Chemotherapy and Infectious Risks: Geneva University Hospital Informs You

Neutrophils, also known as "white blood cells," are a type of white blood cell that helps protect your body from microorganisms and infections. They are, in a way, your "bodyguard."

At Geneva University Hospital, our oncologists, hematologists, and nurses will inform you about the side effects associated with chemotherapy.

One of the most common side effects of chemotherapy is a significant decrease in neutrophils. This decrease is called neutropenia or transient agranulocytosis. That is, it appears a few days after treatment and lasts for about 7 to 10 days. This is a long enough period to consider the risk of infection.

To reduce the risk of infection, doctors Matti Aapro, Edya Fuhrmann, Claudine Helg, Volker Kirchner, and the team of nurses in the outpatient oncology department will give you some tips that are relatively easy to follow but that patients often forget.

Characteristics and Symptoms

"Neutropenia is usually defined as a lower number of neutrophils of 500/mm3 or less than 1000 cells/mm3. The risk of infection increases with the severity of neutropenia, especially at a level below 100 neutrophils/mm3."

Fever (38 °C or above) is often the first warning sign of the onset of infection, but there are other symptoms as well, such as nausea, unusual pains, mouth ulcers, etc. You should immediately contact your doctor if you have any doubts about the onset of an infection.

Some Recommendations from Our Experts

Handwashing

Handwashing is essential to remove all visible and invisible contaminants. But handwashing is in no way a substitute for hand disinfection.

It is essential to wash your hands in the following cases:

• If they are dirty
• After touching raw food
• Before cooking
• Before sitting down at the table
• After using the toilet (including changing a baby's diaper)
• After blowing your nose
• After contact with an animal or its belongings
• After doing crafts, gardening, etc.

Oral hygiene

Impeccable oral hygiene can only be achieved when the care of the teeth and gums is carried out carefully after each meal.

We recommend:

• Rinse your teeth immediately after each main meal
• Use a timer to ensure a 2-minute brushing
• Use a soft-bristled toothbrush that is less aggressive on the gums and change it at least once a month
• Try an electric toothbrush for effective plaque removal
• Use flossers and an irrigator
• Use fluoridated toothpaste

The mucous membrane of the mouth can become irritated and injured after chemotherapy treatment. To reduce this risk, oral hygiene should be carried out 3 times a day with a solution prescribed by your oncologist. Avoid foods with high alcohol content to minimize irritation of the mucous membrane.

Dietary hygiene

Microorganisms multiply at temperatures from 5 °C to 60 °C and develop especially quickly in the range between 25 °C and 40 °C. When the temperature rises, the number of microorganisms can double within a few minutes and reach several million within 6 hours.

Microbial contamination of food products occurs mainly due to lack of hygiene during the preparation of raw plant or animal products or during the storage of ready-made products.

The risk of poisoning with pathogens (salmonella, campylobacteriosis, listeriosis, Escherichia coli, etc.) can be minimized by following a few simple tips:

• Avoid cooking if you have the flu. It is better to delegate this cooking task
• Set the thermostat on the refrigerator to a range of 0 °C to + 4 °C, and clean and disinfect it weekly and monthly with diluted bleach
• Avoid cross-contamination by protecting your food with plastic wrap
• Check and comply with expiration dates
• Eat well-cooked meat (70 °C)
• Dishes with fresh eggs (tiramisu, mayonnaise, chocolate mousse, etc.) should be made with very fresh eggs and consumed on the same day