I agree with the social worker on being careful with bodily fluids and not engaging in sexual acts with a partner who seems to be ill to prevent contracting STIs while immunocompromised. But for a heterosexual female patient, I would also add contraception as something to consider, to prevent pregnancy while actively undergoing chemotherapy and/or radiation. Possibly use two forms of contraception: IUD or contraceptive pill or other hormonal method, in addition to a barrier method such as condoms.
I agree. In addition it would be important to discuss avoiding “rough” sexual practices with a compromised immune system; with thrombocytopenia or leukopenia the risk for bleeding/infection is present for any cancer patient whether partnered or not.
I appreciate the fact that the social worker highlighted the need to be more aware of the increased risk of infections like the common cold, but I would have liked for her to talk a little more about safe sex practices to avoid STIs, for example barrier devices. I also appreciate kpmalvey’s comment about the need for immunocompromised patients to avoid “rough” sexual practices.
I can appreciate this topic and it gave me a great way to start the conversation. I am high on talking to my patients about Neutropenia and diet and avoiding sick contacts and crowded areas. This will help me bring up the topic of practicing safe sex to avoid STI and pregnancy. I liked it.
Whenever I speak to my patients about this (especially prior to treatment)- I make sure to go over neutropenia and thrombocytopenia and how that relates to their sexual life. I usually advise patients to refrain from penetrative sex while their counts are low and I explain the reasoning for that. I also like to emphasize the need for double contraception.
Barrier protection is very important for preventing STIs, especially since patients receiving chemotherapy are at an increased risk for infection. It is also important for the partner as well, since chemotherapy is in body fluids several days after treatment. I have found some of the above suggestions to be very helpful, and will start incorporating them more as I educate my patients.
<span style=”color: #000000; font-family: Calibri;”>I agree that in the explaining the important part of “why.” I would have like to see more listening from the patient of what worked and did not work in the past to build on motivation for change. </span>