Opportunistic infections are just what they sound like – little germs that find the opportunity to attack when your immune system is down – and they can cause serious setbacks during your chemotherapy or radiation therapy for colon cancer. According to Dr. Lisa Richardson at the Centers for Disease Control and Prevention (CDC), about 60,000 cancer-fighting people develop a serious infection during treatment that requires hospitalization.
How It Starts
Both the cancer and the treatment decrease your amount of circulating white blood cells (WBCs), which are your bodys front line defense against infection. Specifically, cancer treatments affect a special type of WBC, called neutrophils. The neutrophils are your soldiers –the biggest fighting force your body has. They eat bacteria and take out your biological trash. When chemotherapy kills rapidly dividing cells, such as cancer cells, it also kills these WBCs. Although they will regenerate, you are going to have to take extra precautions against infection in the meanwhile.
As your neutrophil count (in your blood) drops, your risk of infection increases. Because there are no outward signs that your neutrophils are decreasing, your doctor and nurses will be monitoring your blood during your treatment. This is one of the many reasons cancer-fighters suffer so many needle pokes and blood draws during chemotherapy.
What to Watch
Even despite your best efforts, there is a chance that you will still develop an infection during treatment. You can't do anything to prevent your WBC count from decreasing, but you can report early signs and symptoms of infection to your doctor immediately. The sooner your infection gets treated, the sooner you can return to fighting cancer. Signs of an infection might include:
- Fever greater than 101 degrees Fahrenheit or greater than 100.4 degrees sustained for over an hour
- A new cough or runny nose, or a change in the sound of your chronic cough
- Nausea, vomiting or diarrhea (only if this is a new symptom for you)
- Sore throat or new sores in your mouth
- New pain or abdominal pain
- Changes in urination including burning, pain, or increased frequency (need)
- Redness, drainage, or pain at a wound or surgical site
- Fever, chills, or new headache
Decreasing Your Risk
There is little you can do to completely prevent a decrease in your neutrophils (your doctor will call this neutropenia). However, there are many actions you can take to help your immune system and prevent infections from getting access to your body. You are most susceptible to infections about seven to 12 days following your last chemotherapy session. Along with watching for signs of infection during this time, be sure to follow these guidelines to protect yourself:
- Wash your hands frequently, but especially before and after you go to the bathroom, touch a public object (doorknob), and eat or drink
- Let a family member clean up after the family pet, and be sure to wash your hands after touching your pet
- Wear vinyl gloves when gardening or touching raw meats (and wash your hands after you remove the gloves)
- Cook foods thoroughly and avoid raw or undercooked foods, such as oysters or sushi
- Do not drink any unpasteurized liquids, such as raw milk
- Bath daily and keep your skin moisturized (even a simple cut or skin crack provides an entry for germs)
- Brush and floss your teeth daily
- Avoid crowds, young children and schools during this time
- Wear a face mask if you must go out in a crowded public place, such as the mall
- Do not touch your eyes, nose, or mouth without using a clean tissue as a barrier
- Keep household surfaces clean with an antibacterial agent
Aside from these measures, one of the best things you can do – to advocate for yourself – is learn more about infections and how they affect cancer patients. The CDC has paired with Amgen in a campaign called 3 Steps Forward. Their purpose is to educate people with cancer, caregivers and even healthcare providers about the dangers of infection and cancer. 3 Steps Forward uses an interactive website, found at Preventcancerinfections.org, which educates about ways to protect yourself or your loved one, and even has an interactive worksheet that will tailor your advice to your disease and risk level.
Centers for Disease Control and Prevention. (n.d.). Neutropenia and Your Risk for Infection. Accessed on November 12, 2012.
Marrs, J.A. (April 2006). Care of Patients with Neutropenia. Clinical Journal of Oncology, Volume 10, 2.
3 Steps Forward. (n.d.). Take Three Steps Toward Preventing Infections During Cancer Treatment. Accessed November 9, 2012.
Richardson, L. (August 2012). New Tool to Prevent Infections During Chemotherapy. CDC Expert Commentary.