Several further email exchanges with the oncology nurse provided some interesting clarifications. I was advised to be careful about “sloppy” kissing. Also to note that tears, saliva, urine, et cetera would all have traces of the drugs.
5-FU, part of my FOLFOX chemo cocktail, interferes with RNA transcription, and is notably teratogenic, i.e., capable of generating horrendous birth defects. So I wrote back and asked how much of this precaution is diligence to avoid conception with this crap in play, and how much of it is related to drug half life and breakdown products. I pointed out that I have had my vasectomy, I don’t bareback anyone who is fertile in her own right, so the odds of a defective pregnancy approach those required for divine intervention.
She wrote me back and commented that she thought that most of the science around chemotherapy and sex was about teratogenecity.
I understand this from a liability point of view. I understand this from a conservative medicine point of view. I do not want to introduce cytotoxins to my loved ones through sex, kissing or even excessive sweating. I truly will be the Toxic Avenger, as will anyone who goes through this process. I will not be cowboying my way through my intimate life against all medical advice.
But I find it amusing, and frustrating, that the focus is so overwhelmingly on fertility and its risks that there doesn’t seem to be a clear-eyed view, or available information, on the chemo risks in nonfertile sexual environments. Which would of course apply to gay/lesbian couples, the elderly, and anyone of reproductive age who’s been medically or surgically rendered infertile. That has to be a fair amount of people, all working under this fertility management regimen.