Avoiding Infections Helps Keep Cancer Patients Healthy

Armen Hareyan's picture
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Infections are a major cause of illness and death in cancer patients, but simple steps and common sense can help keep patients healthy and improve their chances of a good recovery.

An important first step is to reduce their risk of developing infections, which can be due to the cancer itself or to the therapy used to treat it.

"Even common infections that pose no serious threat to people without cancer can be hazardous to people with cancer or undergoing cancer therapy," says Dr. Jeremy Young, an infectious disease specialist at the James Cancer Hospital and Solove Research Institute at The Ohio State University. "Chemotherapy can do a great job of killing cancer cells, but it can also destroy white blood cells, one of the body's first-line defenses against infection."

Infections are a particular problem for those with leukemia who receive bone-marrow or stem-cell transplants, says Dr. Steve M. Devine, director of the Blood and Marrow Transplant Program at The James.

"Leukemia or lymphoma patients who undergo transplants have a deeper and longer period of low blood counts, and their therapies often affect multiple types of white blood cells, which can increase the risk of bacterial, viral and fungal infections," says Devine.

Sometimes, infections may even lessen the effectiveness of cancer therapy by delaying the next cycle of chemotherapy, which can reduce the response to the therapy or raise the risk of relapse, says Devine.

Steps to prevent infections in cancer patients begin in the hospital. They include testing patients to learn if they harbor viral infections that are often acquired during childhood and remain in the body throughout life. They include cytomegalovirus, Epstein-Barr virus, herpes virus, toxoplasmosis and some fungi.

Normally, the immune system keeps these infections under control and harmless.

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If cancer therapy weakens the immune system, however, these microbes have the opportunity to multiply and cause disease. These "opportunistic infections" can be another source of illness for cancer patients.

"Rapid testing is available for the detection of many infectious pathogens, which can enable us to diagnose opportunistic infections before symptoms appear, allowing us to start preventive therapy early," Young says.

Patients may be vaccinated for influenza or pneumonia prior to chemotherapy, and be given preventive antibiotics. "These strategies are tailored to the individual patient and allow us to prevent a number of opportunistic infections," Young says.

Infections are also a cause of concern at home, but patients and families can take simple steps to reduce that risk. Most measures, such as frequent hand washing, are a matter of good common sense. Immune-suppressed patients should avoid close contact with anyone who shows signs of a respiratory tract infection or other communicable diseases.

Even some foods pose a risk of infection. The most common culprits include undercooked meat, unwashed vegetables, un-pasteurized milk, and well water.

"Pathogens that are sometimes present in foods may not affect others in the family, but they can potentially cause serious illness in a cancer patient who has received chemotherapy," Young says.

If food drops to the floor - don't eat it; throw it away. Patients should also avoid or minimize contact with animals, and never handle excrement or clean litter boxes. Caregivers should wash hands thoroughly after touching a pet and before touching the patient.

Transplant patients, leukemia patients, and solid-tumor patients who have very low blood counts or are immune-suppressed may be asked at times to wear a paper mask that covers the nose and mouth as protection against inhaling disease-causing microbes.

Cancer patients who develop infections should seek help promptly. Signs of an infection include fevers, chills, sweats, and pain or inflammation at the site of infection. Coughing, shortness of breath and chest pain can be signs of pneumonia. Patients should watch incision sites for signs of inflammation - redness, warmth, swelling, tenderness - because they signal an infection.

"If signs of infection are seen, it is important to seek care immediately to prevent the problem from worsening," Devine says. "Preventing infections when possible and recognizing early when they occur, can go a long way to improving a cancer patient's outcome."

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