Your risk of infection increases during chemotherapy when your body doesn't produce enough white cells (called neutrophils and monocytes) to keep your immune system working properly. This means that bacteria, viruses and fungi in the environment, in your nose, mouth and colon, and on your skin can invade your body without fear of being destroyed by white cells, thereby causing infection. Furthermore, chemotherapy can damage the lining of your mouth and intestines, making it easier for bacteria to enter your blood.
To prevent infection, the following precautions may be taken:
- You may be given antibiotics to prevent or treat infection.
- Although a transfusion isn't generally used for patients who have a low neutrophil count, it may be an option if you have a high fever, an infection that's unresponsive to antibiotics, blood fungal infections or septic shock.
- You may be given a class of drugs known as growth factors. Growth factors can stimulate your marrow to make new white cells. Growth factors used most frequently are G-CSF (granulocyte colony-stimulating factor; filgrastim [brand name: Neupogen] and pegfilgrastim [brand name: Neulasta]). (Children undergoing chemotherapy are given growth factors only in certain circumstances.)
- The medical staff and your visitors must wash their hands frequently and take other precautions so they don't expose you to bacteria, viruses and other infection-causing agents.
- If you're receiving chemotherapy or other drugs through a central line or port, your caregivers must clean your catheter meticulously.
Symptoms to Watch For
If you see any signs of infection developing after you arrive home, don't delay in seeking medical attention. If you have even one of the following symptoms, contact your doctor immediately:
- A temperature of 38.3° C (101° F) or higher
- Persistent coughing
- Tenderness at a site prone to infection, such as the area around the anus or the nasal sinuses
- A sore throat
- Pain when urinating
- Frequent diarrhea or loose bowel movements
Cancer treatment can destroy cancer cells as well as healthy, infection-fighting white cells. If your white cell counts decreases moderately, you won't need special precautions, especially if the cells return toward normal within a short period. However, if you have a severe or prolonged low white cell count, especially after intensive drug therapy, you may be at greater risk for infection.
12 Ways to Reduce Infection Risk
- Make sure your healthcare team takes steps to avoid exposing you to bacteria, viruses and other infection-causing agents: They should practice frequent and vigorous hand washing or, in some cases, wearing masks, gowns and/or gloves.
- Discuss how to avoid infection with members of your healthcare team if you're receiving outpatient anticancer therapy. Caregivers need to be meticulous in cleaning catheters to reduce the risk of bacteria entering the body.
- Wash your hands thoroughly, especially before eating and before and after using the bathroom. This applies to everyone — people in treatment and those around them.
- Avoid crowds and individuals with contagious diseases such as colds, flu, measles or chicken pox.
- Check with your doctor about getting vaccinations. Find out whether you should avoid people who've recently been immunized with live, weakened forms of organisms or viruses that cause the disease, such as measles, and how long you should stay away.
- Clean your rectal area gently but thoroughly after each bowel movement. Ask your doctor for advice if irritation or hemorrhoids are a problem. Check with your healthcare team before using enemas or suppositories.
- Don't cut or tear your fingernails' or toenails' cuticles; avoid cuts or nicks when using scissors, needles or knives; use an electric shaver instead of a razor to prevent cuts; use an extra soft toothbrush that won't hurt the gums; and don't squeeze or scratch blemishes.
- Wash cuts and scrapes right away with warm water, soap and an antiseptic.
- Take a warm (not hot) bath, shower or sponge bath every day. Don't rub skin to dry it; use a light touch to pat skin dry. Use lotion or oil to soften and heal skin if it becomes dry and cracked.
- Wear protective gloves when gardening or cleaning up after animals, young children or others.
- Avoid uncooked fruits and vegetables if you have a persistent low white cell count. Ask your healthcare team for diet and nutrition advice.
- Report any signs or symptoms of infection to your doctor immediately. These include:
- A fever of 38.3° C (101° F) or greater; don't use aspirin, acetaminophen or any other medicine to reduce a fever without checking with your doctor
- Loose bowel movements
- A burning feeling when you urinate
- A severe cough or sore throat
- Unusual vaginal discharge or itching
- Redness, swelling or tenderness, especially around a wound, a sore, a blemish, an intravenous catheter site or a vascular access device
- Abdominal (stomach) pain
For Kids: The Hand-Washing Experiment
If your child has cancer, he or she should be taught how to prevent infections, especially by keeping the hands clean.
Let your child know that washing his or her hands the right way can prevent infections from spreading.
Teach your child to wash his or her hands:
- Before and after making or eating meals or snacks
- Before and after changing diapers
- After coughing, sneezing or blowing your nose
- Before and after using the bathroom