Chemotherapy Principles

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Safety precautions

For health professionals

Many chemotherapy drugs are considered hazardous to healthy people. That’s why the nurses and doctors who give chemotherapy will take precautions to avoid direct contact with the drugs while giving them to you.

Chemotherapy drugs can be dangerous to others in these ways:

  • They can cause abnormal changes in DNA. (They are mutagenic.)
  • They may be able to alter development of a fetus or embryo, leading to birth defects. (They are teratogenic.)
  • They may be able to cause another type of cancer. (They are carcinogenic.)
  • Some may cause skin irritation or damage.

Nurses may wear special gloves, goggles, and gowns when preparing and giving you chemotherapy. Pharmacists or nurses prepare the drugs in areas with special ventilation systems to avoid spattering and/or inhaling the droplets that can form while mixing.

If you’re in the hospital, the health care professionals caring for you may use special precautions when they handle your urine and stool for a few days after treatment. This is because your body waste may contain the drugs. If you get chemotherapy at home, you will be given special instructions and precautions to ensure the safety of your caregivers and those living with you.

Special procedures are used to dispose of materials that were used to mix and give the drugs. There are separate plastic containers to dispose of sharp items, syringes, IV tubing, and medicine bags. Gowns and gloves are disposed of in special bags. If there are any visible leaks or spills, special precautions are used to clean up the drugs.

For patients and their loved ones

There are many things you can do during and after chemotherapy to keep yourself and your loved ones from being affected by the drugs while your body is getting rid of them. It takes about 48 hours for your body to break down and/or get rid of most chemo drugs.

Most of this comes out in your body fluids — urine, stool, tears, saliva, and vomit. The drugs are also found in your blood. When these drugs leave your body as waste, they can harm or irritate skin — even other people’s skin. Keep in mind that for this reason, toilets can be a hazard for children and pets and it’s important to be careful. Talk to your doctor about these and any other precautions you should follow.

During and for 48 hours after you finish getting chemotherapy:

  • Flush the toilet twice after you use it. Put the lid down before flushing to avoid splashing. If possible, you might want to use a separate toilet during this time.
  • Both men and women should sit on the toilet to use it. This cuts down on splashing.
  • Always wash your hands with warm water and soap after using the toilet. Use paper towels to dry your hands.
  • If you vomit into the toilet, clean off all splashes and flush twice. If you vomit into a bucket or basin, carefully empty it into the toilet without splashing the contents and flush twice. Wash out the bucket with hot soapy water and rinse it, emptying the wash and rinse water into the toilet, then flushing it. Dry the bucket with paper towels and throw them away.
  • Caregivers should wear throw-away waterproof gloves if they need to touch any of your body fluids. (These can be bought in most drug stores.) They should always wash their hands with warm water and soap afterward — even if they wore gloves.
  • If a caregiver does come in contact with any of your body fluids they should wash the area very well with warm soap and water. Although this isn’t likely to cause any harm, try to take extra care to avoid this. At your next visit, let your doctor know this happened. Being exposed frequently may lead to problems.
  • Use a condom during sex and do so for about 2 weeks. The drugs can be found in semen and vaginal secretions. (You may want to ask your doctor how long you should do this.)
  • Drugs might also be found in saliva, so avoid deep kissing and sharing food or drinks with others. Clean flatware and dishes thoroughly with soap and warm water and rinse well before washing a second time with the other dishes.
  • Any clothes or sheets that have body fluids on them should be washed in your washing machine — not by hand. Wash them twice in hot water with regular laundry detergent. Do not wash them with other clothes. If they cannot be washed right away seal them in a plastic bag.
  • If using throw-away adult diapers, underwear, or sanitary pads, seal them in plastic and throw them away with your regular trash.
Adapted from The Cleveland Clinic Foundation. Chemotherapy Precautions During and After Treatment. 2012. Available at http://my.clevelandclinic.org/services/Bone_Marrow_Transplantation/hic_Chemotherapy_Precautions_During_and_After_Treatment.aspx

Last Medical Review: 02/07/2013
Last Revised: 02/07/2013