Infectious Complications In Cancer Patients

While advances in both the treatment of cancer and the management of its complications have led to significant improvement in patient survival, infections remain a significant cause of morbidity and mortality in patients with neo plastic disease. In this patient population, infection risk results from a complex interplay between the host’s underlying immunodeficiencies, local tumor effects and treatment-induced immunosuppression. New chemotherapeutic approaches and antimicrobial prophylaxis and treatment practices continue to shape the spectrum of infections in these patients. Clinicians who treat infections in cancer patients are continually challenged by the emergence of new pathogens and by the increasing antimicrobial resistance of established ones. The aim of this book is to emphasize unique aspects of management of infectious diseases in the cancer patient. With the increasing complexity of this patient population, optimal management requires a multidisciplinary approach and this fact is fully reflected in the contributions, all from recognized authorities in the field. Ultimately, it is hoped that this volume will assist specialists in infectious diseases and haematology/oncology in the diagnosis, management and prevention of infection and optimization of the overall care of patients with malignancies.

Despite the major developments in the therapeutic armamentarium for the treatment of infection, the morbidity and mortality of this complication remains very high in patients with compromised defences. Cancer and its treatment represents a major predisposing condition to a variety of infections. These adverse events are still with us, in spite of much progress in the therapy of infectious disease, since cancer therapy is becoming more aggressive, yet further lowering the host's capacity to cope with infections. Moreover, the pathogens adapt effectively to drugs, and at a pace that might outrun industry's capability to produce new agents. Finally, new pathogens are appearing as a consequence of both selection and severe immunosuppression. Infection is so common among cancer patients that its diagnosis and management represent a daily challenge to all oncologists, who must continually strive to keep abreast of developments in the area. The present comprehensive review of the most crucial and challenging aspects of the infectious complications in cancer patients will help them to do just that.

Infection is a major cause of morbidity and mortality in patients with neoplastic disease because of compromised host defenses. These defects result in an increased risk of infection and its complications. The nature of the underlying malignancy, the immunodeficiencies associated with it, and the treatments directed against it are all important determinants of infection. In recent years, the introduction of more intensive chemotherapeutic regimes and the widespread use of bone marrow and peripheral stem cell transplantation have changed the pattern of infection in many patients. Furthermore, the increasing use of central venous access devices and antimicrobial prophylaxis has changed the epidemiology of infection in these patients as well. The goal of this volume in the Cancer Treatment and Research series is to emphasize that while the management of infection in cancer patients is common, it is constantly changing. With the increasing complexity of these patients, optimal management requires a multidisciplinary approach. Ultimately, it is hoped that this book will assist clinicians in the diagnosis, management, and prevention of infection in order to optimize care for patients with cancer.

As the demographics of the population shift toward an increasingly aged society, the number of individuals with cancer increases and with it the need to give the most comprehensive possible health care delivery. Although much has been written about the specific therapy best suited for the various types of cancer and about the basic and clinical research which has dramatically improved treat ment, overall patient care requires attention to supportive care, which includes such items as pain management, the use of blood products, nutrition, and psychosocial needs. Yet infection remains the leading cause of death in cancer patients and is a major cause of morbidity and hospitaliza tion, making it a major aspect of the supportive care of cancer patients. It therefore deserves a full exposition. Bone marrow transplantation is increasingly being utilized as part of a therapeutic modality in the treatment of cancer patients. Transplantation patients are at such a particularly high risk of developing a wide variety of different types of infection, that they inevitably can serve as an excellent framework for discussion of all the types of infections that occur during the treatment of cancer. The patient undergoing allogeneic bone marrow transplantation is at particularly high risk of infection due to the major perturbations of host defenses, which include granulo cytopenia, cellular immune dysfunction, humoral immune dysfunction, blood product transfusions, and vascular access devices. Each of these perturbations results in a different set of infectious disease problems.

Infection in the cancer patient is extremely common, either precipitated by the cancer itself or by the cancer therapies. Virtually all cancer patients develop an infection during their illness, often life-threatening and requiring urgent treatment. This book decribes the presentation and management of all infections met by the clinician.

Principles and Practice of Cancer Infectious Diseases is a comprehensive and insightful work dedicated to elucidating the problem of infections in cancer patients. This essential volume reviews common and less often encountered infections, while establishing the difficulties behind preventing, diagnosing, and treating infectious diseases in cancer patients. Key sections are devoted to the presentation of clinical symptoms and the identification of major etiologic agents. A cadre of leading clinicians provide a detailed assessment of the risk factors for various infections, critical strategies in preventing and managing infections, and study of the interactions between the pathogen and host's immune function and inflammatory response. With its in-depth knowledge and concise treatment of the distinct facets of infections in cancer patients, this volume is an indispensible tool for all infectious disease specialists and clinical oncologists.