Carolyn Vachani, RN, MSN, AOCN

Flu vaccine information is everywhere you turn these days, from the supermarket to the news. Every year around this time, questions about flu vaccination start popping up in cancer clinics. Many people with cancer may be wondering how they can best prevent getting sick, and if they should be vaccinated against the flu. Here are the facts…

According to Neil Fishman, MD, associate professor of Infectious Diseases and director of Healthcare Epidemiology and Infection Control at The University of Pennsylvania, all immunosuppressed individuals should receive influenza vaccination (a single shot now includes both “seasonal” strains and the H1N1 strain). People currently undergoing treatment for cancer and those who are in remission should be vaccinated, as both of these groups are at higher risk for developing complications from influenza infection. These patients should receive only the injected vaccine, since the inhaled form contains live viruses. It would be best to receive the vaccine when they are the least immunosuppressed in order to guarantee a maximal response. This means that they should not receive the vaccine during their nadir (the time when blood counts are at their lowest, typically 7-14 days after treatment). Talk with your healthcare team about the best time for you to get vaccinated.

Dr. Fishman also advises that people with cancer (particularly those on therapy or post-transplant) also get a pneumovax vaccine. This vaccine helps to prevent a common strain of bacteria that can cause pneumonia as well as other serious infections. The CDC recommends pneumovax for adults over 65, for smokers and for “people with certain health problems” – this includes health problems or treatments that weaken the immune system. People with cancer may require a second dose of pneumovax, given 5 years after the first. Patients should discuss their need for re-vaccination with their healthcare team.

Remember, while receiving cancer treatment, you are at an increased risk of getting infections, including colds and the flu, particularly when your blood counts are low. What precautions should you take as a patient receiving cancer therapy? Most importantly, wash your hands often- it is the easiest, most effective way to prevent the spread of infection. Keep hand sanitizer in your bag, desk, car or anywhere you may not be able to access a sink for handwashing. Avoid touching your eyes, nose and mouth- that is how germs get in. It is perfectly acceptable not to shake hands or to ask people who are sick (or have sick people in their household) not to visit you. Ask any visitors to wash their hands upon arrival and, whenever possible, avoid places with crowds of people, particularly when your blood counts are at their lowest. Have other members of your household get vaccinated as well; you don’t want them bringing these infections into your house where it will be harder to avoid.

Still, even the best handwashers get sick sometimes, so don’t blame yourself if you do. Get plenty of rest, drink plenty of fluids, and help to prevent the spread of the flu to others by staying home when you are sick.

You can learn a lot more about cancer and the flu through the CDC webpage on this topic.

Now roll up your sleeve – this won’t hurt a bit!

Carolyn Vachani, RN, MSN, AOCN

Flu vaccine information is everywhere you turn these days, from the supermarket to the news. Every year around this time, questions about flu vaccination start popping up in cancer clinics. Many people with cancer may be wondering how they can best prevent getting sick, and if they should be vaccinated against the flu. Here are the facts…

According to Neil Fishman, MD, associate professor of Infectious Diseases and director of Healthcare Epidemiology and Infection Control at The University of Pennsylvania, all immunosuppressed individuals should receive influenza vaccination (a single shot now includes both “seasonal” strains and the H1N1 strain). People currently undergoing treatment for cancer and those who are in remission should be vaccinated, as both of these groups are at higher risk for developing complications from influenza infection. These patients should receive only the injected vaccine, since the inhaled form contains live viruses. It would be best to receive the vaccine when they are the least immunosuppressed in order to guarantee a maximal response. This means that they should not receive the vaccine during their nadir (the time when blood counts are at their lowest, typically 7-14 days after treatment). Talk with your healthcare team about the best time for you to get vaccinated.

Dr. Fishman also advises that people with cancer (particularly those on therapy or post-transplant) also get a pneumovax vaccine. This vaccine helps to prevent a common strain of bacteria that can cause pneumonia as well as other serious infections. The CDC recommends pneumovax for adults over 65, for smokers and for “people with certain health problems” – this includes health problems or treatments that weaken the immune system. People with cancer may require a second dose of pneumovax, given 5 years after the first. Patients should discuss their need for re-vaccination with their healthcare team.

Remember, while receiving cancer treatment, you are at an increased risk of getting infections, including colds and the flu, particularly when your blood counts are low. What precautions should you take as a patient receiving cancer therapy? Most importantly, wash your hands often- it is the easiest, most effective way to prevent the spread of infection. Keep hand sanitizer in your bag, desk, car or anywhere you may not be able to access a sink for handwashing. Avoid touching your eyes, nose and mouth- that is how germs get in. It is perfectly acceptable not to shake hands or to ask people who are sick (or have sick people in their household) not to visit you. Ask any visitors to wash their hands upon arrival and, whenever possible, avoid places with crowds of people, particularly when your blood counts are at their lowest. Have other members of your household get vaccinated as well; you don’t want them bringing these infections into your house where it will be harder to avoid.

Still, even the best handwashers get sick sometimes, so don’t blame yourself if you do. Get plenty of rest, drink plenty of fluids, and help to prevent the spread of the flu to others by staying home when you are sick.

You can learn a lot more about cancer and the flu through the CDC webpage on this topic.

Now roll up your sleeve – this won’t hurt a bit!

Carolyn Vachani, RN, MSN, AOCN

Flu vaccine information is everywhere you turn these days, from the supermarket to the news.  Many people with cancer may be wondering how they can best prevent getting sick and if they should be vaccinated against the flu, both seasonal and H1N1 (often called Swine flu).  Here’s the facts…

According to Neil Fishman, MD, associate professor of Infectious Disease and director of Healthcare Epidemiology and Infection Control at The University of Pennsylvania, all immunosuppressed individuals should receive the influenza vaccines (both seasonal and H1N1).  This includes people receiving cancer treatment. These patients should only receive the injected vaccines and not the inhaled forms of the vaccines, which use a live virus.  It would be best to time the vaccine to when they are the least immunosuppressed in order to guarantee maximal response.  So, they should not receive the vaccine during their nadir (the time when blood counts are at their lowest, typically 7-14 days after treatment).  Talk with your healthcare team about the best time for you to get vaccinated.  You can receive both the seasonal flu and H1N1 vaccines at the same time.

Dr. Fishman stresses that the novel H1N1 influenza virus is not any more dangerous than seasonal influenza at this point. It is no more deadly, but we need to take the same precautions we take for seasonal influenza.

Remember, while receiving cancer treatment, you are at an increased risk of getting infections, including colds and flus, particularly when your blood counts are low.  What precautions should you take as a patient receiving cancer therapy?  Most importantly, wash your hands often- it is the easiest, most effective way to prevent the spread of infections.  Keep hand sanitizer in your bag, desk, car or anywhere you may not be able to access a sink for handwashing.  Avoid touching your eyes, nose and mouth- that’s how germs get in.  It is perfectly acceptable to not shake hands or ask people who are sick (or have sick people in their household) to not visit you.  Ask any visitors to wash their hands upon arrival and, whenever possible, avoid places with crowds of people, particularly when your blood counts are at their lowest.  Have other members of your household get vaccinated as well- you don’t want them bringing these infections into your house where it will be harder to avoid.

Even the best handwashers get sick, so don’t blame yourself if you do.  Get plenty of rest and fluids and help prevent the spread of the flu to others by staying home when you are sick.

Now roll up your sleeve- this won’t hurt a bit!

Also see Ask the Experts: Exposure to People After Vaccines.

Carolyn Vachani, RN, MSN, AOCN

One of the saddest days I ever experienced working in the cancer center was when a woman, newly diagnosed with breast cancer, broke down in tears and told me that she had caused her breast cancer. She further clarified that her sisters and mother had told her that you get cancer as a punishment for something you have done. Can you imagine this reaction from the very people you turn to for support at such a time? Unfortunately, misinformation or “myths”about cancer are everywhere. It is in those emails that get passed along to thousands, warning you not to freeze your water bottle or the tragic story told by your cousin Sally about her next door neighbor’s sister. You may be thinking, what can I do about it? A lot, actually. Become a cancer myth buster!

Cancer myths spread because people don’t know the facts, and don’t bother to check their facts before telling them to others. They don’t do it to be hurtful; in fact, they are usually trying to be helpful. Cousin Sally’s story may be the only thing she knows about chemotherapy, and so she wants to tell you about it. The reality is that every person’s cancer diagnosis, treatment course and side effects are different, and no whisper-down-the-lane story is relevant to your situation. Period. Feel free to inform Sally of this fact.

Let’s debunk some of the common myths. Perhaps you have heard that a tumor biopsy or surgery will cause the cancer to spread. This is a common misconception. Some websites claim that they have proof that this is true because some person had a biopsy and then his or her cancer spread, or that the cancer is able to spread through the needle hole used for the biopsy, along the tract of the needle. While it may be possible for cancer cells to “seed” along the needle tract, if a cancer diagnosis is determined from a biopsy, further therapy (surgery, radiation or chemotherapy) is performed to try and remove or kill any stray cells. An untreated cancer will spread throughout the body via the bloodstream or lymphatic system. This is the definition of cancer- it has the ability to spread, surgery or not.

I have no family history of ________ cancer, so I am not at risk. Absolutely false! Almost 80% of colorectal cancers and 70-80% of breast cancers are diagnosed in people with NO family history! There is no type of cancer that only runs in families and can’t occur at random

Cancer is contagious. False, false, false! You should have no fear of visiting, hugging or kissing a friend with cancer- in fact you should make a point to do so to show them your support! People receiving therapy are not toxic or dangerous to others (including children). The only exceptions to this are those receiving brachytherapy- a specific type of radiation where the radiation is implanted.

Now, to those emails that get me all worked up…

You get an email warning of something that causes cancer and asks that you pass it on to all your friends. STOP! Take a minute to check it out. You can use one of my two favorite places to myth-bust an email: snopes.com and about.com. Or try a google search for the basic premise of the email, for instance “freezing plastic water bottles causes cancer”. I usually check all three places to confirm (and if I need more facts, I’ll do some library searching, but this is not necessary). Then I hit “reply to all” and straighten out the confusion. Ok, so maybe coming from an oncology nurse background, I get a little more leeway, but most people wonder if this stuff is true, and they just don’t know how to find out, so they will appreciate your help.

Now, go forth and bust some myths!