The cool autumn breeze rustles through the maple trees outside Karen Henley’s small bungalow in Saint John. Inside, the 64-year-old retired teacher settles into her favorite armchair, adjusts her oxygen tube, and carefully administers her cancer medication. Two years ago, this moment would have required a lengthy hospital visit. Today, it’s just another Tuesday at home.
“I used to dread those hospital trips,” Karen tells me as I sit across from her on a recent visit. “Four hours of driving, finding parking, waiting rooms full of other sick people. By the time I got home, I’d be completely drained. Now, my treatment comes to me.”
Karen is one of the first twenty patients enrolled in New Brunswick’s pioneering at-home lung cancer treatment program, launched this September by Horizon Health Network. The initiative represents a significant shift in cancer care delivery that healthcare providers believe could transform treatment experiences for patients across the province.
The program focuses on oral therapies for non-small cell lung cancer, allowing patients to take prescribed medications in their homes rather than receiving intravenous chemotherapy in hospital settings. For residents of New Brunswick—Canada’s only officially bilingual province with vast rural areas—this approach eliminates substantial travel burdens while maintaining clinical efficacy.
Dr. Nadia Lachance, Chief of Oncology at the Saint John Regional Hospital, has been advocating for this program for nearly three years. “Geography shouldn’t determine cancer outcomes,” she explains during our conversation at the hospital’s oncology ward. “With many modern lung cancer treatments available in pill form, we saw an opportunity to bring high-quality care directly to patients while reducing strain on our facilities.”
The program involves more than simply mailing medications. Specialized oncology nurses make regular home visits, conducting assessments and providing education. Patients also receive virtual check-ins between visits and have 24-hour access to clinical support through a dedicated phone line.
Statistics from Cancer Care New Brunswick show approximately 680 New Brunswickers are diagnosed with lung cancer annually. Nearly 40 percent live more than an hour from the nearest cancer treatment center. For these patients, each hospital visit represents not just medical care but a significant logistical challenge.
“We’re seeing the healthcare system adapt to patient needs rather than forcing patients to adapt to the system,” says Dr. Lachance. “It’s a small but meaningful revolution in how we deliver specialized care.”
The program builds on lessons learned during the COVID-19 pandemic, when healthcare providers were forced to find alternative delivery models. Data collected by the Canadian Cancer Society during that period suggested patients receiving at-home treatments reported improved quality of life metrics and, crucially, better medication adherence—a critical factor in treatment success.
Back in Karen’s living room, she shows me a carefully organized medication box and a tablet computer provided by the program. The tablet connects her with her healthcare team and contains detailed instructions for her treatment regimen.
“Having lung cancer is terrifying enough without having to navigate the healthcare system,” she says. “This program gives me some control back. I can take my medication while watching my grandchildren play in the yard instead of staring at hospital ceiling tiles.”
The financial implications are significant as well. Early projections from Horizon Health suggest the program could reduce hospitalization costs by approximately $4,300 per patient annually while freeing up capacity in oncology departments. This matters in a province where healthcare spending accounts for nearly 40 percent of the total budget, according to New Brunswick’s Department of Finance.
However, the program isn’t without challenges. During a visit to the Saint John Regional Cancer Centre, I speak with Marie Arsenault, the program’s coordinator, who acknowledges the complexity of ensuring patients receive appropriate support outside clinical settings.
“We’re constantly refining our processes,” Arsenault explains. “There’s a delicate balance between hospital-level monitoring and the comfort of home care. We’ve implemented rigorous training for our home-visit nurses and established clear protocols for when patients need to return to hospital settings.”
Patient selection is also carefully considered. Not everyone with lung cancer qualifies for at-home treatment. Candidates must meet specific clinical criteria and demonstrate the ability to manage medications independently or have adequate support systems in place.
For Indigenous communities in New Brunswick, the program offers particular promise. Jessica Paul, a health navigator with the Wolastoqey Nation, sees the initiative as addressing longstanding barriers to care.
“Many of our community members have deep distrust of institutional settings based on historical trauma,” Paul explains when we meet at a community center in Tobique First Nation. “Receiving treatment at home, surrounded by family and cultural supports, makes a world of difference in both physical and spiritual healing.”
The program’s success has sparked interest from other Canadian provinces. Health PEI representatives have already visited to observe the model, and discussions are underway with Nova Scotia Health to explore similar initiatives.
As evening approaches, Karen prepares dinner while waiting for her weekly nurse visit. On her refrigerator, held by magnets, is a calendar marking her treatment milestones. Her recent scans showed tumor shrinkage—positive news delivered via video call rather than in a sterile consultation room.
“Cancer takes so much from you,” Karen reflects, stirring a pot of homemade soup. “This program gives something back—dignity, time with family, normal moments between the hard ones. That matters just as much as the medicine.”
For healthcare providers and policymakers in New Brunswick, the early success of this program represents more than just a new treatment model. It signals a fundamental rethinking of how specialized care can be delivered in a province characterized by geographical challenges and an aging population.
“We’re just at the beginning,” Dr. Lachance tells me as we conclude our interview. “If we can successfully treat complex conditions like lung cancer in home settings, imagine what other innovations might be possible. The hospital walls are becoming more permeable, and that’s good medicine for everyone.”
