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Advanced Prostate Cancer
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Safety at home for patients on chemotherapy

Chemotherapy is a cancer treatment that uses drugs or medicine to kill cancer cells. It is sometimes just called 'chemo'. Patients can have chemotherapy in different ways.

- Intravenous ( IV ) chemotherapy is given into the patient's vein, and goes straight into the blood.

- Oral chemotherapy is given by mouth, as tablets, capsules or liquids that the patient swallows.

Bush medicine : Bush medicine could cause problems for patients having cancer treatment. The patients should check with their doctor before using bush medicine.

There are important safety measures that you should take while caring for patients who are having chemotherapy. You also need to educate your patients and their families and their carers about safety. This section explains :

- How to protect yourself and your patients' families and carers from chemotherapy drugs.

- How to support patients who are taking oral chemotherapy at home.

- What equipment you may need, like gloves and spill kits.

Safety information for all chemotherapy patients :

Chemotherapy drugs kill cancer cells but can also damage normal cells. Each time the patient has chemotherapy, it can take up to seven days for the chemotherapy drugs to leave the body. During these seven days, chemotherapy drugs can be in the patient's body fluids or waste products, including :

- blood

- urine

- vomit

- saliva

- semen

vaginal secretions

- sweat

- stool/faeces

If you accidentally touch any of these fluids, some of the chemotherapy drugs could get into your body through your skin. You and your patient's family and carers need to take special care to stay safe for the first seven days after each chemotherapy treatment. The information given below explains how to do this.

Women who are pregnant or breastfeeding should not touch :

- chemotherapy medication

- body fluids ( urine, vomit, etc. ) of someone having chemotherapy

- any bedding, clothing, or cleaning cloths with the above body fluids on them

Educate your patient about cleaning up spills :

- If there is a spill of any body fluids or waste ( eg. stool, urine,vomit etc. ), put on rubber gloves and use a disposable cloth to clean up the spill straight away.

- Place the cloth in plastic bag and tie it closed; then place that plastic plastic bag into another plastic bag and tie it closed - this is called 'double bagging' . The plastic bag can then be placed in the normal household rubbish.

- Towels, linen or clothing that have body fluids on them should be machine washed separately in a hot or cold wash on the longest washing cycle. They can then be dried outside.

- If there is a spill of body fluids on bench top or floor, wear rubber gloves and wash it off with lots of water and detergent.

About feeling sick and vomiting :

- It is a good idea to keep a plastic bowl or bag ( without holes in it ) handy for this.

- A bowl used for vomiting should not be used for anything else.

- Wash the bowl out after each use.

- Throw it away at the end of the chemotherapy treatment.

About going to the toilet :

- After going to the toilet, close the lid and flush the toilet on full flush. This is so that fluids from the toilet don't splash out.

- Men should sit down when using the toilet so there is no splashing.

About having sex :

- Patients and their partners should always wear condums when having sex in the first seven days after chemotherapy treatment. This is because low amounts of chemotherapy drugs may be passed in the semen or vaginal secretions.

Safety information for patients taking oral chemotherapy at home :

- Make sure that the patient knows how to take the oral chemotherapy drugs.

- Most patients will have a written plan, telling them when to take their tablets. It is a good idea for you to go through this with them to make sure they have understood this information.

- Make sure the patient knows they must take the oral chemotherapy exactly as their doctor or pharmacist has told them to. This includes taking it on the right day, at the right time and with or without food as directed.

Check that the patient knows how to store the oral chemotherapy drugs safely. It is important to :

- keep the chemotherapy drugs in their original packaging

- store any chemotherapy drugs ( tablets or liquids ) as the doctor or pharmacist advises

- store them safely away from children or animals

Educate the patient how to handle oral chemotherapy drugs safely :

- Your patient can handle the oral chemotherapy drugs because the treatment is for them.

- After taking the drugs, they should wash their hands before touching anything else.

- You and the patient's family or carers should never touch chemotherapy medicine with your bare hands. This is because some of the chemotherapy drugs could be absorbed into the body through the skin.

- You should always ware a pair of rubber gloves to touch or handle chemotherapy drugs.

- Wash your hands after taking off the gloves.

How to take oral chemotherapy drugs safely. Your patient should :

- take the chemotherapy exactly as directed by the doctor or pharmacist ( may be with food or on an empty stomach )

- swallow the chemotherapy tablets or capsules whole - never crush, cut, chew or bite tablets and do not open capsules

- wash the hands after handling the chemotherapy tablet or capsule.

- If the patient cannot swallow the tablets, talk to the doctor straight away.

Important things to know :

What if my patient vomits after taking the chemotherapy tablets?

- If your patient vomits straight after taking a dose of oral chemotherapy, they should not take a replacement dose but contact the treatment team for further advice.

- If they have been given anti-sickness tablets to stop nausea and vomiting, they should take this medicine as the doctor or pharmacist has instructed even if they do not feel sick.

- If they have taken the anti-sickness medication and it does not stop them from vomiting, speak with the doctor about what to do.

- make a note to tell the doctor or nurse from the treatment team about any missed or vomited doses.

What if the patient forgets to take their chemotherapy tablets ?

- If your patient forgets to take a chemotherapy dose, they should take the next doseat the normal time as prescribed.

- Refer to the patient information sheet that they may have been given for further information and if the patient is unsure about what to do, speak with the doctor or clinic staff on the next working day.

- If there are any tablets left after completing the chemotherapy treatment the tablets or capsules should be returned to the cancer clinic or the pharmacy.

Useful equipment :

Gloves : The best gloves to use are nitrile gloves which are made from synthetic rubber and are resistant to chemotherapy.

- Two pairs of disposable gloves or

- Home-made spill kit : This may include incontinence pads or disposable cloths, gloves, plastic apron, vomit bags/bowl and plastic bags

Important :

- Be careful when removing gloves.

- Do not touch the outside of the gloves with your bare hands.

- Wash your hands after removing gloves.

Acknowledgements :

With thanks to Cancer Institute NSW under Creative Commons Attribution 4

My thanks are also due to the Administrator of jimJimJimJim.com Forums Australian advanced prostate cancer support groups

Sisira

17 Replies
oldestnewest

Thank you for the information.

Rich

1 like
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Thank for the informative post, the first I've seen on the subject of administration of chemo at home.

1 like
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I don't think it happens.

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Martin, what do you men? You think it want happen ? End of the world or something!!!

Happy New Year to you friend!

Sisira

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huh?

people who receive chemo need care at home, but the chemo is not administered at home - is what the post meant.

Reply

Martin, to clarify further, oral chemo drugs such as tablets and capsules when prescribed have to be taken at home. True the IV infusions taken by most of the PCa patients are administered in the hospital environment but the patients will still carry the toxic elements in their blood, body fluids and excretory matter up to 7 days from the date of infusion. Unless you stay in the hospital, the potential risks will move into the home environment when one returns home. Thus is the concern for safety for everybody at home. One may argue and say nobody has ever died for not following these safety guidelines after having received chemo treatments! Safety at home is a concern for SELF and is a matter of discipline to ensure PROTECTION for others as well.

Thank you for your interest in the follow up.

Sisira

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Very good post, one I can understand, Thank you!

Of course what do I know?

1 like
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I had my first chemo yesterday and was told to wear a condim when having sex, as included in your comprehensive set of safety instructions. And I had to laugh athe nurse, I had half my nerves removed during RP, I had the other half burnt out by IMRT and I was chemically castrated 9 months just in case I harboured any thoughts about having sex again.

Seriously, by the time you get to chemo, are any men still able to do it?

1 like
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Hazard,

These guidelines are more to prevent the hazards that may be caused by the toxic chemotheraputic drugs to ensure safety for the patients as well as their care givers in a home environment.

Thanks for reading the text and for your comments.

Wishing you a very Happy New Year!

Sisira

2 likes
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Happy New Year to you too! I shall be sitting at home listening to some Neil Young records with my lovely wife and a friend of hers who is big fan of Neil.

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While I appreciate Sisira' list of cautions, I did have that same thought as you. You aren't alone.

Reply

Happy New Year to you and your family! WSO

Sisira

1 like
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And a very Happy New Year to you and yours, Sisira

Ed

Reply

Sisira

Thanks for the information...

j-o-h-n Saturday 12/30/2017 11:25 AM EST

Reply

Happy New Year to you and your family, J-o-h-n !

Sisira

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I'm on xtandi & have really bad hot flashes. Now my wife,age74,has begun to have hot flashes. She blames me. Any thoughts on this?

Reply

I am not talking through any experience. So far I have used only the first line ADT Zoladex for two years without any hoyflashes. Neither am I a chemist or a medical professional to understand and explain about drug interactions. I have never heard of any similar experiences from those who are using Extandi. Though Extandi ( Enzalutamide ) is not a chemotheraputic drug, it is a strong drug, and may have such properties rarely on some individuals or although we never hear of hotflashes being contagious, it may happen rarely because it is a skin condition. If your wife is not under any similar medication and yet experiences hotflashes, obviously she will put the blame on you. What I can suggest is when we have some bad skin problem, we take precautions to protect others by keeping others away from contact from us at home by various hygeinic practices. Also do your best to get rid if your hotflashes. Some uses a small fan and also transdermal oestradiol patches to overcome this problem.

Happy New Year to you and your wife!

Sisira

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