We have been having a lot of conversations on the advanced prostate cancer on-line group this last month about chemotherapy. Three of our advanced prostate cancer warriors have been openly sharing their experiences as they start docetaxel (taxotere or chemotherapy). Join the group at: Join the advanced prostate cancer on-line support group.

It is important to now that besides destroying cancer cells, chemotherapy also destroys healthy cells, including infection-fighting white blood cells. The destruction of the white blood cells directly suppresses our immune system making a cancer survivor while under treatment very prone to other, potentially dangerous, infections.

“Most chemotherapies will decrease the activity of your bone marrow,” says Stephen I. Shibata, M.D., associate professor of medical oncology at City of Hope National Medical Center in Duarte, California. “The drugs reduce the production of red blood cells, which may lead to anemia, and white blood cells, which can affect your immune system.” Even a mildly depressed white cell count can reduce the body’s ability to fight off foreign invaders.

There are a few simple activities that you can do to help minimize your risk while taking chemotherapy:

1. Wash your hands frequently. Always be assiduous about washing before and after eating, using the bathroom, and touching animals or children. Use soap and make sure you scrub your hands well. A trick that is taught at culinary schools is to sing the “Happy Birthday” song slowly twice through. You should also carry around a small bottle of hand sanitizer and use it frequently. Be conscious of where you put your hands and try not to put them into your mouth.

2. Eat a healthy, balanced diet. Many men taking taxotere experience bouts of anorexia (a loss of appetite), nausea, and subsequent weight loss. Work with a dietitian to ensure that you do eat a good diet with an adequate caloric intake. Pay attention to your protein intake because proteins are a basic building block used by your immune system to prevent and fight infections. Ask your doctor about supplements, should you be taking them and what should you take?

3. You are venerable to bacteria in food, so be aware of food safety issues. Make sure that anything you eat has been handled properly. Cook meat and poultry thoroughly to kill any bacteria and other microorganisms. Be careful to avoid contaminating kitchen surfaces, cutting boards, and cooking utensils with uncooked meats and poultry. Eliminate from your diet raw foods like fish, seafood, meat, and eggs. All of these foods pose a high risk for causing illness.

4. Take care of your teeth and gums. Brush your teeth after meals and before bedtime, using an extra-soft toothbrush that won’t hurt your gums. Floss gently, but talk to your doctor about whether flossing is the best way to protect your gums during chemotherapy treatment.

5. Keep your skin hydrated and moisturized. Dry, cracked skin is more likely to break, become uncomfortable and be more susceptible to infections. Do not squeeze or scratch pimples as they too can create open sores that would also place you at higher risk of infection. The same is true of biting or tearing at your cuticles.

6. Keep all of your body clean. Take a warm bath or shower at least daily making sure to gently clean your rectal area after you use the toilet. Tell your physician if you develop hemorrhoids or dry, irritated skin as these offer a place for bacteria to enter into your body.

7. Avoid people who are sick. Because chemotherapy makes you more vulnerable to infections, it’s important to avoid people who have colds, the flu, chicken pox, measles, and other contagious illnesses. It’s also a good idea to steer clear of people who have recently had a “live virus” vaccination, such as the chicken pox and polio vaccines. Try not to take public transportation because you never know what infections your fellow riders could expose you to.

8. Avoid accidents and injuries. Wear gloves when gardening; be careful when handling sharp objects; and shave with an electric razor to prevent cuts. In the unfortunate event that you do get cut, scraped, or otherwise injured, be sure to clean the area with warm water and an antiseptic. The quicker you clean and cover the injury, the less risk there will be of infection.

Work to avoid unnecessary exposures to any possible infections. Think about what you are going to do and ask yourself if it puts you at an unnecessary risk of exposure to possible infections. There is nothing wrong with declining to participate in an activity that puts you at risk. You can always visit or participate in another activity later on; if you do get an infection it is possible that you will not be able to “make up” the missed activity in the future. Be self protective.

Joel T Nowak, M.A., M.S.W.