Many of the women who have opted for high-dose chemo and ABMT for ovarian cancer have paid for the treatment. themselves. Doctors have attempted to reduce costs by offering the therapy on an outpatient basis.
In Chap's protocol, the patient has surgery to remove the cancer. After recovering, the patient's peripheral stem cells are filtered from the blood and frozen. The patient undergoes two to four high-dose chemotherapy treatments as an outpatient, at 25-day intervals. After chemo, the stem cells are thawed and re-injected to restore the blood count and immune system.
"We wanted to see if we could bring down the cost," says Chap of the outpatient approach. "Breast cancer patients were in the hospital and bored to death. I don't know how often patients would say, 'I could be home for this.' Well, why not?"
Patients who undergo ABMT have very weakened immune systems and must avoid germ-ridden environments, experts say. Home is the best place for that.
"The most dangerous place with a person with an impaired immune system is the hospital," Dillman says. "The organisms one acquires in the hospital are more virulent."
Outpatients must take precautions such as consuming a low-bacteria diet (no fresh fruits or vegetables that can harbor bacteria), thorough hand-washing and wearing a mask to and from the hospital for check-ups.
Complications or side effects sometimes force patients into the hospital, Dillman says. And it's too soon to say how much outpatient high-dose chemotherapy and ABMT saves in costs.
In terms of comfort, patients like the setup and the hope the aggressive therapy gives them, Chap says.
"We've had five patients. All of the patients have done quite well and have unanimously said they liked being at home," Chap says.
Jensen says the early days of the treatment were nerve-racking.
As an outpatient, Jensen did not have the reassurance of nearby nurses. "I had to report any suspected fever or pain, and I felt very responsible for myself," Jensen says. "Also, my husband had to be a full-time caretaker. By the second month I was more at ease."
She took advantage of a computer online support group for women undergoing chemotherapy, and she relied on her faith and the prayers of family and friends, Jensen adds. She was especially fortunate to get insurance coverage.
"I feel lucky the insurance company was enlightened enough to do this," she says. "I'm back at work now, and my life is almost normal."