The intersection of two public health threats keeps me up at night: cancer and antimicrobial resistance

Looking ahead towards the UN high-level meeting on antimicrobial resistance, Michael Craig describes the impact of antimicrobial resistance on people living with cancer, and underscores actions we can all take to address this threat. 

Imagine, one day the world has a treatment for any infection on the planet. The treatment saves lives, so much so that everyone on earth lives longer, healthier lives because of it. Now, imagine that one day that treatment stops working for everyone, everywhere. All at once, infections that were curable the day before are now deadly.

What would happen next? Healthcare providers and patients alike would be in crisis. Healthcare systems would buckle. Countries and the global community would have to dramatically redirect resources to try to bring back a cure that was lost. Families and communities would be broken as grandparents, mothers, fathers, and children all around the world perished from previously curable infections. 

Tragically, we don’t have to imagine because this is not science fiction or fantasy. This is happening to us right now with antimicrobial resistance: the fact that medicines, such as antibiotics or antifungals, are no longer able kill the microbes (bacteria, fungi, viruses or parasites) that cause sometimes life-threatening infection.

The difference is scope. This is not happening everywhere in the same way, but the whole world is impacted by antimicrobial resistance. Around the world to varying degrees, antibiotics – the miracle drugs that all of us have taken at one time or another and that all of us will need again in the future– are becoming ineffective against germs.

The impact of the loss of effective antibiotics on people living with cancer, their families, and cancer healthcare providers is grave. Over the past few decades, there has been so much progress in preventing, treating, and curing cancer. Antimicrobial resistance threatens this progress. It is and will continue to steal survival from cancer patients.

Cancer is the second leading cause of deaths worldwide. In the U.S., one of every five deaths is due to cancer, according to United States Cancer Statistics. At the same time, antimicrobial resistance is an urgent public health threat estimated to kill at least 1.27 million people worldwide. 

People receiving cancer treatment are more susceptible to a wide array of infections, and cancer patients have a significantly higher burden of antimicrobial-resistant infections. Patients requiring specific procedures and treatments, such as chemotherapy or other types of cancer care, are at significant risk for infection, and antimicrobial resistance can make it difficult for them to receive effective treatments.

Already, infections are a leading cause of death for cancer patients. It is not difficult to imagine that, even as the science behind cancer treatment advances and chances of cancer survival improve, infections – not cancer itself – could one day be the leading killer of cancer patients.  

An increased risk of death is not the only problem cancer patients face due to AMR. Recently, CDC held its AMR Exchange webinar about the impact of antimicrobial resistance on cancer care. An important topic mentioned during that webinar was the impact on the lives of young cancer patients. One of the experts in attendance spoke of how antimicrobial resistance not only raises the risk of death for children with cancer, but it impacts their quality of life.

Children who are already in survival mode, when faced with risks of contracting an antimicrobial-resistant infection, are admitted into the hospital and sometimes must isolate themselves. These children are unable to leave their rooms due to increased risks and often must remain inside for many days. Their parents must watch as their children, already battling a destructive disease, also fight to remain strong while facing drastic changes in the way they live their life. Antimicrobial resistance is literally stealing life and survival from our children.

While the threat of antimicrobial resistance grows and time is critical, we are not without hope. CDC leads the U.S. public health effort to combat antimicrobial resistance. We know the most foundational and successful tool we have against resistance is stopping infections from happening in the first place.

Since 2016, CDC has invested more than USD 500 million in innovative programs across the US and in more than 60 other countries to slow the spread of antimicrobial resistance. We also support programs domestically and in dozens of other countries to improve antibiotic and antifungal use, track resistance, and implement infection prevention and control activities.

Infection prevention and control efforts in health care can limit cancer patients’ exposure to antimicrobial-resistant germs. We in public health and in cancer care must continue strengthening efforts to prevent infections and focusing on combating antimicrobial resistance as a core component of cancer care. 

Prevention works, and we all play a role in it. Everyone can take steps to reduce risk and help stop the spread of antimicrobial resistance, such as:

• Talking with a healthcare provider about the best treatments if you or a family member is sick. 
• Using antibiotics and antifungals appropriately, which means taking and disposing them as directed.
• Staying up to date on recommended vaccines.
• Keeping your hands clean to prevent infections and avoid getting sick.
• Covering your coughs and sneezes to prevent the spread of respiratory infections.

Additional steps can be found on CDC’s antimicrobial resistance website.

Antimicrobial resistance is a threat that we all will have to fight together. I know if we continue to make the needed investments and do the necessary work, we can ensure that antimicrobial resistance is no longer a threat to cancer care and survival.