When cancer is diagnosed, many patients choose to treat the disease with chemotherapy. But it appears that “chemo” carries health risks not only for the patients receiving it, but for those who care for them.
In fact, studies have revealed that family members of cancer patients can be exposed to chemotherapy drugs (which are hazardous carcinogens themselves) through exposure to the patient’s body fluids. The researchers also found contamination of ordinary household surfaces – up to 48 hours after the treatment was administered.
According to the U.S. Centers for Disease Control and Prevention (CDC), around 650,000 cancer patients receive chemotherapy in outpatient clinics every year – creating an urgent need for precautions on the part of caregivers and family members.
Warning: Exposure to chemotherapy drugs can actually cause several dangerous outcomes
Chemotherapy uses antineoplastic drugs – such as 5-fluorouracil, oxaliplatin, and cyclophosphamide (Cytoxan) – to kill cancer cells. However, antineoplastic drugs (also called cytotoxics) also harm normal cells.
Exposure to these toxic medications can cause nausea, vomiting, hair loss and suppression of bone marrow function. And OSHA (Occupational Safety and Health Administration) warns that the development of secondary malignancies – in other words, cancer – is a well-documented side effect of chemotherapy treatment.
The fact is: chemotherapy drugs can be associated with grave harm – even at very low exposures.
The CDC reports that people who work with antineoplastic drugs have an increased risk of having a miscarriage or a child with a birth defect.
Family members may be exposed via contact with the patient’s body fluids and waste products – such as urine, feces, vomit, saliva and even sweat. In addition, exposure to chemo can occur through trace amounts being left on household surfaces such as doorknobs, bathroom sinks, faucets, light switches and floors – even as long as 48 hours after chemotherapy treatment.
And, because each cycle of chemotherapy is repeated several times, family members living with chemo patients are at risk of repeated exposure.
There is also significant risk for professional healthcare workers performing routine nursing tasks, such as washing treated patients. (However, studies have shown that wearing gloves prevents exposure in hospital settings).
According to the Cleveland Clinic, acute exposure to body fluids contaminated with chemotherapy drugs can cause skin rash, nausea, vomiting, dizziness, abdominal pain, headaches, nasal sores and allergic reactions.
Study results are alarming for family members exposed to chemo drugs
In a study published in 2013 in Journal of Oncology Pharmacy Practice, researchers analyzed urine samples from patients who had received the antineoplastic drug cyclophosphamide – within the last 48 hours.
The team also analyzed samples from family members – as well as testing wipe samples from their homes.
Using gas chromatography and mass spectroscopy, researchers found cyclophosphamide in all urine samples – the treated patients and family members alike. According to the scientists, between 9 and 34 percent of the original dose of cyclophosphamide was excreted in the urine.
In addition, they found surface contamination in the homes of outpatients treated with cyclophosphamide – with 8 of the 12 wipe samples containing the drug.
The researchers asserted that the contamination of the surfaces – and the exposure of the family members – occurred via exposure to waste product excretions from the chemotherapy patients.
The team called for strict precautions by family members and healthcare workers.
Additional study confirms ‘chemotherapy contamination’ of surfaces in the home – placing family members at “high risk”
In a Japanese study conducted by researchers at Fukushima Medical University and published in Journal of Nursing Education and Practice, researchers monitored the urinary excretion of cyclophosphamide by five breast cancer patients for 48 hours after administration.
They also tested wipe samples taken from toilets, doorknobs and faucets in the patients’ homes – and found contamination in all five homes.
Of 28 wipe samples analyzed, cyclophosphamide was found in 17 of them.
Most of the contaminated samples were taken from toilet seats and toilet floors, with toilet flush levers and bathroom doorknobs also showing contamination.
The researchers warned that family members of chemo patients are at “high risk.”
Protect household members with simple precautions
Specific tactics and practices can lower the odds of contamination and exposure.
Experts recommend that the chemotherapy patient use a separate toilet – if available – for at least 48 hours after treatment. If only one toilet is available, male patients should urinate sitting down in order to cut down on splashing.
After urination the lid should be closed, and the toilet flushed twice.
Follow the same protocol – closing the lid and flushing twice – after a patient vomits into the toilet.
To clean up any splashes on or around the toilet, wear waterproof disposable gloves and wipe the area with paper towels. (Note: The Cleveland Clinic recommends wearing two pairs of latex or nitrile glove at once).
Dispose of the used towels in the toilet – again closing the lid and flushing twice.
Used gloves should be discarded in the trash, using a sealed plastic bag. Wash hands well with warm, soapy water.
After emptying, bedpans should be rinsed with laundry detergent and water. Carefully pour the rinse water into the toilet, then close the lid and flush twice.
Use care with dishware
Dishes and cups used by the patient should be washed in the dishwasher, if practical.
If washing by hand — use hot water and plenty of soap. Rinse and dry the utensils thoroughly. Of course, disposable paper or plastic utensils are also an option.
If bedding or linens are soiled with body fluids or waste, launder them separately from other clothing. Wash them twice, using the machine’s hot cycle.
If you do get body waste on your skin, don’t panic. But, do wash the area well with soap and water for five minutes – and observe the area for the next seven days. If redness or irritation develops, consult your doctor.
A special note about contact: According to Chemocare, hugging and kissing a chemo patient is safe. For those in sexually intimate relationships, however, experts advise using protection – and avoiding open-mouth kissing.
No doubt, chemotherapy can be a challenging situation – for patients, caregivers and families. But the above precautions can help ensure that you care for your family member safely, while protecting yourself.