Frequently Asked Questions

Carelene R. Springer, MSN, APRN, FNP-C, AOCNP
Family Nurse Practitioner
Morrison Cancer Center 

1. What safety precautions during active chemotherapy AND/OR radiation should be taken when participating in intimacy acts? How long should they be implemented for?(i.e. Open mouth kissing, sexual intercourse, skin to skin hugging, caregiver assisted showering/toileting) 
   
    
2. What medications or treatment CAN be transferred to a partner through bodily fluids? 
   All chemotherapy is in the bodily system for at least 48 hours after administration.   
    
3. Are there types of sexual acts that should be avoided during active treatment? (i.e. Oral, penetrative, anal, etc) 
   Discourage intercourse, but if they do wish to engage, then the male should wear a condom. If females are undergoing treatment and are premenopausal we recommend two types of birth control (oral contraceptives+condom, we have used Zoladex injections when needed). 
    
4. How do estrogen suppressing medications impact drive and health of vaginal tissues? 
   Unfortunately the aromatase inhibitors do cause issues including vaginal dryness leading to painful intercourse. Decrease in libido is also related to the use of AI's.  
    
5. Many individuals with limited sensation still seek opportunities to enjoy self care activities (i.e. Pedicure, manicure, massage). Are there products or services that breast cancer patients must avoid or be cautious of? (i.e. High water temperatures, essential oils, vigorous scrubbing, hot stones, hormonal lubricates) How long should these be avoided? 
   During treatment I recommend patients enjoy self care activities as they wish but much of that is dependent on what type of cancer they and the type of treatment they are receiving. If a person's treatment causes severe neutropenia, I request they don't engage in activities where there is a chance they could have "broken skin" (pedicure, manicure). If platelets are low - no vigorous massage. Light massage, hot stone massage, etc. are fine. Studies show vaginal estrogen is ok, even for breast cancer patients, non-hormonal lubrication is also ok.   
    
6. How does your clinic/organization address sexual health and intimacy? 
   I am the one who talks with patient about sexual health. I broach the subject during chemotherapy education and offer that I am available to talk at any time. Many patients schedule private time with me (without their spouse).  
    
7. Do you discuss intimacy questions regarding body image for pre/post surgical mastectomy patients? 
   As a breast cancer survivor myself, I am very in tune to body image issues and ALWAYS talk with breast cancer patients, both male and female.   
    
8. What time period should an individual wait after mastectomy to perform self exploration with vibration and/or soft touch? 
   That is a question that can't be answered across the board. A lot of it depends on healing. Once incisions are healed there are no restrictions. 
    
9. What safety precautions during active chemotherapy AND/OR radiation should be taken when participating in intimacy acts? How long should they be implemented for? (i.e. Open mouth kissing, sexual intercourse, skin to skin hugging, caregiver assisted showering/toileting) 
   During – and for 48 hours after – chemo  
   1. Flush the toilet twice after you use it. Put the lid down before flushing to avoid splashing. If possible, you may want to use a separate toilet during this time. If this is not possible, wear gloves to clean the toilet seat after each use. 
   2. Both men and women should sit on the toilet to use it. This cuts down on splashing. 
   3. Always wash your hands with warm water and soap after using the toilet. Dry your hands with paper towels and throw the paper towel away. 
   4. 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.  Empty the wash and rinse water into the toilet, then flush it. Dry the bucket with paper towels and throw the paper towels away. 
   5. Caregivers should wear 2 pairs of throw-away 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 had gloves on. 
   6. If a caregiver does come in contact with any of your body fluids, they should wash the area very well with warm water and soap. It’s not likely to cause any harm, but try to take extra care to avoid this. At your next visit, let your doctor know this happened. Being exposed may lead to problems, and extra care should be taken to avoid this. 
   7. Any clothes or sheets that have body fluids on them should be washed in your washing machine – not by hand. Wash them in warm 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. 
   8. If using throw-away adult diapers, underwear, or sanitary pads, seal them in 2 plastic bags and throw them away with your regular trash.