Superbugs Deadlier Than Cancer Put Chemotherapy Into Question
The emergence of super bugs or germs that are resistant to most known anti-biotics has created a quandary among medical professionals dealing with cancer patients. Chemotherapy, the most common cancer treatment has evolved over the years not just in terms of efficacy but also in improving post treatment quality of life through reduced side effects. However, it does leave patients exposed to possibility of getting their bloodstreams infected by bugs which break through the walls of the digestive tract weakened by chemotherapy. The author notes that this problem is particularly acute in a place like India where twin drivers: a) careless and rampant over use of anti-biotics has led to mutant drug-resistant bacteria; b) poor hygiene and sanitation create a conducive environment for such bacteria to develop and spread.
Worldwide, at least 700,000 people die annually from drug-resistant infections. That number will balloon to 10 million a year by 2050 and will cost more than $100 trillion in lost economic output without corrective actions, according to a U.K. government study, which estimates that by midcentury more people will die from superbug infections than from cancer and diabetes combined.
Germs acquired through ingesting contaminated food and water become part of the normal gut microbiome, but they can turn deadly if they escape the bowel and infect the urinary tract, blood, and other tissues. Chemotherapy is often the culprit, allowing that to happen by weakening the lining of the digestive tract.
Almost two-thirds of cancer patients with a carbapenem-resistant infection are dead within four weeks, vs. a 28-day mortality rate of 38% in patients whose infections are curable, Ghafur and colleagues reported in 2014. Ghafur typically tries a last-resort antibiotic called colistin with the most stubborn antibiotic-resistant strains. Increasingly, that’s failing too, resulting in pan-drug-resistant infections. In the past, says Ghafur, “maybe once in six months, once a year I got this kind of bacteria—resistant to everything.” Now it’s occurring every other week.
Ghafur, one of India’s fiercest anti-superbug campaigners, says the cancer patients he sees dying from drug-resistant bacterial infections represent a so-called post-antibiotic era in which something as simple as a scratched knee can kill. “If you’re talking about the post-antibiotic era, you first see that in cancer patients,” he says. “They are expecting us to cure their cancer with chemotherapy—and there are wonderful chemotherapy drugs—and then we explain it to the family: Yes, your cancer will be controlled, but then you may die of infection.”