Leslie Kathman, MSN, APRN, FNP-C, OCN
Oncology Certified Nurse - Chemotherapy
Morrison Cancer Center
- 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).
General rule of thumb is that for 48 hours post chemotherapy any sexual intimacy would require a condom or barrier method, this excludes kissing/hugging/etc. As for toileting this same rule would apply, it is recommended that the toilet is flushed twice with each use of the toilet or that the patient utilize their own toilet x48 hours. If a patient would get sick, have an accident or need assistance with bodily fluids the caregiver would need to utilize two pairs of gloves. If someone is on an everyday oral chemotherapy these rules would apply to every day. Radiation restrictions are highly dependent on the type of radiation they are receiving.
- What medications or treatment CAN be transferred to a partner through bodily fluids?
Any medication that is considered a chemotherapy/anti-neoplastic agent, to error on the side of caution it is best to consider all oncological medications under this category until you can address on an individual basis with your primary medical oncologist. This would also include oral chemotherapy agents.
- Are there types of sexual acts that should be avoided during active treatment? (i.e. Oral, penetrative, anal, etc)?
All forms except for kissing should be avoided for 48 hours post chemotherapy administration, unless there is a barrier method utilized. If a patient's laboratory monitoring shows abnormalities there may be additional recommendations such as not engaging penetrating intercourse.
- How do estrogen suppressing medications impact drive and health of vaginal tissues?
Many of these medications can cause atrophy of vaginal tissues and can be very drying. This can make intercourse very uncomfortable. Sex drive can be greatly reduced as a result of the overall decrease in Estrogen.
- 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?
Breast cancer survivors who have had surgery to their breast including surgical intervention to the axillary lymph nodes need to avoid any needle pokes (including acupuncture) and squeezing (including vigorous massage or blood pressures) to the affected extremity. These recommendations are typically for life as lymphedema can develop at any time. Utilizing hormonal lubricants would depend on the type of breast cancer that they had and this should be discussed with their primary oncologist prior to utilizing any hormone-based treatments. If a patient has a sensory change from chemotherapy they may not feel water temperatures correctly, they may need to test water temperature in a different way to ensure safety.
- How does your clinic/organization address sexual health and intimacy?
Yes, we address throughout their treatment time and survivorship. However, we do not have dedicated staff for this.
- Do you discuss intimacy questions regarding body image for pre/post surgical mastectomy patients?
Not specifically, we do address their needs for orthotics or reconstruction. We are fortunate that most of our patients that undergo mastectomy see our breast surgeon and her offices handles a majority of these questions/concerns.
- What time period should an individual wait after mastectomy to perform self exploration with vibration and/or soft touch?
I have never encountered this situation, but I would say if they are cleared from a surgical standpoint for all other activity they would be free to proceed with self exploration.
