Infection is a major concern for cancer patients. Fortunately, most of the infections in the home or community are not life threatening to cancer patients. These include the minor viral respiratory infections children and grandchildren pass back and forth. This does not include serious viral infections, like influenzae.

The biggest infectious concern for cancer patients is bacteria already present in the body, mainly the GI tract. Bacteria are a normal component of the GI tract and when white blood cell counts are low, there is risk of the bacteria entering the bloodstream and causing a serious infection called sepsis. Bacteria can also enter the lungs and bladder and cause pneumonia or bladder infections.

When white blood cell counts are low, infection can spread rapidly and be life threatening. Fever or chills may be the first warning sign and should not be ignored.

To lower the risk of infection of neutropenia, growth factors called Neupogen, Granix and Neulasta can be administered by subcutaneous injection to stimulate the bone marrow to produce white blood cells.

The following steps can help lower your risk of infection:

Know your neutrophil count. Neutrophils are a type of white blood cell that is important in preventing infection. Consult the following table to help assess your risk of infectious complications. Ask your physician what your neutrophil count is. Mild neutropenia is 1000 to 1500 neutrophils, moderate neutropenia is 500 to 1000 neutrophils, and severe neutropenia is less than 500 neutrophils.

Wash your hands frequently and use hand sanitizer. This is probably the most important means of reducing infection risk. Some patients wear masks if they are in public during times of low white blood cell counts, though the effectiveness of this is unknown.

Keep distance between yourself and a sick friend or family member.

Know when your white blood cell count is low (usually 7 to 14 days after receiving every 3 to 4 week chemotherapy) and being more cautious during that time.

Receive growth factor injections such as Neulasta, Granix and Neupogen. These injections stimulate the bone marrow to produce infection fighting white blood cells called neutrophils.

Minimize handshaking and exposure to crowds. If your white blood count is critically low, you may want to avoid crowds, handshaking, and public places during that time. Be careful with locations or activities that put you at risk for inhalational exposure, such as sweeping in a dusty barn. If your white blood cell count is only mildly decreased, you will have to use judgement about the risk of infection and how much precaution to take. Staying in the house isolated for long periods of time is not good for mental health. The benefits of human interaction with family and friends may far outweigh the risk of infection.

Avoiding fresh fruits and vegetables is not necessary for most cancer patients. This is a concern for patients undergoing aggressive inpatient chemotherapy for leukemias or bone marrow transplant.