Protect Yourself From Infection
by Kimberly M. Hinckley, RN, BSN, CIC; Gale M. Liddell, BS, MT, CIC;
and Brahm H. Segal, MD
Infections are illnesses caused by microorganisms (germs) such as bacteria, viruses, and fungi. People with cancer may be at increased risk for infections for a number of reasons.
The cancer itself may compromise the immune system, which is what protects the body from infection. For example, certain cancers of the blood may inhibit the body’s ability to make normal white cells that fight infection. In addition, cancer treatments, such as chemotherapy and radiation therapy, can decrease the number of healthy white blood cells.
Neutrophils are a specific type of white blood cell that have a particularly important role in protecting from infection. Neutropenia, or low neutrophil count, can result from certain types of cancer treatment. The longer the duration of neutropenia, the greater the risk of infection. Other medicines used in cancer therapy (such as steroids) can also weaken the immune system.
It’s important for people receiving cancer treatment to be vigilant of signs of infection and report them to their physician. Signs of infection include fever, cough, and skin that is red, tender, and swollen.
Your skin is your first line of defense in preventing infections.
There are different types of medications to treat infections. The most common are antibiotics to treat or prevent bacterial infections. Antiviral and antifungal medications are also sometimes used in people with cancer. Some people who are at high risk for infections may be given antibiotics to prevent infection. People with neutropenia who develop a fever require prompt evaluation and antibiotic therapy.
Keep in mind that there are many kinds of cancer and cancer treatments with different levels of infection risk. Your oncologist can educate you about the risk of infections associated with your specific cancer and treatment and what can be done to prevent them. There are, however, some general guidelines all people can follow to reduce their risk of infection.
Preventing Infection: What You
Taking infection prevention into your own hands has a very literal translation. Hand washing is one of the best methods for preventing the transmission of infections. If your hands are visibly dirty, you should vigorously wash your hands with soap and water until clean; to be most effective, hands should be washed for at least 15 seconds. It is OK to use alcohol-based hand sanitizers when soap and water is not available. You should always wash or sanitize your hands before eating, drinking, or taking medication; after using the bathroom, coughing, sneezing, or blowing your nose; before touching your eyes, nose, or mouth; before and after performing any care involving intravenous lines, catheters, or bandages; and after touching things that are frequently touched by others, such as doorknobs.
It is also important for your healthcare providers, family, friends, and caregivers to wash or sanitize their hands before touching you. Don’t be afraid to ask others if they have washed or sanitized their hands.
You should also strive for good personal hygiene. Your skin is your first line of defense in preventing infections from entering your body. The first step to ensuring good hygiene is to bathe or shower regularly with a mild soap. Change towels daily, and do not share towels with others. Regularly inspect your skin closely for rashes, redness, signs of infection, and cuts that do not heal properly. Use a soft-bristle toothbrush to clean your teeth after meals and before going to bed. Keep bandages dry. If they become wet, change them promptly.
In addition, you should avoid people who are sick and avoid crowds, especially during cold and flu season. Do not handle animal excrement; have someone else change the litter box. Get plenty of rest. Eat a well balanced diet. Do not eat spoiled or expired foods, and do not consume raw meat or seafood. Thoroughly wash fruits and vegetables.
Ask your healthcare provider about vaccines that prevent illness. It is important to talk to your healthcare provider before receiving any vaccines because live vaccines can potentially be harmful to people with certain types of cancer. Encourage those around you to get immunized, as well.
Empowering yourself is one of the most important things you can do to prevent infections during cancer treatment. You have the right to ask everyone who participates in your care to wash their hands. Make sure that anyone who visits you is healthy. And ask questions when you are unsure. Contact your healthcare provider if you suspect you may have an infection. Infections caught early are easier to treat.
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Kimberly Hinckley is a senior infection prevention and control coordinator, Gale Liddell is an infection prevention and control coordinator, and Dr. Brahm Segal is chief of Infectious Disease at Roswell Park Cancer Institute in Buffalo, NY.
This article was published in Coping® with Cancer magazine, July/August 2010.