Facility that will crush chemo drug

[ashleycancerfighter]

My aunt has a very rare form of cancer. Her oncologist prescribed a chemo drug that is highly effective at beating her cancer. The survival rates are 80% and above with the drug. Without the drug, she will likely die within a matter of months or a year or two at the most. The oncologist ordered a swallow study and my aunt passed. However, the nursing home speech pathologist said my aunt coughs a little while taking the pill so they won't administer it to her. They will not crush the pill like they do her other pills because it is a chemo drug. They say you need a special license and room where the person crushes it wears a special hood. Does anyone know where to find such a facility where my aunt could live and they could crush her cancer pills? Alternatively, is there any way for us to sign off and sign a waiver making the nursing home give her the pills? The oncologist said we should try to find a way to do that since the choking risk is so small and she will likely die anyway.

[Rebekulous]

I don't think any facility is going to crush oral chemo -- there's too much risk of exposure for the staff, and I highly doubt there are any SNFs that have a hood to do it properly. You might also be able to talk to the facility and find out if they would do the waiver thing. You might be able to find a compounding pharmacy that would do the chemo as a solution instead of a pill, but that would depend on the stability of the drug.

[KelRN215, BSN, RN]

I agree SNFs don't have chemo hoods or chemo pharmacists. What's to stop your family from stopping in and giving her the medication though? Is your aunt competent? You could also look into a chemo pharmacy which may be able to compound the medication.

[abrn348]

Does her oncologist's office do chemo infusions? If so, they likely have the hood there. Can their pharmacy crush the pills?

[Decitabinequeen]

We mix all of our own chemo prior to infusion as we have a hood (I'm in a clinic). There's no way we'd crush a home medication for a patient and then dispense it back to them.

[AAOnc22]

In general, oral chemo's shouldn't be crushed anyway, there's a reason it is a pill and not a powder. You could try doing some research on if the chemo is available in other forms/routes but usually that will cost more and insurances won't cover it, especially if she passed a swallow eval for pills. Your best bet is to try and get a waiver from the facility to allow her to swallow the chemo, whether administered by their nurse or by family. The only other option would be to switch SNF facilities....Which may be worth the hassle since this chemo seems promising.