Staying Well with Cancer
Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work, Emeritus
SEPTEMBER 19, 2018
Avoid Infection while Living Your Life
Staying well with cancer is not an oxymoron. Many people are healthy except for the cancer, and an important goal is staying that way. It always seems a little crazy that you may physically feel better at the moment of a cancer diagnosis than you will in the months ahead. Surgery and chemotherapy and radiation can certainly make you feel less well and, sometimes, terrible. The good news is that the side effects do eventually pass, and we are likely to regain our pre-cancer level of energy and sturdy health.
A major concern for people going through cancer treatment, especially chemotherapy, is infection. Some people have such rigorous treatment that they must isolate themselves from others and have restrictions on diets (e.g. no fresh fruit or vegetables). Fortunately, these situations are not so common, and, if you have a bone marrow transplant or some other treatment that necessitates such measures, your caregivers will definitely educate you about the rules.
I am writing here about the rest of us, almost all of us who are undergoing cancer treatments. We may be fatigued or experience headaches or nausea or body aches, but the real danger is infection. Patients are generally told to call their doctor if they have a fever greater than 100.5. Instructions to go quickly to the ER should be taken seriously because infections can get very bad very quickly. This can happen during the period after chemotherapy (or sometimes during radiation to a large field) when there is a dangerously low level of white blood cells, called neutropenia. This usually happens between days 7 and 12 after chemotherapy, but it can be timed differently and/or last longer with some kinds of drugs.
How do you know if you are neutropenic, meaning that your white blood count is dangerously low? You don’t, without a blood test. If your doctor thinks that your treatment puts you at risk, you may be advised to avoid crowds during this period. Sometimes, people are on treatment regimens that include coming in for a blood test about 10 days after chemotherapy.
This is useful information, but it absolutely should not be the cause of panic! Sometimes people exaggerate the risk and isolate themselves unnecessarily. It is usually not necessary to stay away from friends or a restaurant, movie theater or other public places. Being too much alone and worried becomes a mental health risk. Unless you are otherwise advised, it is smart to be sensible, but to try to keep at your usual routines.
What can we do to try to stay well? As we have all been told many times, the most important thing is to wash our hands. Certainly wash after using the bathroom and before eating, but wash more often during treatment. Carry a bottle of hand sanitizer and use it frequently. Get a flu shot and ask your family to get one, too. If your doctor suggests doing so, avoid crowds at certain times during your treatment cycle. Take a bath or shower everyday. Avoid being near people who are sick. It boils down to this: Use common sense and hope for a little luck.