When watching the lecture for this week 6, it never occurred to me previously to be sure to instruct patients that STI prevention is only as good as how much the area is covered. So, we need to be sure to instruct our patients that they are vulnerable to anything that is not physically covered by a condom or physical barrier during sexual contact.
Also, there is a lot of ambiguity surrounding the topic of protecting your partner from bodily fluids that may be excreting chemotherapy. Since this patient is on active treatment, there needs to be specific discussions about how long it is expected that their saliva, secretions and urine may contain the chemotherapy they are excreting.
Yes, I am glad the social worker brought this up too. We have a Chemo-at-home patient education blurb that we try to provide to patients on their first day of chemo with instructions about chemo being present in body fluids for 48-72 hours after receiving it and to avoid directly exchanging fluids with anyone during this time. I try to make sure people realize that in addition to sweat, urine, vomit, and saliva, chemo can be present in semen and vaginal fluids and to either avoid sexual contact or use barrier method for this window. It’s not something people necessarily want to hear about on their first day when we are also educating them about the other side effects of chemo etc., but I have had many patients tell me when I reinforce this education a few weeks in that no one told them about any sexual precautions and they really wished they had known.