Chemotherapy could be given at patients' workplace

Editor—The first sentence of the editorial by Young and Kerr about home delivery of chemotherapy assumes that shifting care to the community means shifting it to patients' homes.¹ This is echoed in the introduction of the paper by Borras et al about home versus hospital delivery of chemotherapy for people with colorectal cancer.²

In real life, however, many people are at work all day. For some of these, having treatment in the workplace would be more convenient than either home or hospital. I had a six month course of chemotherapy three years ago (although not for colorectal cancer), and usually I fitted in my chemotherapy around my work commitments. But having to go to the hospital for the treatment meant time out of the working day. If a nurse had come to my workplace there would have been much less disruption. As far as home treatment is concerned, that would have had little, if any, benefit for me because I would have had to wait in for the nurse to arrive (like waiting in for the plumber), or I would have had to go home during the working day to have the treatment. But having treatment at my workplace would have allowed me to get on with my work if there were delays in the nurse arriving, and it would have cut down on travelling.

People's individual circumstances and the state of their health will determine where it is best for them to have treatment, but in looking at alternative ways to deliver services, we need to think not just of home or hospital: people lead their lives in other places too, including places of work and study. Large places of work or study are likely to have a first aid or medical room and perhaps an occupational health nurse, so having treatment should be straightforward. Even in smaller places it is not necessarily impossible.

These principles apply not only to treatments for cancer but also for other diseases, particularly chronic diseases. In the past I have had weekly gold injections, which I had either at the hospital or at the general practitioner's surgery. The option of treatment in the workplace would have been very attractive, particularly as travelling, by any means, with active rheumatoid arthritis is rather a pain.