Help Protect Against Infection
ChemotherapyChemotherapy—The use of drugs to destroy cancer cells. A person on chemotherapy may take one drug or a combination of drugs. Most often these drugs are given by vein using intravenous (IV) infusion. Some can be taken by mouth or given as a shot. can cause a range of side effectsSide effect—Any undesired actions or effects of a drug or treatment. For example, common side effects of chemotherapy include fatigue, nausea, vomiting, and loss of appetite., including nausea and vomiting, hair loss, and fatigue. One side effect that causes concern to oncologistsOncologist—A doctor who specializes in the treatment of cancer. is when you have a low white blood cellWhite blood cell (WBC)—A white blood cell is one of the three main types of blood cells. They are produced in the bone marrow and released into the blood. White blood cells are responsible for fighting infection. There are several kinds of white blood cells, including monocytes, lymphocytes, neutrophils, eosinophils, and basophils. count and develop a fever, which can be a sign of a potentially serious infection Infection—An invasion of microorganisms such as bacteria or viruses that have the ability to multiply and cause disease. .1 You can help manage the risk of developing an infection by working with your doctor to monitor your blood counts.
Learn about ways to recognize and help prevent infections:
Know your blood counts
Your doctor may use a test called a complete blood count before and during your chemo to monitor your risk for infection.2
Steps to help prevent infection2,3
Once you begin chemo, taking the following steps can help you avoid picking up an infection:
- Wash your hands regularly with soap and plenty of water to avoid picking up an infection from things that you touch
- Use hand sanitizer if you have no access to soap and water
- Ask your friends and family to wash their hands when coming into contact with you
- Avoid people with colds or the flu
- Avoid large crowds, which may include sick people
- Bathe daily and dry your skin gently
- Use lotion to help prevent cracks in your skin
- Be careful to prevent cuts or scrapes, because they can provide entry points for infection
- If you get a cut or scrape, cover it with a clean bandage until it heals
- To prevent cuts when shaving, consider using an electric razor instead of a blade
- Handle sharp objects with caution
- Wear protective gloves when performing tasks that expose you to a risk of cuts or scrapes, such as gardening
- Cook food thoroughly to kill infection-causing bacteriaBacteria—The smallest forms of life. Bacteria are the most common causes of infections in people with cancer. Some examples of bacterial infection include food poisoning, pneumonia and strep throat. that may be in raw food
Watch for signs of infection
- Fever higher than 100.5°F (38°C)
- Cough or sore throat
- Severe constipation or loose stools or diarrhea over 24 hours
- Painful or frequent urination, or inability to urinate for more than 4 hours
- Mouth ulcers or sores in the throat or around the rectum
- Unusual vaginal discharge or itching
- Redness, swelling, or soreness of the skin around an implanted port
One side effect of chemo that causes concern to oncologists is low white blood cell counts with fever higher than 100.5°F, which can be a sign of a serious infection
To help you keep your neutrophils at a level high enough to reduce your risk for infection, your doctor may prescribe Neulasta®, which helps to boost the number of neutrophils in your body.
FIND OUT HOW TO START WITH NEULASTA® »
Neulasta® (pegfilgrastim) is a prescription medication used to reduce the risk of infection (initially marked by fever) in patients with some tumors receiving strong chemotherapy that decreases the number of infection-fighting white blood cells.
Important Safety Information
Who should not take Neulasta® (pegfilgrastim)?
Do not take Neulasta® (pegfilgrastim) if you have had an allergic reaction to Neulasta® (pegfilgrastim) or to NEUPOGEN® (Filgrastim).
What should I tell my health care provider before taking Neulasta® (pegfilgrastim)?
If you have a sickle cell disorder, make sure your doctor knows about it before using Neulasta® (pegfilgrastim).
- Spleen Rupture. Your spleen may become enlarged and can rupture while taking Neulasta® (pegfilgrastim). A ruptured spleen can cause death. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.
- A serious lung problem called acute respiratory distress syndrome (ARDS). Call your doctor or seek emergency care right away if you have shortness of breath, trouble breathing, or a fast rate of breathing.
- Serious Allergic Reactions. Neulasta® (pegfilgrastim) can cause serious allergic reactions. These reactions can cause shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, sweating, and hives. If you start to have any of these symptoms, call your doctor or seek emergency care right away. If you have an allergic reaction during the injection of Neulasta® (pegfilgrastim), stop the injection. Call your doctor right away.
- Sickle Cell Crises. You may have a serious sickle cell crisis if you have a sickle cell disorder and take Neulasta® (pegfilgrastim). Serious and sometimes fatal sickle cell crises can occur in patients with sickle cell disorders receiving Filgrastim, a medicine similar to Neulasta® (pegfilgrastim). Call your doctor right away if you have symptoms of sickle cell crisis such as pain or difficulty breathing.
What are the most common side effects of Neulasta® (pegfilgrastim)?
The most common side effect you may experience is aching in the bones and muscles. If this happens, it can usually be relieved with a nonaspirin pain reliever, such as acetaminophen.
- Occasionally pain and redness may occur at the injection site. If there is a lump, swelling, or bruising at the injection site that does not go away, talk to the doctor.
- Neulasta® (pegfilgrastim) should only be injected on the day the doctor has determined and should not be injected until approximately 24 hours after receiving chemotherapy.
- The needle cover on the single-use prefilled syringe contains dry natural rubber (latex), which should not be handled by persons sensitive to this substance.
If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
- Amgen. Data on file.
- Chemotherapy and you. National Cancer Institute website. Update May 2007. NIH Publication No. 07-7156. Available at:
http://www.cancer.gov/cancertopics/chemotherapy-and-you.pdf. Accessed March 2, 2011.
- Infections in people with cancer. American Cancer Society website. Updated September 14, 2009.
http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/InfectionsinPeoplewithCancer/infections-in-people-with-cancer. Accessed March 2, 2011.
- Chemotherapy information for patients and families. University of Pittsburgh Medical Center Web site.
http://www.upmc.com/HealthAtoZ/patienteducation/Documents/Chemotherapy.pdf. Accessed March 2, 2011.
- DeAlleaume L, Tweed EM. When are empiric antibiotics appropriate for urinary tract infection symptoms? J Fam Pract.