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Flu Shots and Chemo

Posted 11/9/2016

Posted in

  I am going to refrain from making any political comments this morning, the day after the Election. Let me only say that we all hope that healing can begin, and that our country can come together and move forward in ways that help us all.

  The topic is flu shots and chemotherapy. Not, as you might expect, should you receive a flu shot while you are receiving cancer treatment? The answer to that one is the standard: "Ask your doctor", who will probably tell you to do so. Instead, this entry is about the puzzling ways that we make decisions re what treatments to accept.

  Without a doubt, chemotherapy is much scarier than flu shots and brings many more side effects and complications. Most people, however, agree to chemo following a cancer diagnosis or progression. Many people, on the other hand, decline flu shots in spite of the genuine awfulness of the flu and the real change of very serious illness or even death for compromised or elderly people.

  Think about it: 

Chemo: Yes. Flu Shot: No. How Come?
— That decision is just plain baffling, says James C. Salwitz, MD

Fall brings school buses, a freshening breeze, and an avalanche of meetings. There are
seasonal sales, myriad projects, and the splendor of colored leaves. The season is also
announced, again and again, by a particular peculiar and perilous decision, which, no
matter how much I try, I do not fully understand. Frankly, I just don't get it.
"Jane, it is time to start chemotherapy."
"What are the side effects?"
"Well, this is powerful chemotherapy. It is necessary to cure your cancer. It will cause hair
loss. It will cause a drop in your blood counts. It might cause severe diarrhea. There might
be numbness of your hands and feet ... that can be permanent. It can damage the muscle
of your heart. You could be allergic. You may require blood transfusions or be hospitalized.
When we finish the chemo, we will start radiation. Do you want to hear about the
"No, that's O.K. I think I have heard enough. That is really scary, but thank you for telling
me. How soon can we begin? I want to start right away."
"We can start in a couple days. First, there are a few things to do. You need blood tests, a
bone marrow biopsy, an MRI of your brain with intravenous contrast, a MUGA scan, a PET
scan with radioactive dye, and the placement of a Mediport."
"A Mediport?"
"That is a catheter surgically implanted under your skin, and the other end goes to the
right side of your heart. It is best way to give chemo."
"Oh, O.K. ... can we get all that done this week? I want to begin."

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