While traditional chemotherapy is effective at reducing or eliminating abnormal cancer cells, the toxic drugs used for treatment often cause temporary side effects. One of the most serious of those side effects is an elevated risk of infection just after treatment. That is because chemotherapy drugs destroy white blood cells, the infection-fighting cells of the body's immune system.
Some chemotherapy drugs are more damaging to white blood cells than others, especially those that harm the body's bone marrow, where all blood cells are formed. If your white blood cell count falls very low, your body is at risk of becoming infected by all sorts of bacteria and viruses that a healthy immune system can normally fight off. The medical term for an extremely low white blood cell count is neutropenia.
Neutropenia is a condition that sometimes follows chemotherapy treatment—often seven to 12 days after the drugs have been administered. Doctors will help you monitor your health during that period and alert you to alert you to any issues. To determine exactly how low your white blood cell count is, physicians will request either a blood test called a WBC (white blood cell count) or CBC (complete blood count). Once a person develops neutropenia, medications must be taken to increase the body's production of white blood cells.
According to Dr. Matthew M. Cooney, oncologist at the University of Ohio Seidman Cancer Center, "It's fairly common for physicians to use [medication] to increase white cell production in cancer patients with neutropenia. If a patient is getting standard chemotherapy that puts his or her immune system at risk — lowering his or her white blood cell count to below normal levels — it's not uncommon to treat that patient with [medication] about 25 percent or more of the time. If a patient has an infection while his or her immune system is lowered, or if the infection persists for a prolonged period of time (usually seven to 10 days), almost always a physician would do one or more of the following for his or her next chemotherapy treatment: He or she would prescribe a lower dose of chemotherapy, plus add on the growth factor [medication] Neulasta, the most common [treatment] given."
Even so, patients receiving chemotherapy are urged to be cautious. Learn the signs of infection, such as running a fever of more than 100.4? F, and take precautions prior to chemo treatments to lower your risk of infection should you develop neutropenia. A few small lifestyle changes can help you better protect your health.
Although you can't do much to safeguard yourself against infection, there are some general guidelines you can follow to help protect yourself if you develop neutropenia:
- Wash your hands more frequently, especially before cooking and eating
- Always wash hands before touching or cleaning any wounds
- Always wash hands after taking out or touching garbage
- Avoid crowds and in-hospital treatments
- Do not share eating utensils, drinking straws, towels or other personal things
- Fully cook meats and eggs and thoroughly wash fruits and vegetables
- Avoid eating sliced deli meats and cheeses and food from open-air salad bars
- Cover your hands with gloves for household chores
- Clean your home with germ-killing disinfectants
- Do not touch pet waste
- Wash hands after changing a child's diaper
- Use a soft toothbrush and brush gently to avoid bleeding
- Trim fingernails and cuticles with a clipper if needed; do not pick cuticles
- Keep your body, mouth, and face clean and bathe daily
- Keep skin conditioned with moisturizers
- Use an electric shaver as opposed to razors
- Avoid activities that are known to cause cuts, scrapes, and/or bruises
Your oncologist will likely know beforehand if you're at risk for developing neutropenia during your chemotherapy and will inform you of those risks. To potentially avoid unnecessary infections, a lower dose of chemotherapy may be used or your doctor may switch to a different chemotherapy drug or combination of drugs.
- The American Cancer Society. (2012). Chemotherapy Principles: An In-Depth Discussion. http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/Chemotherapy/ChemotherapyPrinciplesAnIn-depthDiscussionoftheTechniquesanditsRoleinTreatment/chemotherapy-principles-how-does-chemo-work
- Mayo Clinic Staff Writers. (2011). Low blood cell counts: Side effect of cancer treatment. http://www.mayoclinic.com/health/cancer-treatment/CA00066
- Centers For Disease Control and Prevention (CDC). (2011). Preventing Infections in Cancer Patients. http://www.cdc.gov/cancer/preventinfections/patients.htm
- National Institute of Health. (2011). WBC Count. MedlinePlus.com. http://www.nlm.nih.gov/medlineplus/ency/article/003643.htm
- National Cancer Institute. (2008). Managing Chemo Side Effects. http://www.cancer.gov/cancertopics/coping/chemo-side-effects/infection
- Dr. Cooney, Matthew M., Medical Director, Ambulatory-Based Programs, University of Ohio Seidman Cancer Center, Cleveland, Ohio. Personal interview. 7 June 2012.