What To Do If You Get Sick With a Cold or Flu During Chemo Treatment

How to Handle Colds and Other Illnesses During Chemotherapy

Getting sick is never fun, but it can be especially dangerous when your immune system is compromised by chemotherapy. Colds and other illnesses can quickly escalate into serious infections in cancer patients undergoing chemo treatment.

It's important to take extra precautions to avoid getting sick during chemo. But if you do come down with a cold, flu or other bug, special care is needed to treat symptoms and prevent complications.

Read on to learn what to expect if you get a cold while on chemo and how to handle illnesses properly during cancer treatment.

How Chemo Impacts Your Immune System

To understand how to handle sickness during chemo, it helps to first understand how chemo affects your immune defenses:

• Destroys white blood cells that fight infection
• Reduces antibodies that recognize and target germs
• Weakens the skin/mucous membranes that act as barriers
• Alters the gut microbiome that aids immunity
• Causes side effects like mouth sores and vomiting that raise infection risk

All these chemo side effects make it much easier for viruses, bacteria and other pathogens to invade and multiply. Without a properly functioning immune system, small colds can quickly spiral into pneumonia, the flu can cause sepsis, and foodborne illnesses can be deadly.

Signs of Infection to Watch For

Because of the weakened immune system, any signs of infection should be considered serious when on chemo. Call your doctor immediately if you experience:

• Fever over 100.4°F
• Chills or sweating
• Sore throat
• Nasal congestion
• Coughing
• Fatigue
• Muscle aches
• Skin redness, sores or rash
• Pain or burning with urination
• Vomiting or diarrhea

Monitoring your temperature is crucial, as fever can be the only noticeable sign of infection in immunocompromised patients. Don't delay in reporting symptoms so treatment can begin ASAP.

What Happens if You Get a Cold or Flu

Colds and flu are caused by viruses, so antibiotics are not effective treatment. But that doesn't mean these common illnesses aren't concerning during chemo.

Viruses like rhinovirus, coronavirus, influenza, RSV and metapneumovirus can all wreak havoc on an immunocompromised body. The virus is able to rapidly multiply and spread, moving into the lungs to cause bronchitis or pneumonia.

Pneumonia is especially dangerous, as 30% of cancer patients who develop pneumonia during chemo treatment will die from it. Prompt medical care is critical.

In mild cases with no fever, over-the-counter cough/cold meds may relieve symptoms at home if approved by your oncologist. But caregivers should watch closely for any progression of illness.

What to Do if a Cold Turns into a Sinus or Ear Infection

Sinus infections (sinusitis) and ear infections (otitis media) frequently stem from a simple cold virus. But the immune system is usually able to fend them off before they take hold.

During chemo, that protection is hindered. So colds often graduate into full-blown sinus or ear infections requiring antibiotic treatment and sometimes hospitalization.

Symptoms of sinusitis to report include facial pain/pressure, mucus drainage and headache. Otitis media causes severe ear pain and drainage. Leave these infections untreated and they could spread to the brain.

Intravenous antibiotics are typically given for 7-14 days to treat serious bacterial sinus or ear infections during chemo. Sometimes surgery is needed to drain sinus abscesses or ear fluid.

What Happens With a Gastrointestinal Bug

Viruses like norovirus and rotavirus can wreak havoc on the GI tract. Bacteria like Salmonella, Campylobacter, Clostridium difficile, E. coli and Shigella also cause intestinal illness.

In healthy people, symptoms like diarrhea, vomiting, cramping and fever are miserable but short-lived as the immune system fends it off. But it's a different story for patients on chemo.

Dehydration from fluid loss occurs rapidly, which is very dangerous. Persistent vomiting makes it difficult to keep medications and nutrition down. Diarrhea risk leads to IV fluid replacement.

These gut infections can also penetrate the intestinal wall and enter the bloodstream, causing bacteremia/sepsis. Profound dehydration and septic shock quickly become life-threatening during chemo.

What to Do About a Skin Infection

Cuts, wounds, IV lines and skin breakdown provide pathways for bacteria like Staph and Strep to enter the body. Skin fungal infections are also common.

Cellulitis is a bacterial skin infection marked by spreading redness, swelling and pain. Untreated, it can lead to bacteremia/sepsis via the lymphatic system.

Skin yeast like Candida thrive during chemo too, causing oral thrush and yeast rashes. Dry, cracked skin and mouth sores from chemo let Candida proliferate.

Powerful topical and/or oral anti-fungal medications are required to control fungal overgrowth on the skin and mucosal surfaces during cancer treatment.

How Chemo Impacts the Lungs

The lungs and respiratory system are frequent sites of infection during chemotherapy.

Bacterial pneumonia, TB pneumonia, viral pneumonia and fungal pneumonia are all risks during cancer treatment. Weakened lung function also makes it harder to fight off pneumonia once it develops.

Coughing ability is decreased and mucus clearance impaired, so bacteria multiply freely in the lungs. Shortness of breath, chest pain and cough become serious quickly.

Pneumonia often requires inpatient treatment with IV antibiotics, oxygen support, bronchodilators and sometimes ventilation. Antivirals or antifungals may be used depending on the cause.

Protecting Yourself From Infection During Chemo

Following infection control precautions is absolutely vital during chemotherapy:

Practice Hand Hygiene

Wash hands frequently with warm, soapy water. Use alcohol-based sanitizer when soap isn't available. Avoid touching eyes, nose and mouth.

Care for Your Skin

Keep skin moisturized to avoid cracking. Treat cuts promptly and keep clean/covered. Follow wound care instructions.

Sanitize Surfaces

Use disinfecting wipes and sprays on counters, bathrooms, toys, phones and anything handled frequently by others.

Cook Food Thoroughly

Use a food thermometer to ensure meats, eggs and leftovers reach safe internal temperatures high enough to kill bacteria.

Avoid Sick People

Stay home as much as possible and away from anyone with symptoms of illness. Wear a high filtration mask if you must go out.

Get Vaccinated

Keep up to date on flu, pneumonia, COVID and any other recommended vaccines. But avoid live vaccines.

Take Prescribed Antibiotics

Always finish the full antibiotic course as prescribed, even if you start feeling better.

Notify Your Oncology Team

Report any signs of infection like fever, chills, cough or GI issues immediately to start treatment ASAP.

Caring For Yourself When Sick During Chemo

If you do come down with a cold or other illness, focus on supportive self-care and call your oncologist right away. Helpful tips include:

Rest

Get extra sleep and avoid exertion to help your body's defenses fight infection.

Stay Hydrated

Drink plenty of fluids like water, broth and electrolyte drinks. Avoid becoming dehydrated.

Use Humidifiers

Add moisture to the air to ease respiratory congestion and open secretions.

Take Prescribed Medications

Follow directions carefully for any antibiotics or antivirals prescribed.

Consider Immunoglobulin Therapy

IVIG provides antibodies to aid the weakened immune system against pathogens.

Try Over-the-Counter Meds with Caution

Discuss use of OTC decongestants, expectorants, antidiarrheals and fever reducers with your oncologist.

Adjust Your Chemo Schedule if Needed

Postponing treatment for a week or two lets your body recover when seriously ill.

When to Go to the Emergency Room

Seek emergency medical care right away if you have:

• Difficulty breathing
• Severe weakness or dizziness
• Chest pain
• Confusion
• Fever over 104°F
• Uncontrolled vomiting/diarrhea
• Sudden severe pain

Infections can quickly take a turn for the worse when the immune system is compromised by chemotherapy. Don't delay emergency care if your symptoms are escalating.

Staying Healthy During Cancer Treatment

While getting sick during chemo may be inevitable, focusing on overall health can help minimize risks:

• Eat a balanced, nutrient-rich diet
• Take supplements if advised
• Get moderate daily exercise
• Reduce stress through yoga, meditation, etc.
• Take antiviral/antibacterial herbs like elderberry, garlic, etc.
• Consider probiotic supplements to improve gut health

The healthier your body going into chemo, the better it can withstand low white blood cell counts and improve immune recovery between cycles.

Getting sick while undergoing chemotherapy is scary. But by understanding how to prevent infections, recognize symptoms promptly and care for yourself when ill, you can avoid severe complications and safely get through your treatment.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.