Vaccinations have been an important part of healthcare prevention initiatives since the late 1790s when the first smallpox vaccine was developed. Since then, vaccines helped stop the spread of other deadly diseases including, polio, measles, hepatitis, flu, and most recently, coronavirus (COVID-19). If you have cancer, you might be wondering if getting vaccinated, like the annual flu shots, is helpful or harmful, especially if you are currently receiving cancer treatments. In order to answer that question, you need to understand what vaccines are and how they work.
What are vaccines
When a “foreign” substance enters the body, your immune system produces antibodies to fight it off. This foreign substance is called antigen. An antigen can be a pathogen (bacteria and viruses), chemicals, toxins, and pollens. Vaccines are used to “teach” your immune system to recognize and fight off antigens from certain diseases, such as those mentioned above. There are six types of vaccines: live virus, inactivated virus, subunit, toxoid, mRNA, and viral vector.
Live Virus Vaccines
Live virus vaccines use the weakened form of the virus. They help the immune system recognize the virus to create a lasting protective immune response, but do not cause disease in healthy individuals. Additional doses or boosters for these vaccines are not always needed. Examples include nasal mist flu vaccine, measles, mumps, and rubella (MMR), smallpox vaccine, and varicella vaccine.
Inactivated Virus Vaccines
Inactivated virus vaccines are taken from live viruses that have been killed. The killed virus can create an immune response but are incapable of causing disease. Multiple doses and boosters are often needed to build up immunity for full protection. Examples include polio vaccine and flu (injection) vaccine.
Subunit vaccines do not use live pathogens but rather pieces of a pathogen. Since they are not made with the whole organism, they cannot make you sick. Examples include hepatitis B vaccine, shingles vaccine, and pneumonia vaccine.
Toxoid vaccines neutralize the toxic activity caused by bacteria rather than the bacteria itself. An example of this is Tdap, a combination of three vaccines that protect against tetanus, diphtheria, and pertussis. Boosters for these vaccines are recommended every 10 years.
Messenger RNA (mRNA) vaccines use the virus’ genetic code. When injected, the RNA material enters the cells causing it to produce antigens specific for that virus, which then triggers an immune response. This mechanism does not change your cells or your DNA, rather it teaches the cells the unique make-up of that specific virus so it is better equipped with antibodies when exposed to it in the future. Examples are COVID-19 Moderna vaccine and COVID-19 Pfizer vaccine.
Viral Vector Vaccines
Viral Vector Vaccines work similarly to that of mRNA vaccines, except they use a harmless virus to deliver the genetic code to the cells in your body. Examples are ebola vaccine and COVID-19 Johnson and Johnson vaccine.
Are vaccines safe for people with cancer?
Cancer and cancer treatments make you immunocompromised, or have a weak immune system. This makes you more vulnerable to infections. If an infection is not found and treated early, it can be life-threatening. As you have read, vaccines require an immune system response to work. It is that immune response that makes you feel sick after receiving a vaccine. With a weak immune system, vaccines will not work as well as they should. Vaccines may still be given, but it is important to know which ones are safe and when. Generally, immunocompromised individuals should not get live virus vaccines. When you are actively receiving chemo or radiation treatments, any vaccine is not recommended except for the flu shot and COVID-19 vaccine.
Flu viruses change constantly, so it is recommended to get the flu shot every year to reduce the risk of infection. The flu can be life-threatening, especially to those with weak immune systems, so prevention is very important. The American Cancer Society recommends that cancer patients receive the inactivated flu virus vaccine every year. People with cancer should not get the nasal mist flu vaccine because it contains the live virus. The best time to get the shot depends on your cancer type and treatments, so discuss it with your doctor beforehand.
The National Comprehensive Cancer Network (NCCN) recommends that people with cancer get fully vaccinated against covid, including boosters. If you are in the process of receiving stem cell transplant or cellular therapy, you should wait to receive the covid vaccine three months after finishing treatment. Cancer patients receiving any other treatments should get vaccinated as soon as possible.
How to stay healthy
Whether you are fully vaccinated or not, you must still do what you can to prevent infections:
- Wash your hands often
- Avoid large crowds, and if you must, wear a mask
- Stay away from anyone with the flu, flu symptoms, or any other infections
- Follow your healthcare team’s recommendations after any treatments
- Contact your doctor right away if you are exposed to any illness or having any symptoms
Do not delay in preventing infections. Talk to your doctor today about getting vaccinated. If you are still unsure, our team of experts at OncoPower are ready to answer all your questions.
Chemotherapy is often administered through a catheter inserted into your vein. The common type of catheter used for long term and frequent chemotherapy treatment is an implanted port, or chemo port. It is a catheter connected to a small plastic or metal disc that goes under the skin. Chemo port placement is done by a surgeon or a radiologist, with local anesthesia or conscious sedation. They are usually put in the right side of your chest, but can also be placed on the left side, under your arm, or abdomen.
Benefits of having an implanted port
Having a port for chemo is a common choice for cancer patients because:
- it can remain in place and be used for years
- it is hidden. You will only feel a bump under your skin
- it can be used for medications and blood tests. There is no need for multiple needle sticks
How is a chemo port used for treatments
A trained healthcare professional, typically a nurse, will access your chemo port. Here are key points to remember during port access:
- Ask the nurse to numb the area beforehand. This is not necessary but helpful for your comfort. A numbing cream can be easily applied over your skin and left for 30 minutes.
- Make sure that you, the nurse, and everyone else in the same room are wearing masks during the procedure.
- Your nurse is going to wear sterile gloves during the procedure. If necessary, help him or her keep the sterility of the gloves by keeping your hair, clothes, jewelry, and blankets away.
- The port access needle stays in place while in use. So please be very mindful of your access site.
- Know the kind of port you have. Power-injectable ports can be used for contrast injections, such as those used for CT scans or MRI.
Once your chemo port is accessed, it is covered with a clear sterile dressing and can be used for medications and blood draws. Keep in mind, some hospitals have policies that will not allow port access for other medical treatments if you are actively receiving chemo. This is to reduce the risk of losing your only access– your life line.
Caring for your chemo port
Your chemo port needs to be flushed to prevent infection and to keep it from being clogged. While your port is accessed, it will need to be flushed with saline at least once a day. Prior to removal, your nurse will flush your port with saline and a small dose of heparin to prevent clots from forming. When your port is not routinely being used, you need to have it accessed and flushed every 4 to 6 weeks.
You can also take charge of the cleanliness of your chest port while it is in use:
- Keep the clear dressing clean and dry. Alert your nurse if it looks dirty or is peeling so it can be changed.
- Make sure the hub at the ends of the external catheter are wiped before each use.
- If your port access is being used for several days, ask your nurse for disinfecting protector caps. Most facilities have these as part of their routine intravenous (IV) catheter care intervention.
- Always wash your hands before touching the external catheter
When to call your healthcare provider
Contact your health care team right away if:
- the area around your port appears red, swollen, or bruised, and is painful and warm to the touch
- your arm that is on the same side of your body as the port is swollen
- you see a lot of bleeding around the port or the access catheter
- you see fluids leaking out of the access catheter
The bottom line is, chemo ports are helpful in preventing multiple needle sticks for frequent chemotherapy treatments and blood draws. But before you make a decision about them, you need to understand the pros and cons of having one and how to manage it. For more information about chemo ports, visit the OncoPower education library and watch four short illustrative videos presented by our patient navigator.
Talk to your oncologist today if having a port for cancer treatments is right for you. Our team of medical professionals at OncoPower are standing by to answer all your questions.
Nausea is a common side effect of some cancers and cancer treatments. Nausea is feeling sick to your stomach, or feeling like you might want to throw up. This symptom can be mild or severe, and even lead to vomiting. Regardless of the severity, nausea can be very uncomfortable and can affect your health.
What can cause nausea with cancer
- Certain Cancers (brain, liver, stomach, pancreas, colon, appendix, ovaries)
- Cancer Treatments (chemotherapy, radiation therapy, immunotherapy)
- Certain medications used to help with cancer treatment side effects. The most common of these are pain medications.
Who is at risk for cancer nausea
Unfortunately, there are certain personal factors that can make you more likely to have cancer nausea. You may be more vulnerable if you have one or more of these:
- History of motion sickness
- Morning sickness during pregnancy
- Prone to nausea and vomiting when sick
- Have a high level of anxiety
What can happen when you get sick to your stomach
The major concern for nausea is decreased nutrition. This is because if you are feeling nauseous, your appetite might be low, or you choose not to eat anything at all in fear of worsening your symptoms or throwing up. Failing to seek treatment for nausea and vomiting can lead to serious health complications. Malnutrition is detrimental to cancer care, and health in general. It can cause weakness, weight loss, inability to fight infections, and inability to finish cancer treatments. Uncontrolled vomiting can lead to dehydration and pain. Read more about malnutrition from our blog post here.
How to manage your symptoms with medications
There is no standard regimen to treat cancer nausea and chemotherapy-induced nausea. However, there are many different kinds of medications available that can help manage your symptoms:
- Drugs that can block the vomiting center in the brain (Prochlorperazine).
- Drugs that can speed up the emptying of your stomach (Metoclopramide, Domperidone)
- Drugs that can block the receptors in the gut (Ondansetron).
- Drugs that are used for other symptoms, but can help reduce nausea and vomiting. Examples of these, and commonly prescribed, are anti-anxiety drugs (Lorazepam) and steroids (Dexamethasone).
There are many medications not mentioned. Talk to your doctor which one is right for you. Keep in mind that some of these can be taken by mouth or injected through an IV access by a healthcare provider.
How to manage your symptoms with dietary modifications
Prevention is key to help with nausea. Your doctor may prescribe a medication to be taken 30 minutes to an hour before meals. However, there are ways to relieve nausea and vomiting without using medications:
- Try eating small frequent snacks rather than large meals
- Avoid high fat, greasy foods, especially before treatments
- Avoid strong odors. Also pay attention to what smells trigger nausea for you
- Do not lay flat for at least 2 hours after eating
- Drink plenty of fluids, but avoid drinking liquids during meals
- Always talk to your doctor first before trying any of alternative and complementary treatments
- If you are vomiting, do not drink or eat for several hours to give your stomach time to heal. Start back on food slowly. Begin with small amounts of clear liquids like water or broths. Then advance to light, mild food like jello or toast. If you can eat that without vomiting, then you can try solid food.
Ask a dietitian for advice on the best food to eat during treatment and recovery. He or she can also recommend ways to help manage your symptoms that will best suit your lifestyle. Watch this video presentation by our registered dietitian Rachel Spencer for more information about nutritional help with nausea.
When to contact your healthcare provider
Nausea and vomiting can be caused by medical conditions unrelated to your cancer and treatments. So, it is important to contact your doctor if:
- You are not getting relief despite medications and careful dietary modifications
- You are vomiting 4 or more times in a 24-hour period
- You have abdominal pain before nausea and vomiting occurs
- You are bothered by the side effects of your medications
Treatments are individualized to your signs and symptoms and lifestyle. Do not let nausea ruin your road to recovery. Talk to your healthcare team today about what works best for you. Our experts at OncoPower can help you get started.
Cancer fatigue versus normal fatigue
In general, everyone gets tired. Then, we go to sleep and feel better. Fatigue is an unusual tiredness that can profoundly affect your quality of life. It can last up to several weeks or longer. Cancer fatigue goes beyond that- it affects you physically, emotionally, and mentally. It usually comes on suddenly and no amount of sleep can help restore your energy. It is important to know that you are not suffering alone. Cancer related fatigue affects 80% to 100% of people with cancer.
What causes fatigue in cancer
The exact reason for cancer related fatigue is unknown. However, it may be related to several causes:
- Cancer treatments (chemotherapy, radiation therapy, immunotherapy, bone marrow transplant, and biologic therapy)
- Decreased Nutrition
How to recognize when there is a problem
Some symptoms are expected during and following cancer treatments:
- Whole body tiredness
- Decreased energy
- Inability to concentrate
- Lack of motivation
- Increased irritability
Talk to your doctor if you experience any of these symptoms persistently for weeks or longer. Your doctor may conduct a physical exam to evaluate the severity of your symptoms. He or she may ask questions to examine the nature of your symptoms. It may also help to keep a journal to track your fatigue and contributing factors.
How to manage cancer related fatigue
Cancer fatigue treatment is managed on an individual basis. However, the first step is to recognize that the problem exists. With the help of your doctor, you can determine the root cause of the problem. After that, an appropriate treatment can be prescribed. There are several actions that experts recommend to help ease your symptoms:
- Blood tests can determine anemia. If you are anemic, your doctor may prescribe iron therapy, blood transfusion, Erythropoiesis-stimulating agents (ESAs), and supplements (B12 and folic acid).
- Talk to your doctor about ways to manage pain. Several medications exist to manage pain. You can also try a non-pharmaceutical approach, such as acupuncture, massage, relaxation techniques, and meditation. OncoPower has a wonderful meditation suite you can use any time.
- Talk to a dietitian. He or she can recommend dietary changes to help improve your appetite and nutritional intake. If your intake is poor because of nausea, there are several treatments available that can help you. You can check out more information about that on this video presentation by our registered dietitian Rachel Spencer.
- Seek mental health support. Therapy can help you manage stress, anxiety, and depression. In-person and online support groups can also help.
- Physical activity is important. It can help improve your quality of life and energy. In fact, according to the American Cancer Society, physical activity may help you cope with side effects of treatment and possibly decrease your risk of new cancers in the future.
Everyone experiences cancer fatigue differently. It may be a common side effect of this illness, but it does not have to affect your life. Talk to your doctor today.
For more information on cancer fatigue management, watch this video presentation by our experts at OncoPower.