WORKS JUST AS WELL, IS CHEAPER
But the doctor who treated her was very supportive.
Considering their financial condition, he suggested that she get the remaining chemo sessions done at her home under his supervision.
“He gave us confidence and advised us to get the remaining treatment at our home and assured us that it would not be a problem. From the sixth cycle which started in June, I started my chemo sessions at home. At times we would also video-call him to crosscheck if I was following the right procedure,” says Kanchan.
She is still continuing the chemotherapy but now two drugs have been dropped after the doctor’s guidance. “For radiotherapy, we had to go to the hospital which is also very expensive and we spent around Rs 4 lakh. Every time before radiotherapy we had to get the Covid test done, each round costing us Rs 500,” says Kanchan.
But her anxieties eased with her home chemotherapy sessions. “At the hospital, the staff treated patients nicely only when doctors were around. At other times, they paid no attention to your issues. During my second chemo session in the hospital, there were issues with my cord which was not properly placed on my chest, causing me extreme pain. What people do not realise is that a cancer patient is anyway bogged down emotional stress. The pain can snap your tether literally. There was nobody to adjust my cord between 9 am and 10 pm as I struggled with pain. My son could ultimately get a nurse who fixed it,” she says.
For home chemo sessions, a trained paramedical officer from a home care service visits Kanchan’s house and sets up the drip stand with the required injections. “He brings sanitiser, gloves, drip stand and any other medicine that we might fall short of. He sits for three-and-a-half hours till the time the infusion continues and in cases of emergency, coordinates with the doctor,” Kanchan says.
“I think people suffering from cancer can go for at-home chemo sessions after consulting their doctors,” she suggests, clearly satisfied the experience.
Praising the paramedical officer, Kanchan says that he has been extremely cooperative and patient with her. “He charges Rs 10,000 per session and sits there for three-and-a-half hours,” she adds. And had he not been around, she would not have been able to defeat cancer again. “I am very grateful to him,” she adds.