Safe handling of bodily fluids after chemotherapy
Dear OncoLink "Ask The Experts,"
After chemotherapy treatment, are there recommendations for safe handling of patient secretions, urine, etc for when they return home?
Carolyn Vachani RN, MSN, AOCN, OncoLink's Medical Correspondent, responds:
Thanks for your question. At the University of Pennsylvania Medical Center we do not give any specific recommendations for handling of secretions for patients undergoing chemotherapy, with a few exceptions. In the case of patients who are receiving treatment with radio-immunotherapy, there are some more specific recommendations. The medications used in radioimmunotherapy are Bexxar and Zevalin. Zevalin emits radiation in beta rays, and therefore is mostly confined to the body. These patients are told to wash hands thoroughly after urinating, clean up any spillage of urine with soap and water immediately, and to abstain from having sexual intercourse for one week.
Bexxar is different in that it releases radiation in gamma and beta rays and therefore emits radiation from the body. These patients are given more isolating instructions. These include: sleeping alone (5 days), no kissing or sexual intercourse (7 days), minimize time with pregnant women and children (5 days), and minimize close contact with others (5 days). They are also instructed to drink plenty of fluids (5 days), flush the toilet 2-3 times after each use and wash hands thoroughly, if possible, use a separate bathroom from others (5 days), use disposable eating utensils (5 days), use separate bath linens and launder them separately (7 days), maintain a separate toothbrush holder (5 days), and wipe the telephone mouthpiece with a tissue after each use (5 days).
One other special case is the treatment of bladder cancer with BCG. The BCG is a live bacteria, and can therefore infect others. Healthcare workers are at risk of infection by these bacteria when preparing the medication for instillation into the bladder, and it should be prepared with aseptic technique. After treatment, these patients are advised to urinate sitting down to avoid splashing of urine. For the first six hours after treatment, urine should be mixed with an equal amount of bleach for 15 minutes to disinfect before flushing. Patients should increase their fluid intake to flush the BCG from the bladder.