Managing Infections

The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.

• What Will I Learn By Reading This?
• What Is An Infection?
• Why Can Chemotherapy Raise My Chances Of Getting An Infection?
• How May My Low White Blood Cell Count Be Treated?
• What Can I Do To Lower My Changes of Getting An Infection?
• When Should I Call My Doctor?
• What Have I Learned By Reading This?
• Key Words

What Will I Learn By Reading This?

When you have chemotherapy (key-mo-ther-a-pee) to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. You will learn:

• What an infection is
• Why chemotherapy raises your chance of getting an infection
• How your doctor will lower your chance of getting an infection
• Things you can do to help lower your chance of getting an infection
• When to call your doctor

It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.

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What Is An Infection?

Your body is amazing. It is like a fortress that is protected by your skin and your white blood cells. White blood cells are your body’s defense system. When germs (tiny living organisms that can’t be seen with the human eye that can make you sick) enter your body, they can attack a part of your body or your whole body. This is called an infection. Germs can enter your body in many different ways. For example, they can enter through a cut in your skin, or through food that is not cooked the right way. When you have an infection, you may have pain, redness, or swelling in one place in your body or you may get a fever. Your body fights these germs with the help of your white blood cells.

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Why Can Chemotherapy Raise My Chances Of Getting An Infection?

Picture of white blood cells fighting a germ

Chemotherapy is usually given in cycles (set time periods), with periods of rest to give your body time to grow strong and replace healthy cells that might have been lost during treatment. The anticancer medicines you take can affect the healthy cells in your body, including your blood cells. Your blood is made up of three kinds of blood cells:

• White blood cells help you fight infections. Your white blood cells are your body’s defense system.
• Platelets help your body stop bleeding when you cut yourself.
• Red blood cells carry oxygen from your lungs throughout your body.

You may get an infection because the anticancer medicines you take affect your body’s ability to make white blood cells. You are most likely to get an infection one to two weeks after your chemotherapy treatment. Speak to your doctor or health care team about when you are most likely to get an infection. The good news is that there are ways to treat a low white blood cell count and lower your chances of getting an infection.

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How May My Low White Blood Cell Count Be Treated?

During your chemotherapy treatment your doctor will ask you to have blood tests. These blood tests tell your doctor how your body is doing. When you have a blood test, a nurse or technician will take a small amount of blood from your arm with a needle. The blood tests will tell your doctor if you have a low white blood cell count. A low white blood count is also called neutropenia (new-tra-pee-nee-ah). If your white blood cell count is too low, your doctor may stop your chemotherapy until your white blood cell count is higher. The good news is that the low white blood cell count caused by your chemotherapy is treatable.

The most common treatment for a low white blood cell count is to take a medicine that tells your body to make more white blood cells. These medicines are called colony stimulating factors (CSF). These medicines are usually given to you one to three days after your chemotherapy treatment. Depending on which CSF your doctor uses, you may take the medicine every day for up to two weeks.

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What Can I Do To Lower My Changes of Getting An Infection?

It is important for you to lower your chances of getting an infection to keep your doctor from stopping or delaying your chemotherapy treatment. There are many simple things that you can do to lower your risk of getting an infection during your chemotherapy treatment.

• Wash your hands often with an antibacterial soap. Be sure to wash your hands before and after you eat, before and after you make your meals, after you use the bathroom, and after you touch any animals.
• Ask visitors to wash their hands.
• Stay away from crowds. For example, go shopping or to the movies when the stores or theaters are not busy.
• Stay away from people with colds or the flu, including those people who say they are “getting over something” or “coming down with something”.
• Stay away from children who have been given a vaccination (medicine given a person to keep them from getting an illness) for the chicken pox or polio.
• Be careful not to cut or nick yourself when shaving. Use an electric shaver instead of a razor.Be careful not to cut or nick yourself when using scissors, needles, or knives.
• Do not cut or tear the cuticles of your nails.
• Use a soft toothbrush to clean your teeth. Brush your teeth gently. Gargle with salt water or watered down hydrogen peroxide (a ½ a cup of hydrogen peroxide mixed with ½ a cup of water) to help keep your mouth clean. Floss your teeth only if your doctor says it is ok.
• Clean your anal (the area around your anus) area gently but thoroughly after each bowel movement. Talk to your doctor or health care team if you have hemorrhoids (swollen veins around your anus which are itchy or painful).
• Do not eat raw fish, seafood, meat or eggs.
• Do not change animal litter boxes, bird cages, and fish tanks during your time of highest risk for infection. Animal waste carries germs in it that can cause you to become ill when you are at your highest risk.
• Take a warm (not hot) bath, shower, or sponge bath every day. Pat your skin dry using a light touch. Do not rub too hard.
• Use lotion to soften and heal your skin if it becomes dry and cracked.
• Clean cuts and scrapes right away. Clean them daily with warm water, soap, and an antiseptic (a substance that kills germs) until they are healed.
• Wear gloves if you are working in your yard.

Plan For Lowering Your Chance of Getting An Infection

• If you have animals, is there someone who can help you take care of them during your treatment?
• What plans will you make if you watch young children and one of them gets sick during your chemotherapy treatment?
• How do you get in touch with your doctor or health care team if you need help?

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When Should I Call My Doctor?

You should call your doctor if you have:

• A fever higher than 100° F or 38° C
• Chills, in particular shaking chills
• A cough or sore throat
• Loose stools (diarrhea) over a 24 hour period
• A need to urinate more than normal or a burning feeling when you urinate
• Mouth sores (small cuts or ulcers that appear on your lips or mouth during your chemotherapy treatment) or sores in your throat
• Redness, swelling, or sores on your skin
• Sinus pain or pressure
• Blisters on your lips or skin
• Earaches, headaches, or a stiff neck

If you have any of these signs talk to your doctor or health care team right away. If you doctor finds that you do have an infection, there are medicines and treatments that can help you feel better. It is important that you talk to your doctor or health care team about any side effects you may have during or after your treatment. Your health care team can help treat these problems..

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What Have I Learned By Reading This?

You learned about:

• What an infection is
• Why chemotherapy raises your chance of getting an infection
• How your doctor will lower your chance of getting an infection
• Things you can do to help lower your chance of getting an infection
• When to call your doctor

If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.

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Key Words

• Anticancer: medicines used in the treatment of cancer.
• Anal: the area around your anus.
• Antiseptic: a substance that kills germs.
• Anus: the opening through which stool passes out of your body. The act of passing stools is called a ‘bowel movement’ or ‘opening your bowels’.
• Chemotherapy (key-mo-ther-a-pee): a prostate cancer treatment, which treats your whole body with powerful anticancer medicines to kill many of your prostate cancer cells.
• Colony stimulating factors (CSF): medicines that tell your body to make more white blood cells.
• Cycles: set time periods.
• Germ: tiny living organisms that can’t be seen with the human eye that can make you sick.
• Hemorrhoids: swollen veins around your anus, which are itchy or painful.
• Infection: when germs enter your body causing you to have a fever or pain, redness, and swelling in one part of your body.
• Mouth Sores: small cuts or ulcers that appear on your lips or mouth during your chemotherapy treatment.
• Neutropenia (new-tra-pee-nee-ah) : A low white blood count.
• Organism: a tiny form of life.
• Platelets: cells in your blood that help stop bleeding.
• Red Blood Cells: cells in your blood that carry oxygen from your lungs throughout your body.
• Side Effects: unwanted changes in your body caused by your prostate cancer treatment.
• Vaccination: a medicine given a person to keep them from getting an illness.
• White Blood Cells: cells in your blood that help you fight infection.

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