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Stage IIIA with PD-L1 >50% treatment in Covid-19 world


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We received results from my father's biopsy performed on Feb 24th.  He has stage IIIA NSCLC squamous cell lung cancer in station 7 and 11 lymphnodes with an upper lobe tumor which is relatively small.  Station 7 is metastatic.  His biomarker testing came back with positive testing for PD-L1 >50% expression (good news!) but negative for the EGRF mutation.  

We are in Canada so the process has been slow in the universal health care system.  I believe they are recommending combination therapy with radiation, chemo, and the immuno drug pembrolizumab.  We are schedule for his first consultations with the radiologist (April 9th) and the oncologist (April 15th), another long agonizing wait before any treatment.  

We received a call today that the in-person consultations will now be telephonic due to the corona virus.  My further concern is that his treatment start may or will get delayed because of the covid environment we live in as well.  

So my questions are- can the chemo and immuno be administered at home?  And secondly, if we continue to get stuck in the queue in Canada, can we at least administer the immuno drugs through a private nurse if we can get a prescription for the drug independently from a doctor in the US or his Canadian health team?  Just trying to make sure we are thinking of and exploring all options if anyone has any recommendations or thoughts.  

Thanks so much in advance,








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I've never heard of anyone receiving chemotherapy or immunotherapy at home. I think it would be too dangerous. The clinic where I was treated at had to have an oncologist (doctor) in the building during all hours of chemotherapy infusions.  

I can't begin to give you advice about the Canadian medical system.  A lot of politicians in the US are pointing to the Canadian medical system as the model for a future American system. I didn't realize the delays in the Canadian system. By comparison, I had my first oncology consultation in the hospital the day after I was admitted for scans and biopsy.  Sorry I can't be more helpful.

Stay the course.


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Hi Shane,

I know of Home Care Agencies that do administer chemotherapy at home. The nurses are certified oncology nurses (OCN) with special training. Patients are screened for eligibility. Also, only certain chemotherapy drugs are eligible. There are some chemo drugs that are administered via an IV pump in the home. You may want to talk to your physician to see if it is available in your area and if your father would be an appropriate candidate. 

Take Care, DFK

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Thank you, Tom.  There is no perfect system, but feeling like we are at the DMV with a cancer diagnosis it not the solution the US wants. Thanks for your thoughts again.  

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Hi Shane, the Lung Cancer HELPLine might be able to answer some of your questions and provide additional resources in your area.  It is a free service staffed by oncology social workers.  Here is more information if you want to give them a call: https://lungevity.org/for-patients-caregivers/support-services/lung-cancer-helpline

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