World Cancer Day: The Cancer and Sepsis Connection

February 3, 2020

Just about everyone has been touched by cancer in some way, be it through a friend, colleague, family member, or even yourself. According to the Centers for Disease Control and Prevention (CDC), there were 1,658,716 new cases of cancer reported in the United States in 2016 – the most recent year for statistics. That’s almost the same number of people who live in Austin, Texas, or the entire state of Idaho. In that same year, there were 598,031 deaths to cancer, the second leading cause of death in the U.S., after heart disease.

February 4th is World Cancer Day, the day when agencies across the world work to raise awareness about cancer prevention, detection, diagnosis, and treatment.

Along with fighting the disease, people with cancer are also at high risk of complications related to cancer and its treatments, including infection, which can then trigger sepsis. Sometimes it is sepsis that causes death among cancer patients, not the cancer itself. A study published in October 2019 looked at cancer-related versus non-cancer-related sepsis. After looking at more than 1 million sepsis hospitalizations in the U.S., researchers found that one in five were cancer related. Rehospitalization was also an issue. The authors wrote: “Patients (23.2%) discharged from cancer-related sepsis were rehospitalized within 30 days, compared with 20.1% in non-cancer-related sepsis.” Death from sepsis was also higher among patients who had cancer, at 28% for cancer-related sepsis versus 20% of non-cancer-related sepsis. Unfortunately, many times, death certificates often use wording like, infection secondary to cancer, or complications from cancer, rather than saying sepsis. Therefore, outside of a study, it’s not possible to get an entirely accurate number of sepsis cases among cancer patients.

There is also another connection with sepsis and cancer. According to a study published in March 2019, adults over 65 years who have survived sepsis are at higher risk of developing certain types of cancers later in life. The researchers compared almost 2 million sepsis survivors 66 years old and older with 200,000 controls – people the same ages who had not had sepsis. The researchers found that sepsis survivors were at higher risk of developing some types of cancer, including some types of leukemia and lymphoma, as well as cancers of the lung, colon, rectum, and liver. The researchers are not sure if the sepsis may have triggered a process that contributed to certain types of malignancies or if, somehow, that sepsis was an indicator that there was cancer starting somewhere in the body. Other types of cancer might be associated with the type of infection that triggered the sepsis. For example, some types of liver infections are possible causes of liver cancer.

But it’s not all bad news. Although researchers found that there was an increase in risk for some cancers, they also found that there was a decreased risk for other cancers, including melanoma and cancers of the breast, prostate, kidney, and thyroid.

The researchers did point out that there are many variables that could contribute to the higher or lower risk of cancer among sepsis survivors, such as the infections themselves, the antibiotics used to treat infections, and other illnesses that may already be present. They encourage more research to see if other researchers come to the same conclusions and if they can find the underlying mechanisms that may affect cancer development.

If you or someone you know has cancer, infection prevention is as important as ever, particularly if you are undergoing immune-suppressing treatments. Speak with your cancer care team about what you should do if you suspect an infection. Different offices and facilities have different protocols for their patients. In the meantime, if you suspect you may have sepsis, call 911 or go to your local emergency room as quickly as possible. Time is of the essence.

Visit Sepsis and Cancer, part of our Sepsis and… library to learn more.