We report a case of administrating an anticancer tablet to a castration-resistant prostate cancer (CRPC) patient undergoing tubal feeding. The patient was undergoing tubal feeding due to progressive bulbar palsy and impaired consciousness with dysphagia. The patient was doing well on maximum androgen blockade at home for prostate cancer. However, his prostate-specific antigen (PSA) was elevated, and the disease was progressing into CRPC. Since imaging tests showed no metastasis, we prescribed apalutamide. we needed to administer it via gastrostomy because the drug was in tablet form. The tablet was crushed and mixed with warm water, and the administration was performed by a facility nurse and the patient's family at home. The patient‘s PSA decreased after three months of administration and was below the measurement limit after nine months, indicating significant efficacy.
Occupational exposure prevention measures have been promoted for the handling of anticancer drugs to ensure the safety of healthcare workers. As home care advances, more people are expected to receive cancer chemotherapy at home or in facilities for long-term care. Not only ward nurses but also outpatient nurses, visiting nurses, and facility nurses need to be fully aware of possible effects due to exposure to anticancer treatments. In addition, it is necessary to promote education and prepare manuals to prevent exposure and provide guidance to patients and their families. Collaboration among multiple professions is also essential in in-home healthcare. In the present case, the daughter who administered the drug at home was a former caregiver. In living environments such as homes and facilities for long-term care, there is a possibility of exposure to active anticancer drugs contained in the excretions of patients.