Infections are the second leading cause of death among people with cancer, trailing only the cancer itself.
Henry Skinner, Ph.D.
CEO, AMR Action Fund
Dr. Cary Adams
CEO, Union for International Cancer Control
Last year, a father of three in his 40s who lived in suburban New England was diagnosed with lymphoma, a type of cancer that affects the blood. He underwent months of grueling treatments, including chemotherapy. While there were numerous side effects, the therapies worked and sent his cancer toward remission.
However, he then fell sick with a common bacterial infection that overwhelmed his worn-down immune system. He ultimately died, leaving behind his wife and young children. The antibiotics that he was prescribed — the same drugs we rely on to clear up everyday ailments like strep throat and urinary tract infections — did not work because the bacteria had become resistant to them.
It’s a tragedy that happens far too often around the world — to men, women, and children. Infections are the second leading cause of death among people with cancer, trailing only the cancer itself.
The declining efficacy of antibiotics
It’s disheartening but not surprising as many factors conspire to make cancer patients incredibly vulnerable to infections. Their immune systems are compromised, they’re in and out of healthcare facilities on a regular basis, and they undergo medical procedures such as surgery, PICC line and port insertions, and drug infusions, for which there is always some risk of infection.
Antibiotics have played an overlooked but instrumental role in cancer treatment for decades. Oncologists rely on antibiotics to both treat infections that occur in cancer patients and to reduce the risk of acquiring infections during and after chemotherapy, surgeries, bone marrow transplants, and other procedures.
However, antibiotics aren’t guaranteed cures, as they once were, due to the rapid rise of antibiotic-resistant bacteria, often referred to as “superbugs.” Superbugs are a global plague already associated with more than 4 million deaths annually. By 2050, they are expected to contribute to approximately 10 million deaths each year — the same number of cancer deaths we will see in 2024. For cancer patients, their families, and their medical teams, this is hugely problematic.
The rise of superbugs
A recent study in the journal “Cancer Medicine” showed that hospitalized cancer patients are up to twice as likely to have infections caused by certain superbugs. The study, supported by the Cancer and AMR Consortium, of which both our respective organizations are members, examined data from more than 4 million hospital admissions in the United States and found that cancer patients had significantly higher rates of numerous superbugs that the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have identified as high-priority pathogens for which few new treatments are in development.
The risks that superbugs pose to cancer patients are real. Tremendous advances in cancer treatments have occurred in recent years, and patients are benefiting from immunotherapies, precision medicine, and other new technologies. That progress, however, is and will be increasingly eroded by superbugs.
Hope for the future
While superbugs are a major challenge for people with cancer, there are actions that can beat back this scourge. It is imperative that hospitals and health systems continue investing in infection prevention and control practices. Small efforts, like handwashing; putting in place effective stewardship practices to ensure the appropriate use of antibiotics; and closely adhering to best practices for administering injectable medicines, inserting catheters, and taking blood draws can significantly reduce the risk of infection.
It’s also crucial that we develop new and effective tools for diagnosing and treating infections. More than 1,500 therapeutic candidates are in clinical development against all types of cancer. However, when it comes to high-priority drug-resistant bacteria that are killing so many patients, fewer than 40 drugs are in clinical development, and the WHO has warned that “innovation is badly lacking” in the field. That is bad for everyone, especially cancer patients.
As such, we need to reassess how we value antibiotics, and we need policies that encourage investment into this cornerstone of modern medicine to ensure appropriate and effective antibiotics are available to patients who need them.
We also need to build awareness of this issue among caregivers and patients, healthcare professionals, policymakers, and patient advocates. The more informed oncologists are about superbugs, and the more cancer patients understand the risk of infections and the importance of effective antibiotics, the better prepared they will be for navigating the myriad challenges of treatment.
Cancer patients face so many worries from the moment they are diagnosed. Superbugs need not and should not be one of them.
