Cancer and cancer treatments may decrease the effectiveness of the body’s natural defense, the immune system.1 Some types of chemotherapy may temporarily reduce the blood cells, including a type of white blood cell called neutrophils.2 These are responsible for fighting infection. If the neutrophils count drops significantly (neutropenia), the patient be at a greater risk for infections.3
Dexamethasone, a type of steroid medication, is commonly used in cancer treatment. It can also suppress the immune response. High doses and prolonged use of immunosuppressive drugs such as chemotherapy and dexamethasone increase the likelihood of developing an infection.4 Older adults and those who were in poor health before treatment or had poor nutrition are also at greater risk for infection.5 Some opportunistic infections are especially common in those undergoing treatment for cancer (e.g., shingles and yeast infections).6
If the patient is receiving treatment that is known to pose a risk of infection, they should not work in close quarters with those who are sick, especially with contagious illnesses. Nor should they work in close contact with the public, especially at certain times of year (e.g., flu season). Patients at risk of infection should not handle human or animal waste. They need access to a washroom or to have hand sanitizers readily available to reduce infection risk.
What patients can do
Speak to your patient about the risk of infection and its signs and symptoms. Show them how to monitor for side effects of cancer and its treatment. Encourage your patient to contact their healthcare team or seek urgent medical care when they have concerns.
Signs of infection include:
- fever (greater than 100.4° F or 38° C), chills or sweating
- sore throat
- shortness of breath and cough
- painful or frequent urination
- mouth sores
- abdominal pain
- redness or swelling at any wound, injury, or site of catheter or tube
One of the simplest and most effective ways to prevent infection is through frequent hand washing. Sometimes antibiotics are required to treat infections.
It is important to diagnose and treat infections as quickly as possible to prevent them from spreading into the bloodstream (sepsis), which may be fatal.
To lower risk of infection, encourage your patient to wash their hands frequently, avoid those who are sick, eat a nutritious diet, drink adequate fluids, exercise regularly, and get plenty of rest. Consult the BC Cancer Agency’s page on neutropenia for more information.
There are several ways that jobs can be modified to lower the risk of infection:
Modify work tasks and schedules:
- Work from home as much as possible.
- Meet by telephone or video-conferencing instead of in person.
- When possible, designate work materials and tools for the patient’s use only (e.g., phones, computers, heavy equipment).
- Use personal hand sanitizer, disposable sanitizing wipes and disposable gloves when handling shared equipment is necessary.
Modify the work environment:
- Relocate the workstation away from others to minimize exposure to germs.
- Request hand sanitizer and antibacterial soap in all bathrooms and kitchens.
- Request hand hygiene education for all staff.
- Ask that the employer educate staff about the compromised immune systems of employees with cancer.
- Request air-purification systems and proper ventilation to reduce air-borne illness.
- Try to gain access to a private washroom.
- Request a mini-fridge to keep the patient’s food and medication separate from that of their colleagues.