Cancer treatments and infections may decrease the effectiveness of your 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 your neutrophils count drops significantly (called neutropenia), you may be at a greater risk for infections.3 Dexamethasone, a type of steroid medication, is another drug that is commonly used in cancer treatment; it can also suppress the immune response. High doses and prolonged use of immunosuppressive drugs like chemotherapy and dexamethasone increase the likelihood of developing an infection.4 Older adults and those who were in poor health before treatment or suffer from poor nutrition are also at greater risk for infection.5 Some “opportunistic” infections are especially common in those undergoing treatment for cancer, including shingles and yeast infections.6
Vocational implications
If you are receiving treatment that is known to pose a risk of infection, you should not work in close quarters with those who are sick, especially with contagious illnesses. Adopt infection prevention measures when working with the public, especially at certain times of year (flu season). Avoid handling human and animal waste. You will need access to a washroom or to have hand sanitizers readily available, as frequent hand washing is an important way to reduce your risk of infection.
What you can do
Speak to your healthcare team about your risk of infection and learn to monitor for side effects of your cancer and treatment. Know the signs and symptoms of infection and when to contact your healthcare team or seek urgent medical care with 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
- diarrhea
- 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. An infection that has spread to the bloodstream is a condition called sepsis that may be fatal.
To lower your risk of infection, wash your 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.
Job accommodations
Modify your work tasks and how you work:
- Work from home as much as possible.
- Evaluate if you can avoid travelling to work with public transit or travelling during rush hours.
- Schedule meetings to be done over the telephone or video-conferencing instead of in person.
- When possible, designate work materials and tools for your use only, avoid sharing equipment (phones, computers, heavy equipment). Keep a personal mug, dishes and utensils and do not share with co-workers.
- Keep a personal hand sanitizer in your workstation, as well as disinfecting wipes to clean surfaces prior to use (e.g., computer keyboards, phones etc.).
- Wear disposable gloves when handling shared equipment is necessary.
Modify your work environment:
- Relocate your workstation away from others to minimize your exposure to germs.
- Request hand sanitizer and antibacterial soap to be placed in all bathrooms and kitchens, at your workstation, and hand hygiene education to be provided for all staff.
- Avoid working with sick co-workers. If appropriate, you might provide education to your co-workers regarding your compromised immune system. You could choose to do so informally, or speak with your manager or human resources department.
- Air purification systems and proper ventilation can reduce airborne illness.
- Request access to a private washroom.
- Consider a mini-fridge to keep your food and medication separate from your colleagues. Bring pre-packed meals. Do not prepare food in common kitchen areas.