Abstract
The treatment of cancer has undergone many advances in recent years, leading to significant increases in patient survival. Improvements have come not only in the therapies themselves, but also in our ability to sustain critically ill patients. This, in turn, has allowed more intensive cytotoxic chemotherapies and an increased application of bone marrow transplantation for a broader range of neoplasms. More aggressive chemotherapy regimens have led to more profound immunosuppression and increased risk of infection. Longer survival in more critically ill patients, as well as the relative success of antibacterial therapies, have contributed to a dramatic increase in the incidence of invasive fungal disease among oncology patients. Additional risk factors for fungal infection, common in cancer patients, include the interruption of natural protective barriers by indwelling intravascular catheters, extensive surgical procedures, and chemotherapy-induced disruption of mucosal integrity.
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