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Barrier Contraception - Glivec

Hi all, I don’t know if anyone can tell me, I have looked on lots of info sites about Glivec and called the help / info line who referred me to my doctor. I have been told by one consultant that barrier contraception ( Durex or similar ) is not needed and by another it is.

No problem with birth control as I had the snip 10 years ago, my concern is that Glivec is a chemo i assume therefore can I pass the effects of it affect to my wife, eg chemicals, CML passing on, illness. The one doctor said that Glivec could lower her own resistance to chemo if god forbid she ever needed it.

Thanks Nigel

 

Hi Nigel,

I am very surprised at the advice you received. I have NEVER heard any CML expert clinician express this opinion. Remember, Glivec is a targeted therapy and not chemotherapy in the way we normally understand that class of drugs.   Chemotherapies are extremely untargeted, developed from the kind of weapons used in the 1st world war- e.g mustard gas- which had the effect of destroying bone marrow of those who were exposed. 

Chemotherapies used to treat cancer (in general) are an entirely different class of drug - they are 'global' in their effects and destroy ALL cells no matter what.

Even so, I would not postulate (like one of your doctors has) that any cancer patient who has had chemotherapy is, by having unprotected sex, guilty of transfering chemicals to their partner throught a transfer of bodily fluids, and possibly lowering their future immune response to disease... I find this proposterous.

TKI's (imatinib/Glivec, nolotinib, dasatinib etc) are compounds designed to target a particular signal pathway within the white cells that harbour the PH chromosome- i.e these PH+ cells are uncontrolled because signalling to reproduce is controlled by the abnormal fusion protein Bcr/Abl- two chromosomes- 9 and 22- swop small parts which fuse together to form a new abnormal chromosome called the PH chromosome.

TKI's are a group of chemicals that are designed to target the active pocket in the cell which is switched to ON by this abnormal protein and so the cell continues to reproduce itself ad infinitum. Imatinib/Glivec fits into the pocket and blocks the protein- thus the cell dies.

TKI's have NO effect on sperm. This is why men who are treated with TKi's (as opposed to women who need to come off treatment while they are planning pregnancies) can and do father children without detrimental effects on the foetus.

Thus your sperm cannot have any effect on your wife's immune system or effect her in any way. 

Also Tki's have a half life of around 11 - 12 hours. This is why you need to take these drugs every single day to keep the plasma level at around >1000 ng per ml. which it is thought to be the level that produces the optimal responses.

I hope this helps allay your fears. I know this is a steep learning curve but take your time and try not to worry too much. 

Take a look at some of the video's on the video page.... particularly the parts 1 and 2 of Dr. Brian Druker's educational series. 

 

Best wishes,

 

Sandy

Hi Nigel

I agree with what Sandy says - the advice given by the doctor who suggested Glivec would somehow be passed on to your wife is most odd and I have never heard that before, nor read it anywhere.  And Glivec is not a conventional chemo - indeed, I wouldn't call it chemo at all.  It works in a quite different way, and is extremely selective for the defective protein we CMLers have. For those that don't have that protein, it doesn't do terribly much!

As for passing on CML, don't worry.  It is not something you catch or can pass on. 

CML is a rare disease and there are those who really know their stuff (CML specialists), and those who know a bit about it (general or non CML haematologists). GPs know virtually nothing about it.  For this sort of detail, I would always trust the advice of a specialist so when I've been given advice by general haematologists I have always checked it with the specialists later, and if they disagree, I obviously follow the specialist. When I see my GP, he asks me about CML...

Richard

Thanks for the notes both Sandy and Richard, very helpful, for info the advise was from my specalist !

Hi Nigel,

Just for clarity on this specific and very important issue- you say this 'advice' was from your specialist- is that a CML specialist or a general haematologist?

Best wishes,

Sandy