Guidelines for the safe prescribing, handling and administration of Systemic Anti-Cancer Therapies (SACT)

1 Jun 2016
Northern Ireland Cancer Network
Type of resource: 

This document has been reviewed and updated by the Northern Ireland Cancer Network (NICaN). It is intended for use across each of the cancer units and the cancer centre. It is based on a document produced by the North and North East London Cancer networks to which we express our sincere gratitude for granting us permission to adapt their guidelines.

Throughout this guideline the term SACT is used, the majority of which are cytotoxic. This guideline does not include hormonal therapies which are SACT .

The term ‘cytotoxic drug’ is generally used to refer to any agent that may be genotoxic, oncogenic, mutagenic or teratogenic. The health risk of any procedure involving cytotoxic drugs stems from the inherent toxicity of the drug and the extent to which workers and patients are exposed. Although in therapeutic doses some of these drugs are known to produce neoplastic changes in the long term, there is conflicting evidence on the effect of the much lower level of occupational exposure.

SACT drug administration for cancer patients throughout the network should be provided by a multidisciplinary team in which doctors, chemotherapy competent nurses and pharmacy staff work to approved written protocols to provide integrated care both within the hospital and the community.

SACT drugs are potentially harmful to both the healthcare professionals involved in their preparation, administration, handling & disposal and to the patients receiving them. While the risks to patients are, in the main, well documented and can be balanced against the clinical benefits, the risks to health care staff are largely theoretical. It is therefore prudent with the present state of knowledge to take every reasonable precaution to protect staff from unnecessary exposure.