Sepsis (blood poisoning)

Having cancer and some cancer treatments can make your body unable to fight infections.

White blood cells called neutrophils help us fight infections. Some cancer treatments temporarily reduce the number of neutrophils in the blood. This is most common if you have chemotherapy. It is less common with targeted therapies and immunotherapy.

Having a lower number of neutrophils means a minor infection can become very serious. It could become life-threatening within hours.

Your risk of infection and sepsis depends on the type of cancer drugs you are having. It also depends on the type and stage of the cancer, your age and your general health.

You should keep your cancer or haematology team’s 24-hour helpline number with you at all times. Store the number in your mobile phone. You can also ask family and friends to keep a note of the number.

Do not delay – always call your hospital team’s 24-hour helpline sooner rather than later. Sepsis is easy to treat if it is caught early.

Other ways to help protect yourself include:

• Tell your family, friends and work colleagues about your risk of sepsis.
• Plan how you would get to hospital quickly if you needed to.
• Keep a record of the treatment you are having and when you last had it.
• Look out for symptoms of early infection or sepsis.
• Call your cancer team urgently if you have any symptoms of infection.

It can be difficult to know if the symptoms you have are an infection or a treatment side effect.

Do not delay contacting your team. Neither you nor your doctor can tell which infections might lead to sepsis. All infections people get during cancer treatment are treated urgently.

Infections do not get better on their own. Early infections can be treated easily. You need to start antibiotic treatment quickly as an infection can be dangerous.

Contact your cancer or haematology team urgently if you have any of the following symptoms:

• You feel less well than normal.
• Your temperature goes over 37.5°C (99.5°F).
• Your temperature goes below 36°C (96.8°F).
• You have flu-like symptoms. This includes feeling shivery, cold and unable to get warm.
• You have a urine infection. Symptoms include:
  • pain or discomfort when you pass urine (pee)
  • passing urine more often than usual
  • feeling that your bladder is not empty after passing urine
  • being unable to wait to empty your bladder (urgency)
  • leaking urine (incontinence)
  • pain low down in your tummy
  • urine that is cloudy or strong smelling, or that contains blood.
• You have a chest infection. Symptoms include feeling short of breath, having a sore chest or coughing up green phlegm.
• You have diarrhoea. This means passing more stools (poo) than is usual for you or having watery or loose stools. If you have a stoma, it will be more active than usual.
• You have a skin infection. Symptoms include redness, heat, swelling or pain, especially around a PICC line, central line, cut or wound.
• You have a tooth infection. Symptoms include:
  • throbbing pain in your tooth or gum that may come on suddenly and slowly gets worse
  • pain that spreads to your ear, jaw and neck on the same side as the affected tooth or gum
  • redness or swelling in your face.

Telephone assessment

Your hospital team will ask about your symptoms and your temperature. They might ask you to go to hospital urgently. This may be to an acute oncology unit, haematology department or A&E (emergency department). It is important to go to the hospital as soon as possible, so you can be seen and treated if needed. You may have to stay in hospital for treatment.

Hospital assessment

The hospital team will treat you as an emergency. They are likely to:

• examine you
• take some blood, including a sample to find out the number of neutrophils in your blood
• arrange other additional tests, depending on the signs and symptoms you have
• decide whether you are neutropenic and have an infection or signs of sepsis
• give you an antibiotic by injection or through a drip into your blood stream (intravenously) within 1 hour of your arrival.

Sepsis treatments

The hospital team might give you antibiotic tablets to take at home if your risk of developing complications from your infection is low. They will tell you how important it is to go back to hospital quickly if you have any problems.

Most people with sepsis need to stay in hospital for antibiotic treatment into their bloodstream.

If you need to stay in hospital, your hospital team will talk to you about what antibiotic treatment you need and for how long. They will also talk to you about how long you might need to stay in hospital for.

We are committed to making our website as accessible as possible, to make sure that everyone can use it.

We have information about sepsis in over 16 languages, and in other formats including audiobooks, and easy read.

If we don't have what you are looking for, you can ask for information to be translated for free or provided in a format to suit you. Email us at cancerinformationteam@macmillan.org.uk or call us on 0808 808 00 00.