Doctor, Doctor: Focus on sepsis
Network - Winter 2013
We asked Imrana Malik, M.D., assistant professor in the Department of Critical Care, about MD Anderson’s initiative to raise awareness about the common but little-known disorder called sepsis.
What is sepsis, and how common is it?
Sepsis occurs when the body attempts to fight an ongoing infection. Initially, this can be an appropriate and necessary response to infection; however, sometimes sepsis causes the body’s immune system to go into overdrive and damage its own tissues and organs. This can lead to shock, which is the failure of multiple bodily organs, as well as death.
Sepsis is common. Throughout the world, someone dies of the disorder every 3-4 seconds. Yet it’s not very well known.
Why should cancer patients and their caregivers be concerned about it?
Worldwide, sepsis causes more deaths each year than prostate cancer, breast cancer and HIV/AIDS combined.
Cancer patients have a particularly high risk for sepsis because they may have frequent hospital stays, increasing their risk of acquiring an infection. They may also have depressed immune systems because of cancer treatments, and may have additional weakness due to poor nutrition, illness or frailty, all of which increase the risk of developing an infection.
What are the symptoms?
Sepsis can present in many different ways, but some of the most common signs are:
- Fever and shaking chills
- Reduced mental alertness, sometimes with confusion
- Nausea and vomiting
- Increased heart rate, greater than 90 beats per minute
- Increased respiratory rate, greater than 30 breaths per minute
- High or low white blood cell count
- Low blood pressure
- Altered kidney or liver function
How can it be prevented?
Awareness of the problem and a high degree of suspicion are key tools in prevention and early treatment. Prevention includes good hygiene and hand-washing techniques, as well as close attention to signs of the disorder. Once the signs of sepsis are present, getting prompt and appropriate medical attention improves patient outcomes.
Once it’s begun, what are the ways to treat it?
There’s no single agent or strategy to treat sepsis. That’s why it’s so dangerous. We have to not only fight the infection directly with antibiotics, but also support any failing organs resulting from the disorder (with dialysis and life support, for example). Using these strategies, we buy time for the body to heal and recover.
It's been called an "equal-opportunity" threat. Why is this?
Sepsis can happen to anyone. It requires only an infection and a delay in identification and treatment.
In patients with depressed immune systems, such as some cancer patients, sepsis can happen even if there's no delay in identification or treatment, because the immune system can't fight the infection.
Why are health care providers so determined to raise awareness of and prevent sepsis?
Our goal is to keep our patients safe from the threat of sepsis, which can be especially dangerous if the immune system is depressed. Cancer patients deserve a fair shake at fighting cancer without losing the battle to sepsis along the way.
As we raise awareness about sepsis, we will collaborate with all health care workers and the general public to find ways to prevent it — which is the best way to fight it.
In this issue
Head and neck cancer survivor stays positive
Doctor, Doctor: Focus on sepsis
‘A clinical instinct:’ Hospitalists improve care for acutely ill inpatients
Telephone Support Line needs your help