Chemotherapy safety at home

Cancer treatments include chemotherapy, hormone therapy, targeted cancer drugs and immunotherapy. These treatments are also called systemic anti cancer therapy (SACT). As part of your treatment, you might have one or more of these drugs:

• through a vein (intravenous)

• by mouth (oral)

• another route, such as under the skin (subcutaneous)

Some of the by-products of these drugs come out of your body in your vomit, wee, poo, blood or other bodily fluids for some time after your treatment. This can be harmful to others. So you must take precautions if you go home:

• after SACT at the hospital

• with a chemotherapy pump

• with chemotherapy, hormone therapy or targeted drug tablets or capsules

Handling poo, wee and vomit

There are things you can do to deal with your bodily fluids safely during this time:

• Close the lid and flush twice after using the toilet. To avoid splashing, men should have a wee sitting down.

• Wash your hands well with soap and water after using the toilet. Clean the area with soap and water if body fluids splashed on your skin.

• Wear gloves when cleaning the toilet, wiping up any wee, poo or vomit, or changing incontinence pads. Wash your hands with gloves on, remove them, and throw them in the household waste. Rewash your hands.

• Clean the toilet daily with a product containing bleach.

• Carers should wear gloves when handling a bedpan or urinal. Empty the contents into the toilet close to the water. This will limit splashing. Keep the gloves on and wash the bedpan or urinal with soap and water after each use.

• Double bag incontinence pads and throw them in the household waste. For example, put the used pads in a bag or bin liner and then place this into another bin liner before throwing it in the household waste outside the home.

• If you have a stoma, wear gloves when emptying the stoma bag. Wash the stoma bag daily with soap and water.

Handling waste or laundry

When handling waste or laundry that is soiled with SACT or body fluids, you can do the following:

• Handle contaminated waste or laundry with gloves. Wash your hands before and after removing the gloves.

• Place contaminated waste in special bags if you were given these. Otherwise, double bag it in plastic, leakproof bags. Place in the regular household waste.

• If you’re having chemotherapy through a pump at home, you may want to place a plastic mattress protector on your bed. This is to prevent chemotherapy spillage into your bed if an accident happens.

• If a spillage happens, wear gloves, blot the area dry with a kitchen towel, and remove the contaminated clothing or linen immediately.

• Wash the mattress or plastic mattress cover 3 times with warm, soapy water and let it dry.

• Wash soiled laundry straight away if possible. If you can’t, place it in a leakproof plastic bag. Wash it as soon as possible.

• Wash soiled laundry separately from other laundry on the longest and hottest cycle. Wash twice without removing it from the machine between washes. Use regular laundry soap.

Dealing with spills

If SACT or body fluids are spilled or splashed, use a spillage kit if you’ve been given one or follow the below steps. A spillage kit usually contains:

• gloves
• shoe covers
• a face mask
• an apron or long-sleeved gown
• a waste bag

Your nurse will give you instructions on how to use the kit if necessary. 

Spillage on floors or surfaces

• Always wear gloves to clean up.

• Alert others around you of the spill.

• Be careful not to step into the spill or get any on your shoes.

• Remove or turn off any fans in the direction of the spillage.

• Create a barrier with paper towels around the spillage so it doesn’t spread further.

• Use paper towels to wipe up the spill.

• Clean the area with soap and water. Rinse the area using paper towels.

• Throw out waste in specially marked containers (if you were given them). Otherwise, double bag in leakproof plastic bags.

• Wash your hands before and after removing gloves.

Spillage on the skin

If you accidentally get medicines from your pump on your skin:

• Rinse the area and wash it with soap and water.

• Wear gloves if you’re a carer helping the person to clean their skin

• Contact your hospital advice line.

• Do not apply any moisturiser to the affected area.

• Check your skin for redness, soreness, irritation or blistering in the affected area afterwards. Contact your advice line if this happens.

Spillage in the eyes

• Wear gloves if you’re a carer helping the person to wash their eyes.

• Wash the eyes with plenty of water for at least 10 minutes.

• Contact your advice line immediately or go to Accident and Emergency (A&E).

Contraception and pregnancy

SACT may be in semen and vaginal fluid. To prevent exposure of your partner to these fluids, you can do the following:

• Use barrier methods (condoms, femidoms or dental dams) during oral, vaginal or anal sex for as long as you’ve been asked to do after treatment. This applies to both you and your partner.
• You or your partner should use effective birth control to prevent becoming pregnant while taking SACT. Depending on the drugs, this might be for several months or years after treatment. Some of these drugs can harm the developing baby (foetus), especially during weeks 1 to 12 (first trimester). Menstrual cycles can become irregular during and after treatment. So, it is not always possible to know if someone is at a time in their cycle when they could become pregnant or is pregnant.

Safety for family and friends

• It is safe to hug and kiss your partner, family or friends.

• You can also visit, sit with, hug, and kiss children.

• If you’ve had SACT treatment, you can be around pregnant women. But they should not clean up your body fluids after you’ve had treatment.

• You can share a bathroom with others. If body fluids splash on the toilet, wear gloves and clean the area with soap and water. Others may use the toilet after you’ve cleaned it up.

SACT tablets or capsules at home

• Keep tablets or capsules out of reach of children and pets.
• You should try to limit the handling of SACT tablets or capsules. Push them out from the packet into a small cup or pot, for example, a shot glass. Tip this into your mouth. If you cannot do this, wash your hands thoroughly with soap and water after handling these medicines. Keep the cup or pot separately for this purpose.
• Anyone helping you with SACT tablets or capsules should wear gloves.
• Anyone who is pregnant, thinks they are pregnant, or who is breastfeeding shouldn't touch chemotherapy or hormone therapy tablets or capsules. If they must help you, they should take extra care, wear disposable gloves, and tip them into a medicine cup.
• Never crush or chew these tablets or capsules. Swallow them whole. Contact your advice line or speak to your pharmacist if you can’t do this.
• Some people may be directed by their pharmacist to crush tablets or open capsules. For example, if you have medicines through a feeding tube. Follow the directions from your pharmacist on how to do this safely.
• Do not take another dose if you have vomited after taking your SACT tablets or capsules. Contact your advice line.
• Make sure you understand your course of treatment and the prescription. This way, you’ll know how many tablets or capsules to take.
• Return unused tablets or capsules to the pharmacist at the hospital you got them from. Never flush any tablets or capsules down the toilet or throw them in the household waste.
• Contact your advice line if you take too many tablets or capsules by mistake.

Practical things to remember

• Throw empty SACT tablets or capsule bottles and boxes in the household waste (not the recycling).

• Return full or partly used bottles of SACT tablets, capsules, or injections to the pharmacist at the hospital you got them from.

• Always wash your hands thoroughly before and after handling SACT medicine or any spillage.

• Carers or family members should always wear disposable gloves if you are likely to come into contact with SACT.

• Change gloves immediately if they are torn or contaminated.

• Put used gloves into a bag and throw them in the household waste.