Chemotherapy infection control

Thanks so much Shar. This forum/chat is so useful and it’s good to know we aren’t alone 

When my I ( not so kindly) passed on covid to my husband the Gp advised us to buy a pulse oxymeter . I think they + BP machine and thermometer are things we should all have in our households. We bought the pulse oxymeter from that well known on line store but made sure it was an approved one with , I think it was, the CE mark. 

as it turned out, we didn’t need it but have it for future use!

We got a digital thermometer from Boots, but have held off the oximeter for now. It all starts on Tuesday, so getting ready in earnest. We were given a booklet by the oncology dept about foods to avoid: the Macmillan website/ book is also very useful for this, under 'Food safety when your immunity is low'. Salad ingredients need to be thoroughly washed, even bagged salad that has been prewashed. I'm not sure we'll bother using lettuce, though spinach seems easy enough to wash. The advice is to rinse under running water. Greek salad sounds like a great idea! And for the first time ever I intend using disposable anti-bac wipes in the kitchen and bathroom. Handwashing seems to be the real first line of defence though.

Good luck with your prep: I found all the information overwhelming at first, but the hospital have been very helpful with information and guidance, even running a 'Demystifying Chemo ' afternoon where all questions were answered. And of course guidance from here has been fantastic! You really are not alone x

Thanks Worriedwife, I just want to be as prepared and informed as I can be. 

Thanks for all the info Downlander and hope all goes as well as it can do on Tuesday. Let me know how things are going. Take care 

The first chemo session feels scary because you are worried about the unknown. My husband was taken into the bay where they put a cannula into his hand. He had 2 nurses with him just watching to see how he was.  He did have abit of a reaction within the first few minutes, he went really hot and had a pain across his chest which went after about 30 seconds. The nurses were very calm, said it was a common reaction and were there to stop the chemo going in if necessary. They then slowed down the rate the chemo went in. On 2nd session they put it in slower and he had no problems. Just make sure your hands are warm as hubbies were cold and they had trouble finding a vein. The nurses never leave the bay so they are always there looking and checking . Good luck 

All the best for tomorrow downlander.

As Shar says they watch you like a hawk during the first session so your husband will be in safe hands. Talking of which, make sure you have your little bottle of hand sanitizer with you at all times as well as your masks. You are taking all the precautions against infection but those around you may be less vigilant.

We are coming into the season when bugs start rearing their heads again which raises the question of flu and COVID vaccinations. It's something I mean to raise with the oncologist at my husband's next chemotherapy session. I know that the standard line is that it is safe to have them provided a live strain isn't used but my issue is timing. I also know that the official line is that it is safe to have them together but is this right for those undergoing chemotherapy owing to the compromised immune system. I know what my views are as a microbiologist so it will be interesting to have the discussion with Alex (medical oncologist). It would be useful to know what you are being advised in the UK.

I asked the oncologist last time we saw him if it was ok to have the flu jab. I thought his reply was a bit off when he said "if he wants". I then asked if there was a time gap between chemo and the jab and he said best to have it a few days before chemo. We see him again this week so I am going to ask again and if having the covid jab at the same time is ok. I think it is his sense of humour but when you are asking a serious question I would like a serious answer.

More digging on what we should do regarding covid and flu vaccinations whilst having chemotherapy and radiotherapy.

American Cancer Society recommendations are:-

It’s generally recommended that vaccines not be given during chemo or radiation treatments – the only exception to this is the flu shot. This is mainly because vaccines need an immune system response to work, and you may not get an adequate response during cancer treatment.

The immune system is a group of cells, tissues, and organs that work together to resist infection by germs, such as bacteria or viruses. Cancer and cancer treatment can weaken a person’s immune system so that it won’t work as well as it should. It’s important to know which vaccines are safe for people with weak immune systems. Before receiving any vaccines, talk to your doctor about your cancer, cancer treatment, risk factors for the vaccine-preventable disease, whether you need the vaccine, and the best time for you to get it.

Cancer Research UK state:-

Coronavirus (COVID-19) vaccine

Specialists say that everyone having systemic anti cancer therapy (SACT) should be considered for the vaccines. Your cancer treatment can also go ahead if you've had the vaccine, and it is unnecessary to be delayed because of it.

Flu vaccine

Some pre school and school children have the flu vaccine as a nasal spray. The nasal spray contains a live but weakened form of the flu vaccine. Talk to their healthcare team if your child has cancer. The doctor may recommend that your child doesn’t have the nasal spray if they have a very weakened immune system. In this situation, your child might have the flu vaccine injection instead.

Adults with cancer can have the flu vaccine injection because this is not a live vaccine. If you are having cancer treatment, do ask your doctor about the best time to have this. This will depend on your situation and the type of treatment you are having.

Macmillan recommendations are:-

Public health experts and cancer specialists have agreed that people living with cancer should receive the vaccine. The covid vaccines that are available can be given to people who are having cancer treatment. Covid vaccines are not live vaccines, they cannot harm you when your immunity is reduced. Vaccines save lives and reduce the need for hospital stays from covid.

Vaccines can be given before, during or after cancer treatment. If you are due to start cancer treatment or have cancer surgery your medical team may recommend that you have vaccinations before treatment begins. Having vaccinations before treatment gives a better chance of protection. 

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My take out from this is that there is no concensus on the covid jab.

All seem to think the flu jab is OK, my caveat would be to have it in week 3 of the cycle if you are having chemotherapy.

Be careful around children who may have been given an attenuated flu vaccine (nasal spray).

Before having any immunisation check with the medical professionals and get more than one opinion if you are about to start treatment or are in treatment with chemotherapy and RT.

If you know you are going to be having to have RT or chemotherapy in the next couple of months get your jabs in sooner rather than later.

From my point of view I will not be having the flu and covid jabs at the same time no matter how much the medical profession say it is safe, and I am pretty healthy.

Thank you for your lengthy reply