About sepsis

Having cancer and some cancer treatments can increase your risk of developing an infection and sepsis. This information explains what sepsis is, when you need to contact your hospital team and what you can do to protect yourself.

It is important to contact your hospital team as soon as you have any of the symptoms of an infection (see below).

What is sepsis?

Sepsis (also called blood poisoning) is a serious and potentially life-threatening complication of an infection. It happens when the body reacts to an infection and attacks its own organs and tissues.

Why might I get sepsis?

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.

When might sepsis happen?

An infection or sepsis can happen at any time. Your risk is usually highest when the number of neutrophils in your blood is at its lowest. The exact time can vary, so ask your healthcare team when you are most at risk.

What is my risk of getting sepsis?

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.

Can I prevent sepsis?

Many people feel anxious or concerned about the possibility of sepsis. You cannot prevent your neutrophil count from dropping.

The most important thing you can do is call your hospital team’s 24-hour helpline straight away if you have any concerns. This reduces your risk of developing a serious complication from an infection.

How can I help myself?

You, and the people close to 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.

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.

These are also other ways you can help yourself:

  • Tell your family, friends and work colleagues about your risk of sepsis. Plan how you would get to hospital quickly, for example who would look after your children or help you to get to hospital.
  • Look out for symptoms of early infection or sepsis (see below).
  • Call your cancer team urgently if you have any symptoms of infection.

It can be difficult to know if the symptoms you have are of an infection or another treatment side effect. Do not delay contacting your team. Neither you or your doctor can tell which infections might lead to sepsis. This is why all infections people get during cancer treatment are treated urgently.

Infections do not get better on their own. Early infections can be treated easily. But, delaying starting antibiotic treatment for an infection can be dangerous.

Looking after yourself before and during treatment

Before treatment

You can look after yourself before treatment by doing the following:

  • Talk to your doctor or nurse about getting the flu vaccine.
  • Buy a thermometer, so you can check your temperature.
  • Have a dental check before you start cancer treatment.
  • Tell your family, friends and work colleagues about your risk of sepsis.

During treatment

Do not be afraid to live your life as normal. You do not need to avoid crowded places or seeing family and friends.

Infections during chemotherapy are usually caused by bacteria that are naturally present in your own body.

You can help yourself during treatment by doing the following:

  • Clean any cuts or grazes straight away and cover them with a plaster.
  • Clean your teeth at least twice a day.
  • Avoid people who are unwell, for example people with chickenpox, shingles, diarrhoea or a fever.
  • Call your hospital team’s helpline if you have been exposed to people with chickenpox or shingles.
  • Follow good hand hygiene.
  • Wash your hands straight away after touching or removing animal waste.
  • Use clean gloves for gardening and any other activities where you might cut yourself.
  • Cook food properly and store it at the correct temperature.
  • Follow any advice you are given about a clean diet. Not all patients need to make changes to their diet. If dietary restrictions or changes are advisable for you, you will have been told about it at the start of your treatment.

Symptoms of an infection that may lead to sepsis

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

  • You feel less well than normal or unable to get out of bed.
  • 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, freezing cold and unable to get warm.
  • You have diarrhoea. This means having 4 or more loose, watery bowel movements in 24 hours.
  • You have a urine infection (see below).
  • You have a chest infection.
  • You have a skin infection (see below).
  • You have a tooth infection (see below).

Symptoms of a urine infection include:

  • pain or discomfort when you pee (pass urine)
  • peeing more often than usual
  • feeling that your bladder is not fully emptying
  • being unable to wait to empty your bladder (urgency)
  • leaking urine (incontinence)
  • pain low down in your tummy
  • urine that is cloudy or foul-smelling, or that contains blood.

Symptoms of a chest infection:

  • breathlessness
  • a sore chest
  • coughing up green phlegm.

Symptoms of a skin infection:

Symptoms of a tooth infection:

  • 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.

Later symptoms of life threatening sepsis - call 999

If you have any of these symptoms, call 999 straight away:

  • Slurred speech or confusion.
  • Extreme shivering or muscle pain.
  • Passing no urine in a day.
  • Severe breathlessness.
  • It is the worst you have ever felt.
  • Skin that is mottled or discoloured.

Early treatment will help prevent more serious complications.

What will happen when I call my hospital team?

Telephone assessment

Your hospital team will ask about your symptoms and your temperature. They might ask you to go to hospital urgently and you might have to stay in. This may be an acute oncology unit, haematology department or ward or an emergency department.

It is important to go to the hospital as soon as possible, so you can be seen and given treatment if needed.

Hospital assessment

The hospital team will treat you as an emergency, but you will not usually need to be isolated in a separate room. They are likely to:

  • offer you an antibiotic by injection or through a drip into your blood stream (intravenously) within 1 hour of your arrival
  • 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.

Treatment options

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

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.

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.

Where can I find more information?

We have more information about avoiding infection. You can also watch our video of Stuart who talks about his experience of cancer treatment and sepsis.

Or you can find out more about sepsis by clicking on any of the following organisations:

  • The UK Sepsis Trust works to raise awareness of sepsis, encourage early diagnosis, lobby politicians to improve standards of care and provide better support for sepsis survivors.
  • Cancer Research UK has information about different cancer treatments and the risk of infection.
  • NHS Choices has information about the symptoms, causes and treatments of sepsis.