The Flu: What Cancer Patients Need to Know

Flu season starts in the fall and ends in the spring – and people with chronic health conditions, such as cancer, are at a higher risk of getting the flu. Fortunately, many of the preventative measures that you can take against this contagious respiratory illness are the same for cancer patients as they are for others.

“Cancer patients may be at a higher risk for complications from influenza – including treatment delays between chemotherapy cycles or secondary pneumonia – than the general population,” explains Brigham and Women’s Hospital epidemiologist Meghan Baker, MD, ScD. “Some patients may be more susceptible to getting influenza due to compromised immune systems.”

Patients undergoing cancer treatment, such as chemotherapy or bone marrow transplants, have fragile immune systems, making them more susceptible to the flu. Adults 65 years of age and older are also more susceptible, as well as those who have medical conditions including kidney and liver disorders. Similarly, people who have had certain types of cancer in the past, such as leukemia and lymphoma, are also at high risk for complications from the flu.

Signs and Symptoms

Unlike the common cold, influenza usually comes on suddenly. Symptoms of the flu include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, tiredness, and occasionally vomiting and diarrhea. Not everyone with the flu will get a fever, however.

People with the flu are most contagious the first three to four days after their illness begins, but people with weakened immune systems, such as cancer patients receiving treatment, might be able to infect others for an even longer time.

Preventing the Flu

The best way to prevent the flu is by getting a flu shot. Because it takes roughly two weeks from vaccination for the body to make flu-fighting antibodies, cancer patients should receive their flu shots as soon as possible before flu season starts, ideally by October. Getting vaccinated later (through January) can still be beneficial.

The best way to prevent the flu is by getting a flu shot.
The best way to prevent the flu is by getting a flu shot.

“We are in favor of vaccinating our cancer patients against the flu,” says Baker. “But if patients are unsure or have questions, we suggest that they talk with their oncologist.”

There are two types of flu vaccinations: A live vaccine, which consists of weakened live virus and is administered via nasal spray, and an inactivated vaccine, a dead strain of the flu that is given as a shot. The inactivated vaccine is safer for cancer patients. In fact, the Centers for Disease Control and Prevention (CDC) recommends that the nasal spray not be used on anyone this 2017-2018 flu season.

Caretakers and others who spend time around cancer patients can infect them without realizing it, so it is important that they also receive flu vaccinations. The CDC recommends that everyone aged six months and older receive a flu vaccine.

In addition to receiving the flu vaccination, patients and caretakers should adopt healthy habits to keep them safe from illness. Proper hand washing, especially after touching doorknobs or other frequently touched surfaces, is a simple but essential way to fend off the flu and other viruses. Alcohol-based hand sanitizers and wipes, which usually line the halls of hospitals, can also kill germs.

“Patients can practice excellent hand hygiene and make sure that those around them do also,” Baker suggests. “They can also avoid large gatherings and potlucks during the flu season, and request that family and friends who are sick not visit them.”

In general, cancer patients should try to avoid close contact with people who have the flu and are contagious. If applicable, caretakers should stay home from work if they are sick, except to seek medical attention.

“If cancer patients develop flu-like symptoms, they should contact their care team as soon as possible,” Baker advises. “Treatment with anti-viral drugs may be an option.”

Learn more about preventing the flu from Dana-Farber.