McGill

Infections

Dr. Christine Maheu, RN, PhD

Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.

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Ms. Rosemary Cashman

Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.

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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital

Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.

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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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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.

Next:

Bleeding problems

Back to the list of common cancer treatment side effects