Treatment Side Effects - Infections

Infections are conditions caused by microorganisms (germs). The most common causes of infections are bacteria, viruses, fungi, and protozoa. Infections can range in severity from mild to life-threatening.¹

Patients with lung cancer are susceptible to infections. The cancer itself can increase the risk of developing an infection, and many of the treatments used to attack the cancer cells can also increase the patient’s risk of developing infections. The presence of infections can complicate lung cancer treatment, as well as compromising the health of the patient.²

Risk factors for infection

Several of the treatments for lung cancer can increase the risk of infection:²

• Chemotherapy targets rapidly dividing cells, which includes cancer cells but also affects normal cells in the bone marrow. By affecting the bone marrow, chemotherapy can cause decreased white blood cells, which increases the risk of infection.²
• Targeted therapy focuses on key features present in cancer cells, which hopefully provides treatment with less effect on normal cells. However, targeted therapies still can cause side effects, and a common side effect of targeted therapies is an increased risk of infection.³
• Surgery for lung cancer involves cutting into the body to remove cancerous tissue. Any opening into the body has the potential to introduce germs, which can grow and become an infection.²
• Radiation therapy can lower white blood cell counts, increasing the risk of infection.

In addition, patients who have advanced age (75 years or older), low scores on pulmonary function testing (forced expiratory volume in 1 second), and those with cancers at advanced stages are more susceptible to infections following surgery for lung cancer.⁴

Common signs of infection

Patients who have lung cancer or who are undergoing treatment for lung cancer should watch for any signs or symptoms of infection and report them immediately to their healthcare provider. Common signs of an infection include:¹

• Fever of 100.5°F or higher
• Shaking chills or sweats
• Sore throat
• Mouth sores or a white coating on the tongue
• Cough or shortness of breath
• Nasal congestion
• Burning or pain when urinating
• Redness, swelling, warmth or drainage at the site of an injury or surgical wound
• Pain or tenderness in the abdomen
• Stiff neck
• Sinus pain, ear pain or headache

Reducing risk of infection

The risk of infection can be reduced by using proper hygiene, including washing hands well and keeping cuts and wounds clean, and avoiding germs when possible. When patients are undergoing treatment for lung cancer and are more susceptible to germs, they should avoid others who are sick or who have just had a live vaccine, as well as crowds.³