Chemotherapy, a common cancer treatment, targets rapidly dividing cells to combat cancer. While effective against cancer cells, it can also affect healthy cells, particularly those in the bone marrow responsible for producing blood cells. This impact often leaves patients with a weakened immune system, significantly increasing their susceptibility to infections.
Understanding the Increased Risk
Chemotherapy drugs can suppress the bone marrow, the soft tissue inside bones where blood cells are made. This suppression leads to a decrease in the production of white blood cells, which are crucial components of the body’s immune system. Among these, neutrophils are particularly important for fighting off bacterial and fungal infections.
A reduction in neutrophil count is known as neutropenia. When neutrophil levels are low, even common germs that the body would normally handle can cause serious infections. The risk of infection is highest during a period called the “nadir,” typically occurring about 7 to 14 days after each chemotherapy session.
Recognizing Signs and Symptoms
Patients undergoing chemotherapy need to be aware of the signs of infection, as symptoms can sometimes be subtle due to a suppressed immune response. Fever is often the earliest and sometimes the only indicator of an infection. A temperature of 100.4°F (38°C) or higher requires immediate attention.
Other potential signs include chills, sweats, or feeling generally unwell. Localized symptoms might also appear, such as a sore throat, new or worsening cough, or shortness of breath. Pain or burning during urination, new abdominal pain, or any new redness, swelling, or pus at a catheter site are also important indicators that require attention.
Immediate Actions When Infection is Suspected
If an infection is suspected while on chemotherapy, contact the oncology care team or go to an emergency room. Do not wait for symptoms to worsen, as infections can progress rapidly in individuals with compromised immune systems.
Patients should avoid taking over-the-counter medications like acetaminophen or ibuprofen to reduce a fever before consulting their medical team. These medications can mask the fever, making it harder for healthcare providers to assess the severity of a potential infection. Be prepared to provide information about recent chemotherapy treatments, exact temperature readings, and all current symptoms to the medical staff.
Medical Management of Infections
Medical professionals promptly evaluate suspected infections. This often involves diagnostic steps such as blood tests, including a complete blood count to assess neutrophil levels. Blood cultures are collected to identify the specific type of bacteria or other pathogen causing the infection. Imaging studies, such as X-rays, may also be performed if a specific site of infection, like the lungs, is suspected.
Treatment for suspected infections often begins with broad-spectrum intravenous antibiotics. These antibiotics are administered quickly, sometimes even before culture results are available, to cover a wide range of potential bacterial causes. Hospitalization is common for close monitoring and continuous administration of these medications, as infections in this vulnerable population can quickly become severe. The treatment regimen may be adjusted once specific pathogens are identified through culture results.
Strategies for Prevention
Preventing infections is an important part of managing chemotherapy treatment. Frequent and thorough handwashing with soap and water is one of the most effective ways to reduce germ transmission. Patients should also avoid close contact with individuals who are sick, especially those with colds, flu, or other contagious illnesses.
Maintaining good personal hygiene, including regular bathing and oral care, can help prevent skin and mouth infections. Proper food handling and preparation, such as thoroughly cooking meat and avoiding unwashed raw fruits and vegetables, minimizes the risk of foodborne illnesses. Discussing recommended vaccinations, like the flu shot, with the healthcare team is also important, as some vaccines may be suitable and provide added protection.