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The Flu Is One Gift That We Don't Have To Keep On Giving For People With Cancer

by Dr. Len December 17, 2013


It's the holiday season, a time of reflection, celebration and for many, giving gifts. But there is at least one gift that no one wants to get, and certainly no one wants to give: the flu. And for people with cancer, and those they come in contact with, the flu can be a very serious event. For that reason and many more, people more than 6 months old-and especially those in contact with people who have serious illnesses like cancer-should get vaccinated against the flu.

Too many of us think the flu is a minor inconvenience. But that is almost certainly because we confuse the typical cold or upper respiratory infection, which usually means discomfort and maybe a day or two off work.  Influenza is a much different and much more dangerous animal, especially to people with chronic diseases.

Over time we have become somewhat immune to the messages about the dangers of the flu, now that we have vaccinations and medicines which can treat the illness. Few are alive who remember anything about the great influenza pandemic of 1918:

"The influenza of that season, however was far more than a cold...The flu was most deadly for people ages 20-40...It infected 28% of all Americans (Tice). An estimated 675,000 Americans died of influence during the pandemic, ten times as many as in the world war. Of the US soldiers who died in Europe, half of them fell to the influenza virus and not the enemy (Deseret News) An estimated 43,000 servicemen mobilized for WWI died of influenza (Crosby)."

We have been fortunate not to have a repeat of that pandemic. But for some of us, the flu remains a deadly possibility, one that we might be able to prevent if we take the precaution of getting a flu shot.

People with cancer are among the groups at especially high risk of getting the complications of flu. And also let's not ignore the "risk pool" of people who live with patients with cancer and those who care for people with cancer. We tend to forget that those healthier folks who help people with serious illnesses can be the transmitters of this potentially serious and life-threatening infection.

Because of those risks, people with cancer and those they come in contact with really need to understand their options about getting vaccinated against the flu, and-assuming they don't have specific contraindications to the vaccine-if at all possible get it done. It is still not too late to get this year's flu vaccination. No one can predict when the vaccine "season" will peak or how serious it will be in any given year. But waiting until the last minute, when the story is all over the news, is not a good idea and it's not good medicine. And worse, it doesn't work.

What I cannot tell you here is which vaccine you should get. That is between you and your health professional. There are several different types of vaccines, some of which are "live" and some of which used killed viruses. Worthy of special emphasis are patients currently receiving chemotherapy or other cancer treatment. They have specific risks with flu vaccines, so they must speak to their health professionals before getting vaccinated.

Preventing the flu is a much better strategy than getting it, or trying to treat it with medicines once the infection has taken hold of your body. A recent study found a significant decrease in deaths in cancer patients vaccinated against the flu compared with those who did not. The Centers for Disease Control and Prevention reports that "we do not know whether cancer patients and survivors are at greater risk for infection with the flu," but they "are at higher risk for complications from flu, including hospitalization and death." The CDC also recommends that people with cancer and cancer survivors should not get the live vaccine, because of their weakened immune systems. According to CDC, the inactivated flu shot is safer for this group.

One issue that confronts people with cancer is whether or not the vaccine is as effective in them as it may be in others. As we age, our immune systems don't react quite as well to all sorts of challenges, including infections and vaccines. And that is the case with the flu shot as well. So even if you are just older but don't have cancer, the vaccine may not have as high a rate of protection as for someone younger. But that is not a reason not to get the shot. The reality is that the more people are vaccinated, the greater the protection in the population and the less chance the flu viruses have to go from person to person. So even if it isn't 100% effective, it still has value. And it may prevent a hospitalization or even death from the flu and its complications, according to published research.

There is a lot more information I could share here, but I want to keep the message simple. And that message is if you are around someone with cancer, get the vaccination. If you have cancer, check with your health professional about which vaccine is best for you, or if you should avoid the vaccine because of your treatment or other condition.

We may take the flu lightly these days, but it really is a deadly serious business-especially for people with cancer who may not have the reserves in their bodies to deal with the infection or its complications.

So during this season of giving, think of the one thing you can do to give the gift of protection from the ravages of the flu. Get vaccinated against the flu if you are around someone with cancer. You can never tell when the life you save may just be someone you care about very, very much. And preventing harm or even saving a life is a wonderful gift that would bring joy to all of our hearts.


For more extensive and up-to-date information about the flu, check out the CDC website. Also, a special thanks to Angela J.P. Cambell, MD, MPH who is a medical officer in CDC's Influenza Division of the Epidemiology and Prevention Branch. Her help was invaluable in providing background on this topic.


About Dr. Len

Dr. Len

J. Leonard Lichtenfeld, MD, MACP - Dr. Lichtenfeld is Deputy Chief Medical Officer for the national office of the American Cancer Society.