Chemotherapy’s Most Serious Side Effect

By Lisa C. Richardson, MD, MPH
Director of CDC’s Division of Cancer Prevention and Control

Like many doctors across the country, I can tell right away when a random phone call from a colleague or friend isn’t so random. It takes me only 30 seconds to know that cancer has struck again and, this time, close to home.

“Lisa, I just got off the phone with my sister and she just found out she has…” Fill in the blank with any stage or type of cancer and the fear I hear in their voice is exactly the same. During that call, I’m no longer someone’s boss, friend, or sister, but rather someone to ask questions that they may feel strange asking someone else.

As an oncologist and lead investigator of the CDC’s Preventing Infections in Cancer Patients program, I am proud to be a part of a program that educates and empowers people with cancer. I’ve seen firsthand the difference straightforward information can make.

Whether it’s one of my patients or a friend, I’m often asked about the side effects of chemotherapy. Usually, they want to know if they’ll lose their hair—a valid and reasonable question. I answer this question for them (depends on the type of chemotherapy), but then start talking about a more serious side effect called neutropenia. It’s one that they might not know to ask about.

Neutropenia, pronounced noo-troh-PEE-nee-uh, is a low white blood cell count. Chemotherapy drugs kill cancer cells as well as healthy white blood cells. Since white blood cells are one of the body’s main defenses against infection, this means you have a higher risk of getting an infection while your white blood cell count is low.

As an oncologist, this side effect is one of my main concerns for my patients. It not only makes them sick, but it can also delay future treatments, put them in the hospital, or cause their death.

I usually try to end every conversation with the following five things to do during chemotherapy:

1. Wash your hands with soap and water. If soap and water are not available, it’s OK to use alcohol-based hand sanitizer.
2. Treat a fever as an emergency, and call your doctor immediately if you get a fever.
3. Know the signs and symptoms of an infection.
4. Ask your doctor or nurse when you’re most at risk for getting an infection.
5. Get a flu shot.

Lastly, to all of you fighting cancer or caring for someone who is fighting this battle, I encourage you to visit CDC’s Cancer website.