Sepsis and Oncology
Recorded On: 01/21/2020
Description:
Cancer is the most common comorbid condition in patients with sepsis. Cancer patients are particularly susceptible to sepsis due to the immunosuppressive effects of cancer treatment, or due to the malignancy itself. The risk of developing sepsis is increased ten-fold by the presence of any type of cancer, and a sepsis diagnosis in cancer patients increases the risk of death by two to three times. This training module explores the unique complexities of sepsis in the cancer patient, and discusses sepsis screening, identification, and treatment in this population. A case study is included, along with a patient’s experience to provide the patient perspective.
Goals:
- Treatment for cancer patients emphasizes special consideration for: Antibiotic resistance related to use of antibiotic prophylaxis can affect treatment options. The use granulocyte colony stimulating factor can affect WBC and bandemia, and thus affect screening for sepsis. Prolonged neutropenia (>7 days) can affect optimal treatment of infections. Severe thrombocytopenia. Often a combination of underlying disease, chemotherapy, and sepsis. Limits surgical interventions for source control, or removal of infected tunneled catheters.
- Clinical suspicion for sepsis remains a priority for all clinicians caring for cancer patients and consistent, ongoing screening for sepsis is conducted.
- Physicians will utilize care plans to perform ongoing screening so sepsis is detected early and treatment plans for cancer patients can be adjusted accordingly.
Learning Objectives:
At the end of the activity, the learner should be able to:
- Define sepsis as related to the cancer patient;
- Recognize the importance of understanding sepsis in cancer patient;
- Describe how sepsis can present in cancer patient;
- Assess the impact of sepsis on cancer care;
- Articulate considerations for management of sepsis in cancer patients and implement these management techniques in patient care.
Target Audience:
Nurses, advanced practice providers, physicians, emergency responders, pharmacists, medical technologists, respiratory therapists, physical/occupational therapists, infection prevention specialists, data/quality specialists, and more.
Imrana Malik, MD
Associate Professor, Department of Urgent Care
UT MD Anderson Cancer Center
Imrana Malik, MD, DABSM, FCCP, is an associate professor in the Department of Critical Care at MD Anderson Cancer Center (MDACC), and is primarily involved in direct patient care in the medical and surgical intensive care units. Her main clinical research interest involves sepsis in cancer patients. She is the co-chair of the Sepsis Committee at MDACC, the mission for which is to decrease mortality from sepsis in cancer patients. Through the Sepsis Committee, she has planned and hosted annual World Sepsis Awareness Day events at MDACC since 2012. For these events, she also created educational videos about sepsis for pediatric, adult, and elderly populations, which can all be viewed on YouTube. In addition, she has organized the World Sepsis Day events and Annual Symposium (One Voice for Sepsis) for the Texas Medical Center, as chair of the multi-institutional TMC Sepsis Collaborative. She has also participated in the planning committee for the Annual Symposium of the Texas Chapter of the Society of Critical Care Medicine (SCCM) from 2012-2014.
Jeffrey Groeger, MD
Chief, Urgent Care Services
Memorial Sloan Kettering Cancer Center
Jeffrey S. Groeger, MD is Chief of the Memorial Sloan Kettering Cancer Center (MSK) Urgent Care Service. After receiving his MD from University of Cincinnati College of Medicine, Dr. Groeger completed his residency at Lenox Hill Hospital, and then his fellowship at Memorial Sloan Kettering Cancer Center. Dr. Groeger subsequently began practice at Memorial Sloan Kettering Cancer Center, where he has been for 39 years. Over the course of his career in urgent care at MSK, Dr. Groeger has had extensive experience in the diagnosis and treatment of sepsis in cancer patients.
Cara Fleming, AGPCNP-BC, AOCNP
Nurse Practitioner
Memorial Sloan Kettering Cancer Center
Cara Fleming, AGPCNP-BC, AOCNP, is a Nurse Practitioner working at Memorial Sloan Kettering Cancer Center (MSK) since 2008. She is board certified as an Adult Geriatric Primary Care NP by the American Nurses Credentialing Center. She is also recognized for her specialty as an Advanced Oncology Certified NP by the Oncology Nursing Certification Corporation. She has dedicated her clinical practice to the acute care of oncology patients while working in the Urgent Care Center and later the Intensive Care Unit. During her time in Critical Care, she served as the principle Clinical Program Manager for the Memorial Sloan Kettering Cancer Center Sepsis Program, developing many institutional advances in sepsis education, protocol, and procedures. She also served on the New York State Department of Health Sepsis Advisory Board. She has since taken her practice to the outpatient arena where she works in MSK’s acute care clinic called the Symptomatic Care Clinic in Bergen County, New Jersey. Sepsis has always remained a primary concern when evaluating her oncology patients.
Provider approved by the California Board of Registered Nursing, Provider Number CEP17068 for 1.5 contact hours.
Other healthcare professionals will receive a certificate of attendance for 1.0 contact hours.
Medical Disclaimer
The information on or available through this site is intended for educational purposes only. Sepsis Alliance does not represent or guarantee that information on or available through this site is applicable to any specific patient’s care or treatment. The educational content on or available through this site does not constitute medical advice from a physician and is not to be used as a substitute for treatment or advice from a practicing physician or other healthcare professional. Sepsis Alliance recommends users consult their physician or healthcare professional regarding any questions about whether the information on or available through this site might apply to their individual treatment or care.