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Spleen problems

Everyone can develop problems with the spleen, even people who have never had cancer. Some cancer treatments can increase this risk. It is important to recognize symptoms and signs that may point to spleen problems.

What are spleen problems?

The spleen is located on the left side of the upper abdomen and plays an important role in defending the body against bacteria. Sometimes spleen problems can occur, which reduce your immune function. This can lead to repeated bacterial infections caused by pneumococci, meningococci and Haemophilus influenzae.

Do I have an increased risk of spleen problems?

Anyone, including people who have never had cancer, can develop spleen problems. However, some cancer treatments can increase this risk.

The following treatments can increase the risk of spleen problems:

  • Surgery in which the spleen was removed

  • Radiotherapy to the spleen or to an area that includes the spleen (10 Gy or more)

  • Allogeneic stem cell transplantation (from a donor) combined with total body irradiation and/or chronic GvHD

  • Autologous stem cell transplantation (using your own stem cells) combined with total body irradiation

You can check the summary of your treatment to see whether you received one or more of these treatments. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated.

Spleen problems do not always result from cancer treatment. There can be other causes.

What are the symptoms and signs of spleen problems?

Certain symptoms and signs may indicate spleen problems. Even if you do not have these symptoms now, it is important to recognise them in case they occur in the future.

Spleen problems can lead to severe bacterial infections with the following symptoms:

  • Fever (38.3 °C / 101°F or higher)

  • Very high fever (39.5 °C / 103°F or higher)

  • Low body temperature (35 °C / 95°F or lower)

  • Chills, shaking, severe shivering

  • Drowsiness or reduced alertness

If you have frequent bacterial infections, make an appointment with your GP or LATER doctor.

What tests are needed and when?

Your regular LATER clinic visits are sufficient. No additional check-ups are required for an increased risk of spleen problems.

What happens if I have spleen problems?

Vaccinations and antibiotics can reduce the risk of severe bacterial infections. Your doctor will create a vaccination schedule with the necessary immunisations. Sometimes long-term antibiotics are needed. You will always receive a supply of emergency antibiotics to take immediately if you develop a fever.

Start taking your emergency antibiotics immediately and then call your GP if you have:

  • Fever (38.3 °C / 101°F or higher)

  • Symptoms or signs of an infection

  • An animal or human bite that breaks the skin

After using the emergency antibiotics, ask your GP for a new supply immediately.

Your GP may:

  • Perform a physical examination

  • Conduct blood tests to assess the severity of the infection

  • Take a blood culture to check for bacteria in the bloodstream

  • Prescribe antibiotics

If you plan to travel abroad, contact the Public Health Service (GGD) or a travel clinic to ask whether additional vaccinations or medicines are needed.

What else can I do?

Living with (an increased risk of) spleen problems can be challenging. Talking with friends and family may help. Connecting with others in similar situations can also be supportive, for example through a patient organisation such as VOX, part of the Childhood Cancer Association Netherlands.

It is important to know that you have an increased risk and to recognise the symptoms and signs. Take good care of yourself. Although a healthy lifestyle does not reduce the risk of spleen problems, it does contribute to overall well-being.

  • Always keep emergency antibiotics at home.

  • Wear a medical alert bracelet so emergency staff are aware that you have no or reduced spleen function.

Pay attention to your mental health as well. Small changes can positively impact your physical and mental well-being. If you have questions or concerns after reading this information, contact your GP or LATER doctor.

Where can I find more information?

On this LATER website you can also find information about:

  • Healthy lifestyle

  • Mental health

The PanCare Plain Language Summaries provide links to reliable information in English.

You can search online for information about spleen problems, but remember that online information is not always up to date or accurate.

Disclaimer

This information is based on the lay summary of the guideline below, created by the PanCare Plain Information Group, and adapted where necessary to the Dutch LATER guideline. If you have symptoms or concerns, do not rely on this information alone—contact your GP, LATER doctor or specialist.