Infection and chemotherapy

As each person’s individual medical profile and diagnosis is different, so is their reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team the possible side effects of treatment before the treatment begins.

Many chemotherapy medicines can damage the bone marrow, where blood cells are made. For most chemotherapy medicines, this effect is temporary and the bone marrow recovers. White blood cells are the cells that fight many types of infections, which means that chemotherapy can leave you at risk for infection. The white blood cell most critically impacted by chemotherapy is called the neutrophil. It fights bacterial infections. The bacteria that cause most infections are normally found on your skin and in your mouth, intestines, and genital tract. Sometimes, the source of an infection is unknown. Infections can happen to people even when they are very careful. If you are fighting infections, you may be given a medicine to boost your white blood cell count after chemotherapy.

How can I help prevent infections?

The following tips may help reduce your risk of infection:

• Wash your hands frequently throughout the day, especially before eating, after using the bathroom, and after touching animals. If soap and water are not available, use antibacterial hand gel containing at least 60% alcohol. 

• Clean your rectal area gently but thoroughly after each bowel movement. Talk with your healthcare provider if the area becomes irritated or if you develop hemorrhoids.

• Stay away from people who are sick with contagious illnesses, including a cold, the flu, measles, or chickenpox.

• Stay away from crowds.

• If you have to be around a crowd, it’s a good idea to wear a mask.

• Stay away from children who have recently been given “live virus” vaccines, such as chickenpox, as they may be contagious to people with a low blood cell count. Oral polio vaccine (OPV) is also a live virus. While it is not currently used in the U.S., it is still used in other countries. Because of that, if you travel internationally, you should also stay away from children who have recently been given oral polio vaccine. 

• Try to prevent accidents and injuries. Be careful not to cut yourself in any way, including the cuticles of your nails. Consider using an electric shaver instead of a razor to prevent cutting yourself while shaving.

• Clean cuts and scrapes immediately with warm, soapy water and an antiseptic.

• To protect your mouth and gums, brush your teeth after meals and before bedtime.

• Don’t squeeze or scratch pimples.

• Take a warm (not hot) bath, shower, or sponge bath every day. Pat your skin dry; don’t rub it.

• Use lotion or oil if your skin becomes dry.

• Stay away from animal litter boxes and waste. Also avoid bird cages and fish and turtle tanks.

• Stay away from standing water, such as in bird baths, flower vases, or humidifiers.

• Wear gloves when gardening or cleaning up after others, especially small children.

• Talk with your healthcare provider before getting any type of immunization or shot, such as flu or pneumonia shots.

• Don’t eat raw fish, seafood, meat, or eggs.

What are the symptoms of an infection?

If you have any of these symptoms, consider it a medical emergency and contact your healthcare provider immediately, before taking any medicines. If you are unable to reach your healthcare provider, go to the emergency room because infections can spread rapidly in a person with a low white count. These are signs and symptoms of a possible infection:

• Fever of 100.4°F (38.0°C) or higher, or as directed by your provider

• Chills, especially chills that cause your body to shake

• Sweating

• Earaches, headaches, or stiff neck

• Blisters on the lips or skin

• Mouth sores

• Severe cough or sore throat

• Sinus pain or pressure

• Loose bowel movements

• Frequent rush to urinate or burning with urination

• Unusual vaginal discharge or itching

• Redness, swelling, drainage, or tenderness, especially around a wound, sore, ostomy (an artificial opening in the abdomen), pimple, rectal area, or catheter site