Preventing Infections in Patients with Cancer at Home

Home patient care

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Because patients with cancer or receiving cancer treatments are at an increased risk for infections, health care workers should assure that their patients know how to protect themselves.

Cancer and chemotherapy can weaken patients' immune systems and reduce the number of white blood cells. Also, chemotherapy can kill healthy white blood cells while targeting cancer cells. Neutropenia is a common side effect after receiving chemotherapy that causes a decrease in the number of white cells, called neutropenia. While neutropenia cannot be prevented, patients can take steps to reduce their risk of getting an infection while their white blood cell count is low.

Health care providers should make sure their patients know these guidelines to protect against infectious diseases while their immune systems are low.

• Hand Hygiene: Patients should wash their hands often with soap and warm water. They should carry alcohol-based hand sanitizer to clean their hands while they are out. Moments for performing hand hygiene include before eating or handling food products, after using the bathroom, after visiting a public place or touching an item touched by others, after taking out the trash, and after touching animals. Hand hygiene is the number one way to prevent the spread of infections, according to the Centers for Disease Control and Prevention (CDC).
• Influenza shots and other vaccines: Patients are encouraged to receive their flu shot every fall. It is also recommended that household members of patients with cancer also receive the flu shot. Cancer patients should always consult with their physician before receiving any vaccine.
• Practice food safety and discuss foods that should be avoided with the health care team. Before handling food products, patients should wash their hands. They should also ensure that all meat or poultry products are cooked thoroughly before eating. The US Department of Agriculture (USDA) recommends that individuals read food packaging before cooking. Not all frozen foods are fully cooked or ready to eat; some can come partially cooked. In a study conducted by the USDA, 22% of participants preparing frozen foods were unaware if the products were raw or fully cooked despite reading the product instructions. A food thermometer can also ensure that cooked meat and poultry have reached their safe internal temperature. Cancer patients should also follow best-by-dates and expiration dates present on the packaging. These dates are printed to ensure the quality of foods, and it is imperative that patients only consume fresh, unexpired foods. It is also a recommendation for cancer patients to avoid foods linked to outbreaks.
• Safely store foods: Cooked or ready-to-eat foods should be placed on upper shelves while raw foods are on lower shelves to avoid leaking or dripping. While at the grocery store, it is recommended that non-perishable items are gathered first. Deli items, dairy, and eggs should be collected last for items to maintain the appropriate temperature while in the shopping cart. When selecting foods, check for proper refrigeration- the items are cold to the touch, the odors are fresh and mild, and the packaging is tightly sealed and free of tear. Groceries should be taken home immediately and stored in the refrigerator or freezer.
• Avoid anyone with a fever, influenza, or other infections. Cancer patients and survivors are at an increased risk of developing influenza complications. Consider asking friends and family to wash their hands when visiting. Care teams could also recommend that patients stay home or wear masks during respiratory virus season.
• Take a shower or bath every day with warm water and mild soap. If they have a PICC (peripherally inserted central catheter) line or dressing- maintain the area dry.
• Brush their teeth several times a day with a soft, clean toothbrush. Chemotherapy drugs can cause sores in the mouth and throat; therefore, oral hygiene is strongly recommended to prevent sores from becoming infected. All dentures, bridges, and retainers should be cleaned daily as well.
• Avoid keeping fresh flowers and live plants in their bedroom. Plants and flowers and their water in vases and pots can harbor harmful fungal spores and bacteria. These fungal spores and bacteria can place cancer patients at a higher risk for infection. Cancer patients should discuss with their care team if they can garden. If they can, garden gloves and hand hygiene is recommended. The skin is the first line of defense and should be protected during gardening.
• Avoid sharing items such as food, drink cups, utensils, and other personal items.
• Discuss with their care team any travel plans. Care teams need to know if patients are traveling, especially since there may be times when flying is not recommended, such as after surgery, when platelets are low, etc. Doctors and nurses will also inform patients if there are any vaccines they may need for traveling purposes.
• Housekeeping and disinfecting: if they feel well, clean the home with disinfectants to kill germs on high-touch surfaces such as telephones and doorknobs. Also, they should try to keep their house dust free. Dust can contain thousands of fungal and bacterial organisms.
• Maintain proper pet care: protect skin from contact with pet bodily waste, if possible, have someone else change litter pans, wash hands after handling pets, avoid being scratched or bitten by pets, and stop pets from licking any open cuts, wounds, or catheters. Also, pets must remain clean and are taken to the veterinarian for regular check-ups and vaccinations. Pets are beneficial in providing companionship and reducing stress and anxiety, but cancer patients need to protect themselves from the germs carried by pets.
• Care for catheters, ports, and other medical devices. Patients should always follow their care team’s instructions and keep their devices clean and dry. Before touching or caring for their devices such as a Foley, port, or PICC ensure that hands are clean and perform hand hygiene. Monitor all insertion sites for redness, swelling, soreness, or drainage and notify physicians timely and appropriately.