Infection the invasion of the body by bacteria, viruses, and fungi that multiply under favorable conditions and cause injury to or destruction of the cells is the most frequent cause of illness in the patient with cancer. The most common infection sites are the respiratory and genitourinary tracts, the skin and mucous membranes, and the blood (septicemia).
Cancer itself and cancer treatment both impair the body’s defense mechanisms in various ways and leave patients very susceptible to infection. Those receiving chemotherapy are especially vulnerable eight to fourteen days after administration of the drug or drugs when the white blood cell count falls to its lowest point.
Surgery, diagnostic measures, the use of supportive treatment measures (injections, catheters, suction tubes, drainage tubes), and even the mere fact of being in the hospital all increase the chance of exposure or susceptibility to infection.
The patient should do everything possible to decrease the risk of infection, eating a balanced and adequate diet (see Loss of Appetite) and conserving energy with adequate and uninterrupted periods of rest and sleep.
In addition, the patient can avoid exposure to potential sources of infection by avoiding:
- People with transmissible illnesses (bacterial infections, cold sores, shingles, colds, flu, chicken pox, measles).
- People recently vaccinated with live or attenuated vaccines.
- Bird, cat, and dog feces. Since feces contain high levels of fungi and bacteria, patients with cancer should not clean birdcages and cat litter boxes and should avoid areas where dogs are frequently walked.
- All sources of stagnant water, such as that in flower vases, denture cups, irrigating containers, respiratory equipment, soap dishes, and liquid soap. To decrease the growth of microbes, a teaspoon of chlorine bleach should be added to each quart of water used in flower vases and a teaspoon of vinegar to each quart of water or saline solution used for respiratory equipment.
- Contaminated equipment. Equipment should be cleaned by vigorous rubbing with a 70 percent alcohol solution, a solution of one part Clorox to thirty parts water, or a 1 to 2 percent iodine solution.
- When the white blood count is exceedingly low, patients should avoid all possible sources of harmful microorganisms. These include un-pared fresh fruits, raw vegetables, flowers, house plants, raw eggs, raw milk and products made from raw milk, and cold cuts and deli items that may have been handled by others. Foods prepared in a blender that cannot be adequately cleaned also should be avoided.
Patients should wash their hands frequently with powdered soap or dehydrated soap flakes (such as Ivory) before preparing or eating food and after using the toilet. They should also cleanse the perianal area after each bowel movement with a mild soap such as Dove and a soft towel, washing, rinsing, and patting dry from front to back. Women should be especially careful to keep the vaginal area clean, and should avoid douches and bubble baths. Finally, precautions should be taken to avoid injuring the mucous membranes, where infectious agents can easily enter the body.
Annual vaccination against pneumococcal and pseudomonas bacteria is a wise idea. In addition, patients should be vigilant for signs of infection and report them to the doctor at once.
- Any fever over 100 degrees Fahrenheit (38 degrees Centigrade)
- Sore throat, coughing, or other cold symptoms
- Chills or sweating
- Frequent or painful urination
- Cuts, boils, pimples, or sties that do not heal, or become red or swollen
- Vaginal discharge or itching