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Neutropenic sepsis

Lshorts21
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Hi everyone, 

 

My dad (71) was diagnosed back in September and started chemo on 11.11.21. He wasn't great after the first treatment (aches, mouth ulcers, migraines, rash) but side effects that can be managed and not completely dibilitating. His consultant said if after the second he had the same effects they would lower the dose. However after his second treatment he unfortunately ended up with Neutropenic sepsis and spent 5 nights in hospital with IV antibiotics. He was discharged and had bloods for his third treatment a few days after. Bloods showed his neutrophils were back upto normal and consultant said they would go ahead with full dose chemo again for his third round and that getting Neutropenic sepsis a third time would be very rare. He was given some injections to start at home 4 days after for 5 days to boost his white blood count just incase. However by day 5 he was having hot and cold shivers again and his temp spiked to 38.2° so got him straight to A&E and again diagnosed with Neutropenic sepsis. He only had a 2 night stay this time as he had had 2 of the injections at home and he was safe to take oral antibiotics. Took a lot longer for him to feel back to himself though. 
 

My questions are; if when after the second round he got sepsis did they then go full dose again for the third when they discussed lowering it even after the less bad symptoms the first round cause? 
 

and 

Has anyone had experience with you or a relative having Neutropenic sepsis twice in a row after chemo treatments and did you/they have it a third time without the dose being lowered? 
 

My dads fourth chemo is on Thursday and obviously he's dreading it as he's so anxious about getting sepsis again and if the recovery will be much harder a third time. Would love to have talked this over with his consultant but apparently they didn't schedule an appointment for this week (unbelievable!) have spoke with his secretary but don't hold out much hope of hearing from him before Thursday. 
 

This is our first experience of cancer in the family so we're not really sure what to expect. Please if anyone has any advice we'd be very grateful. 
 

Thank you x 

  • Hello there and thanks for posting

    I am sorry to hear about your dad's situation and appreciate you having questions about his treatment.

    I'm afraid without being involved in your dad's care it is going to be difficult for you to be able to unpack these questions for you in the way perhaps you had hoped.

    It is good to hear you have contacted the consultants secretary and hopefully a time will be arranged for you to talk all of this through with them. Failing that if your dad has a specialist nurse you could try and speak with them or indeed one of the chemotherapy nurses on the unit.

    Every patient is so different when it comes to treatment and the side effects they experience and how their blood counts are affected. Some patients are more unfortunate than others and can be more susceptible of picking up infections whilst their counts are low than others.

    Usually the growth factor injections given to try and boost the blood counts do work and prevent further neutropenic episodes but occasionally some people will still pick up an infection that their body is unable to fight off without the help of antibiotic treatment.

    As I say I don't think anyone here can say or speculate the reason why they have continued to give the full dose throughout all the cycles so far and this really is something that needs talking through with the consultant. I am however sure they only want and have the best intentions at heart.

    I appreciate neutropenic sepsis isn't something to be taken lightly and can be a very worrying time for both the patient and their loved ones. I imagine you are all very anxious as he approaches his next cycle and how this also may affect him.

    I have to say you may find your dad sailing through this one as the risk of neutropenia is greater with the first 2 or 3 cycles but it is important to share your concerns with the team involved in his care before he has the chemo if possible. As well as asking about the possibility of a dose reduction this time around and see what they say.

    I'm sorry if I haven't been able to answer you in the way you had hoped but do get back if you need to. You are also welcome to call our helpline on 0808 800 4040, Monday-Friday 9-5.

    All the best to you and your dad

    Naomi

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