Cancer care is steadily shifting out of the hospital and into the home. For many patients that is a welcome change. It also raises a question we cannot ignore.
Care travels — do the skills?
When treatment moves home, the side effects move with it. But the concentrated expertise that lives in an oncology ward does not automatically follow. A patient managing a reaction at their kitchen table needs the same quality of guidance they would receive on the ward.
That gap is where avoidable dose reductions and unnecessary suffering creep in.
Building expertise that scales
Closing the gap means equipping more people — homecare nurses, patients and their families — with clear, structured ways to recognise and respond to side effects early. It means accredited training and shared methods, not ad-hoc advice.
This is precisely why I built the Dutch Centre of Expertise for Side Effects of Cancer Medicines: to make sure expertise scales as care decentralises.
An opportunity, not just a challenge
Handled well, the shift home is a chance to make side-effect care more proactive and more personal than it ever was in the hospital. Side effects don’t have to be a barrier — they can be an opportunity to care better.