Cancerwise

Sepsis is a serious condition that occurs when your immune system starts damaging your body’s tissues and organs in an effort to fight off infection. If left untreated, it can lead to shock, organ failure — and in extreme cases, even death.

The good news is that sepsis is treatable if it’s caught early, and there are several easy things you can do to reduce your risk.

So, what signs should you look for if you think you might have sepsis? And, what steps can you take to prevent it? Read on, for the answers to these and seven other questions about sepsis.

What are the stages of sepsis?

In the past, doctors separated sepsis into three different stages. Today, though, medical professionals have simplified this classification system, so that patients are considered to be either in “sepsis” or “septic shock.”

• Sepsis is the presence of infection and findings of organs or systems being affected or damaged by it.
• Septic shock is considered the most serious form, in which you would start seeing dangerously low blood pressure and organ failure.

How serious is sepsis?

Sepsis is considered a medical emergency. So, it needs to be addressed immediately. Your condition can deteriorate very rapidly if you have sepsis, especially if your immune system is already weak. That's why it’s important to seek help quickly. In these situations, minutes matter.

Cancer patients are particularly vulnerable to sepsis, because both the disease itself and certain treatments, such as chemotherapy, can weaken the immune system.

How do you know if you have sepsis?

Sepsis can appear in many different ways, and not everyone will have the same symptoms. Some common signs to look for include:

• Fever
• Chills
• Increased heart rate: defined as greater than 90 beats per minute
• Increased respiratory rate: defined as greater than 30 breaths per minute
• Reduced mental alertness, sometimes with confusion
• Nausea and vomiting
• Diarrhea
• High or low white blood cell count
• Hypotension: also known as low blood pressure
• Altered kidney or liver function

Can’t you get sepsis only in hospitals?

No. Many people believe that sepsis can only happen in a hospital, but that’s not true. You can develop it at any time — even while resting comfortably at home. So, it’s important to let your care team know as soon as you start experiencing symptoms.

Fever is usually one of the most obvious signs of infection. But not all cancer patients will develop one. So, don’t be afraid to tell your doctor, “I think I might have sepsis,” or say, “I’m experiencing these symptoms. Could I have sepsis?”

Asking questions and sharing your concerns will help your care team diagnose and treat sepsis much more quickly, if you have it.

How does sepsis start?

Sepsis begins as an infection in one part of your body. If the infection isn’t controlled, it can spread to your bloodstream and other parts of your body, and eventually cause your organs to stop working properly.

How is sepsis typically treated?

Sepsis is managed in a few different ways.

First, your doctor will give you antibiotics to fight off any bacterial infection. Sepsis often causes hypotension, so you’ll also be given fluids to maintain adequate blood pressure.

Next, your doctor will try to figure out where the infection started. If it’s coming from a catheter or a surgical site, for instance, your doctor will focus on that specific area. Treating the source of infection can often prevent the problem from getting worse.

Sepsis can also damage your kidneys, lungs and heart. If that happens, you may need extra care in the intensive care unit (ICU), such as a ventilator for breathing or dialysis for kidney failure.

Can you recover from sepsis?

Yes. Thanks to advances in screening, diagnosis and treatment, more and more people are surviving sepsis. About 76% of people diagnosed with sepsis now survive the experience, though that figure is lower in people who are over age 60, have cancer, or advance to septic shock.

Recovery time can range from three days to two months, depending on the severity of the infection. However, some survivors experience long-term physical and psychological effects afterward. These are known as post-sepsis syndrome, and can occur weeks or months after getting home from the hospital.

Symptoms of that condition may include:

• Insomnia
• Nightmares and panic attacks
• Muscle and joint pain
• Extreme fatigue
• Poor concentration
• Decreased mental function
• Loss of self-esteem

The symptoms of post-sepsis syndrome can last for months or even longer, depending on how severe your sepsis episode was and how long you received treatment for it. So, it’s important to have follow-up care with your doctor to manage any lingering symptoms.

Can sepsis ever recur?

Yes. About one-third of sepsis patients will be re-admitted to the hospital within three months, often because of another infection or sepsis episode. So, before going home from the hospital, be sure to talk with your doctor about how to monitor yourself for infections, and when you should call for help.

How can I prevent sepsis?

Preventing sepsis starts with preventing infections. So, follow these steps to reduce your risk:

• Wash your hands often with soap and water.
• Stay away from people who are sick.
• See a doctor and start treatment right away if you get an infection.
• Stay up-to-date on your vaccinations.
• Keep any cuts or wounds clean and covered until they heal.

Reach out to your care team if you have any questions.

Imrana Malik, M.D., is a Critical Care physician at UT MD Anderson.

Request an appointment at UT MD Anderson online or call 1-877-632-6789.