Ana Mazanishvili
President of Europa Donna Georgia, Patient Advocate, Founder at Caucasus Cancer Society HOPE
A cancer survivor recalls how she had to stop treatment to manage a resistant infection — and why the experience has prompted her to call for mandatory resistance testing.
When she was 43, Ana Mazanishvili was diagnosed with breast cancer. She elected to have a double mastectomy, but as if that wasn’t traumatic enough, she developed sepsis after surgery. This is a serious reaction to an infection, which progresses quickly and can be life-threatening unless the right antibiotic is administered urgently.
“I had a high temperature, and I felt very weak,” remembers Ana. Then black, dead tissue began appearing on her skin.
Dealing with the AMR threat in cancer patients
With sepsis, every minute counts, so there’s no time for doctors to guess which antibiotic will work. Unfortunately, Ana was prescribed a type that her body was resistant to. This was only discovered when her symptoms persisted, and she was given an antibiotic resistance test.
Unsurprisingly, Ana was keen to start cancer treatment again. However, it wouldn’t be possible with the infection still raging, so she began aggressive antibiotic therapy to survive.
Unfortunately, Ana’s isn’t an unusual story. Sepsis is a crucial clinical manifestation of AMR in oncology patients, who are more likely to die from sepsis than individuals without cancer.1
To deal with this growing threat, Professor Oliver Cornely — Director and Chair of Translational Research at the CECAD Institute of the University of Cologne — believes there needs to be more engagement between patients and their physicians.
“(Patients need to ask their doctors): ‘What is in place if I get a fever or some infection?’,” he says. “‘How do you deal with that risk? What treatments do you want to use — and has resistance been factored in?’ It’s not easy for a patient to address those questions because they’ll usually be overwhelmed with contemplating the underlying disease.”
Antibiotic resistance means that
even the most successful surgery
can be rendered ineffective.
Calls to make antibiotic resistance testing mandatory
Professor Cornely also calls for Antimicrobial Susceptibility Testing to determine which antibiotics will be most effective. “And we need new tools for rapid diagnosis,” he says. “Next-generation sequencing (NGS) might have a place there. But we need to educate how and when to use these tests. Otherwise, we might run after a false positive result. We also need clinical trials on diagnostic assays… and ideally, we would have tests done bedside — point of care tests. That way you don’t lose time by transporting test material and getting back results.”
Thankfully, Ana is a cancer and sepsis survivor. As a patient advocate for the Georgia branch of breast cancer coalition Europa Donna, she wants antibiotic resistance testing to be mandatory. After all, for cancer patients, every incorrect course of antibiotic therapy is lost time when they could be receiving vital cancer treatment instead.
“Antibiotic resistance means that even the most successful surgery can be rendered ineffective,” says Ana. “The patient who has beaten cancer can be overcome by the infection simply because the body is resistant. It’s a matter of life and death.”
[1] Williams, J., Ford, M. & Coopersmith, C. (2024). Cancer and sepsis. https://tinyurl.com/yj3n4mma.
