Advice on working odd hours, infection risk?


Question from Scotty: I'm 35 and being treated for ductal carcinoma. I have AC every other week for 4 cycles, then Taxol every week for 12 weeks. I work part-time at a department store from 6-11 p.m., sometimes until 1 a.m. I want to keep working, but am worried about germs and wearing myself down. (I also have a 2 1/2 year old son to wear me out.) What are your recommendations on working such crazy hours?
Answers - Ruth Oratz, M.D., F.A.C.P. There are many components to this question. The first aspect relates to the risk of infection for individuals taking chemotherapy. The chemotherapy regimen you described can be associated with a significant decrease in the white blood cell count. Our white blood cells help to protect and defend us against infection. Your doctor should be checking your white blood cell count prior to administering chemotherapy at each cycle. If your white blood cell count is low, it may be helpful to receive an additional medication called Neupogen (chemical name: filgrastim) or Neulasta (chemical name: pegfilgrastim) which can help to boost or maintain the white blood cell count during chemotherapy. You should discuss whether or not that is indicated for you with your oncologist. Some oncologists use prophylactic oral antibiotics to protect patients during the timeframe when the white blood cell count is at its lowest. Again, you should discuss with your treating physician what his/her protocol is with respect to this issue. In general, you should avoid contact with individuals who are obviously sick — fevers, coughs, runny nose, etc. This does not mean that you can't go outside or be in public places or take public transportation. But it does mean you should exercise some general caution. Young children, especially if they're in school or day care, as we all know are often exposed to infections from other children and bring them home. Wash your hands frequently. If your own child is sick, speak with your doctor and/or your child's pediatrician about whether or not your child has a bacterial or a viral infection and whether or not you need to be tested and/or treated for infection. Most individuals are able to continue working without contracting serious infections during chemotherapy. The second part of your question refers to the advisability of working long hours. I generally advise patients to listen to their own bodies. If you are able to work those hours, if you are productive and enjoy working those hours and you can manage it, by all means work. But if you find that you need to have some accommodation in your work hours because you are fatigued, then you should talk with your employer about reasonable accommodation in your hours.

On Wednesday, September 19, 2007, our Ask-the-Expert Online Conference was called Working During Treatment. Barbara Hoffman, J.D., Irene Card, and moderator Ruth Oratz, M.D., F.A.C.P. answered your questions about the legal, financial, physical, and emotional aspects of working during breast cancer treatment.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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