Should I Tell My Health Care Provider I Want Complementary Therapies?

You should always discuss any additional therapies or self-care strategies that you want to initiate with your health care provider (e.g., doctor, nurse practitioner, physician assistant). Many complementary therapies may be helpful when done along with traditional medical care. Some complementary therapies can decrease negative side effects from medical treatments (e.g., pain, nausea, vomiting) or decrease anxiety and depression or provide an overall sense of well-being. It is important to discuss any additional herbs, vitamins, over the counter medicines, and complementary therapies with your health care providers because some of these therapies have created severe side effects when combined with traditional medicine. Other therapies may not cause any side effects, but also may not have any proof to support they provide a benefit.

There are many different complementary therapies you may want to consider. They are listed below. Be sure to get referrals and only work with licensed certified individuals who provide the complementary therapy.

Acupuncture (painless needles placed in certain points on the body – used in China for 2000 years)
Aromatherapy (use of highly concentrated oils to treat a variety of conditions)
Chinese medicine
Herbal remedies (come as capsules, tablets, liquids, teas, ointments, and creams – they come from plants and are natural, but this does not mean they are safe for you)
Homeopathy (small amounts of substances are used in liquids to treat illness)
Magnetherapy (controversial – used for muscle, nerve and joint pain)
Massage therapy (apply pressure and movement to soft tissue to help many symptoms)
Meditation (a way to quieting your mind – it can help deal with cancer)
Therapeutic Touch (a process where a practitioner moves his/her hands a few inches above the patient to redirect energy for healing)
Vitamins and minerals (absorbed from what we eat but sometimes need to get extra in pill form)
Yoga (helps relaxation, breathing, flexibility, and over-all well-being)

Resources:

National Certification Commission for Acupuncture and Oriental Medicine (202) 232-1404
American Alliance of Aromatherapy, PO Box 750428 Petaluma, CA 94975-0428 (707) 778-6762
American Aromatherapy Association, PO Box 3679, South Pasadena CA 91031 (818) 457-1742 www.aromaweb.com
American Association of Acupuncture and Oriental Medicine (610) 266-1433 www.acupuncture.com
National Center for Homeotherapy, 801 North Fairfax 81, Suite 306, Alexandria, VA 22314 www.homeopathic.org
Bioethics-Magnetics Institution, 2490 West Moana Lane, Reno, NV 89509-2936 (702) 827-9099
American Massage Therapists Association, 820 Davis Street, Suite 100, Evanston, IL 60201 (847) 864-0123
Insight Meditation Society, 1230 Pleasant Street, Baire, MA 01005 (308) 355-4378 www.dharma.org
Mine Healers Professional Association, 1211 Locus Street, Philadelphia, PA 19107 (212) 454-8079 www.therapeutics-touch.org
American Yoga Association, PO Box 19986, Sarasota, FL 34276 (941) 927-4977 www.members@aol.com/ami/oggasn

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What is the Difference Between Alternative and Complementary Medicine?

Although some health care professionals and many lay people use the terms alternative and complementary therapies interchangeably, they are very different. Alternative therapies are unconventional unproven therapies that reject conventional medicine. These therapies are not approved by the US Food and Drug administration. Some examples have included colonic irrigation, Hoxxey’s cancer treatment and Laetrile. Some people consider these therapies “Quacks” as they are unlicensed.

Complementary therapies are different. They are used in combination with standard medical care and given by licensed or certified therapists. The goal is usually to reduce symptoms (physical and emotional) and improve quality of life. Additionally, complementary therapies generally have years of tradition (like 200 years with Chinese medicine) and research that supports the use of the therapy. As always, if you are considering any additional therapy that was not recommended by your doctor, collect all of the information and discuss it with your doctor first. It is possible a therapy you are considering has been known to produce a severe side effect with the chemotherapy you are receiving.

Because more and more individuals with cancer are seeking information on complementary therapies an office of Alternative Medicine was started at the National Institutes of Health. Through this office people can obtain reliable information, and many scientists are receiving funding for research to determine which complementary methods are the most successful.

Resource: http://nccam.nih.gov/
Toll Free: 1-888-644-6226International: 301-519-3153TTY: 1-866-464-3615 (for hearing impaired) Fax: 1-866-464-3616

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Enhancing Breast Cancer Screening

The following is a review written by a nurse, Valerie R. Vestal, MSN, FNP, RN, at our institution on a study related to breast cancer screening.

Breast Cancer is the most wide spread cancer affecting women and the second leading cause of cancer deaths in the United States. Survival rates are highly dependent on early detection. Research has shown that breast cancer screening methods such as mammography, physical exam, and breast self exam (BSE) may increase the likelihood of early detection and survival rates.

A primary concern of breast cancer research today is to understand what motivates women to comply with breast cancer screening recommendations. Traditionally healthcare providers have thought that health teaching increases compliance; however, recent studies indicate that health teaching alone does not increase compliance with breast cancer screening.

Sixty-two university female employees consented to participate in a quasi-experimental research study to explore the value of utilizing supportive coaches as an intervention to increase breast cancer screening compliance. Secondary aims of the study were to identify the attitudes and beliefs of women toward breast cancer screening and barriers to compliance with the American Cancer Society Guidelines (ACS). A random sample of 200 university female employees were solicited from the university database to participate in the study; sixty-two agreed to consent and final demographic criteria was completed on sixty (n=60) females. Two participants could not participate in the study due to severe health reasons. Participants were predominantly college educated (82%) married middle class Caucasian females (91%) with an age range of 30-60.

All participants were required to complete a prestudy questionnaire, attend a breast cancer screening presentation, and complete a poststudy questionnaire. Questionnaires were developed based on Champion and Dodd’s and colleagues Health Belief Model (HBM) to capture demographic, personal and family health history, breast cancer screening behaviors, and beliefs and attitudes about breast cancer screening using a five point scale.

Study participants were randomly assigned to a control group and an experimental group. The experimental group was provided coaching and supportive interventions through monthly phone calls, mailings, email, posters, stickers, and comic strips. The control group did not receive any intervention. All participants completed the post study questionnaire to evaluate breast cancer screening behaviors.

Descriptive statistics were used to analyze pretest questionnaire. The findings indicate that 34% of participants have a family history of cancer and a fibrocystic breast disease. 12% had reported having had a biopsy, 1% denied a personal history gynecological cancer; however they reported a family history of 29% of breast cancer, 14% for uterine/cervical cancer, and 36% for all other cancers.

70% of the participants reported a clinical breast exam and 70% reported a mammogram in the last year. Only 18% reported performing routine BSE. The significant difference in clinical breast exam and mammography compared to BSE may be because they are included in the universities wellness package. 51% of participants were inspired by the media, 73% from health care workers, 49% from family, and 50% from various other reminders to perform BSE.

In conclusion compliance with BSE was impacted by coaching and supportive sessions. Monthly reminders were useful in assisting participants to remember to perform BSE.

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How Can All Family Members Obtain Important Information from the Doctor?

It is difficult if an individual with cancer has many family/friends that they want to have the latest information. Most doctors and nurses are willing and interested in trying to keep the individual with cancer and family up-to-date, but it is hard especially if some family lives in other states and are in different time zones. Thus, it is important for patients and family to be thoughtful of the amount of time the doctor and nurses spend repeating the same information. Also, different family members may want different amounts of information.

First, remember that the primary person the doctor needs to communicate is with the patient and the patients spouse/significant other/parent. Thus, if you are the family member be sure you do NOT overstep your bounds by going directly to the doctor for information unless the patient has given approval.

One of the best ways to solve this crucial but delicate situation is to have a notebook (like a spiral notebook) for the patient and spouse/significant other. Before each outpatient appointment or before the doctor comes in on rounds each day – make a list of questions that the patient and ALL family members have. Also record any problems, side effects the patient has been having (e.g. pain, insomnia, fatigue, nausea, sadness, anxiety). Then talk with the doctor about all your questions and new physical, psychological or social issues. Write down the answers in the notebook. Then as key family members call or come to visit you can accurately convey the key new information to everyone. This will save time and energy for everyone. If most of the family is out of town the individual with cancer might want to set up a telephone tree giving the accurate information from the doctor to 1 key member who then passes it on to the 2nd family member who passes it onto the 3rd. This information could be communicated to all family through emails.

You may even want to buy a small tape recorder to audiotape key conversations or ask the doctor to write in the book (like the names of chemotherapy drugs. Some individuals who are computer savvy may rather put all this information in a PDA or laptop.)

If you do not understand ANY information, please ASK, ASK, And ASK. At the time of diagnosis and first treatment health care providers tend to tell you everything that will happen for the next few months. This is difficult to absorb. So, as you get through your 1st treatment as the health care professionals to repeat the education/information that you need for the next 1-2 weeks. In this manner, you can get the doctors and nurses to continue to repeat all the information you need to know in small pieces. Ask the doctors or nurses if they can draw pictures or if they have written instructions or handouts. You can then tape or staple these into your notebook

Most often individuals with cancer and their families and friends want to know about side effects. Specifically, they are interested in when will it occur, what will it be like (how severe), how long will it last, what is the cause, and what can you do to help yourself. If this is information you would like, you may need to specifically ask these questions. Health care providers are usually good at listing all the possible side effects you may have but often forget to provide this additional information.

If you have other tips that have helped you and your family, please provide comments for us on this blog.

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What Do You Say To Someone Who Has Cancer?

I have worked with individuals with cancer and their families and friends for several decades and had many family and friends who have been diagnosed with cancer. When I learned yesterday of another very dear family friend has been diagnosed with cancer I thought back to the very first time I knew anyone who had cancer. At that time I struggled with what to say to this dear person who had been told they had cancer. This is a tough question for many family and friends. I will share what I have learned.

In many respects you can say the same things you said to that individual before they had cancer. If you previously liked to talk about sports or shopping you can still discuss those topics. You also should NOT be afraid to talk about the disease. The most important thing you can do is to listen to the words, tone of voice and observe the body language of the individual. They will let you know if they want to talk about the cancer or not or when. If they do not want to talk about it at first just let them know you are willing to listen when they are ready. Also, they will not want to talk about it all the time with everyone so they will want to have other conversations.

If your family member or friend does want to talk then just LISTEN. Do not try to come up with some special words to make them feel better. Just listen. Be supportive. You can remind them of positive coping strategies or strengths they have. It is especially IMPORTANT to not start telling stories of other individuals you have known with cancer. Each individual is different, with different diagnosis, different treatment, different reactions to cancer and treatment. Do try to keep calling, writing or visiting. Often individuals with cancer become isolated as friends and colleagues no longer call or visit.

If you sincerely want something to do to help your friend or family member try offering concrete ways of helping. These might include: grocery shopping, providing rides to cancer treatments, picking up medicine at the pharmacy, help around the house, cut the grass. At first they may not accept the help, but if they are having treatment (e.g. surgery, chemotherapy, radiation) they may end up needing help. Keep offering periodically, but do NOT be pushy. Overall, continue to provide emotional support and a positive attitude and LISTEN.

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Iyengar Yoga for Breast Cancer Survivors

At a recent nursing research conference held in Washington D.C. Dr. Mel Haberman reported on 2 studies with 31 breast cancer survivors. The purpose of the study was to determine if participating in yoga would increase the immune response and quality of life of women with breast cancer who were at least 8 weeks post chemotherapy.

The women participated in yoga classes for 90 minutes twice per week and yoga at home for a total of 8 weeks. The Master Yoga Instructor was also a breast cancer survivor. They measured many physiological measures of the immune system and quality of life by a survey designed for women with breast cancer. They also measured anxiety and depression and social support.

Eleven women completed the study. There was a 56% improvement in lymphocytes (cells that help fight breast cancer cells). All scales on the quality of life scale improved for the women. Symptoms improved (especially in cognitive and menopausal symptoms). The women also expressed a decrease in anxiety, an improvement in pain, an improvement in personal meaning and social relationships.

Although this is a small study with only one type of yoga, there appears to be more and more literature that supports the role of exercise and the use of complimentary therapies in the recuperation of any cancer survivor.

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Good News About Breast Cancer

Breast cancer research has made significant progress in the past decade. Even if there was no further progress from today the number of women dying from breast cancer five years from now would continue to drop because of all the advances made in the last decade. Some highlights of progress that has been made are:

Breast cancer is now recognized as a collection of several specific diseases, which has led to a revolution in treatment (e.g. some tumors are stimulated by estrogen and/or progesterone). So drugs can be targeted against these specific tumors.

It has been learned that a tumor might be Her2 positive. This means that its cells churn out too much of the Her2 protein. This in turn usually spurs aggressive growth. Now there is a targeted drug called Herceptin that can cut the risk of recurrence in half when combined with chemotherapy in women with early stage Her2 positive cancers.

Recently a particularly fast-spreading type of tumor called basal-like breast cancer has been identified. It is now thought that this may contribute to why African American women are more likely to die and to die at a younger age from breast cancer than whites.

There are more ways to detect cancer than standard X-ray films and standard film mammography. There is now a digital mammogram. With this, a breast X-ray is captured electronically and displayed on a computer screen where it can be magnified and tweaked for better contrast. This may be more accurate for women under 50 who are premenopausal or perimenopausal and women of any age with dense breasts. Breast Magnetic Resonance Imaging (MRI) is a strong magnet and radio waves create detailed 3-D cross section images of breast tissue, captured on computer. A contrast agent is injected intravenously and helps highlight suspicious areas. This may be used if the mammogram is inconclusive. Another test that can be used is Breast Ultrasound. This uses high frequency sound waves passing through breast tissue and is captured on a computer screen. This helps distinguish between usually benign fluid-filled cysts and solid masses. This could be used if there is an inconclusive mammogram.

Additionally, PET and CT scans are being developed specifically for the breast. Also the Digital Breast Tomosynthesis (DBT) is another technique scientists are looking at with currently available mammograms, overlapping breast tissue can hide cancers or create worrisome shadows. This is a problem DBT will help solve by X-raying a series of cross sections to create a computerized 3-D image. The radiologist is then able to look at “pages” of individual sections of breast tissue to find cancers that would have otherwise been undetected.

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How Can the Red Devil and Breast Cancer Be Related?

It is not common for women to develop breast cancer in their 30’s. After surviving breast cancer in her 30’s Katherine Russell Rich wrote a book called The Red Devil: To Hell with Cancer – and Back. This book was an account of how she had gotten sick at 32 with breast cancer and survived. After she survived she retreated from the world of cancer until recently when she discovered there is a group called the Red Devils (named after her book). The Red Devils started in 2002 in Columbia, Maryland after Lark Schulze lost her daughter, Jessica to cancer.

The goal of the group was to improve the quality of life for breast cancer patients and their families. They would spend the money on meals, grocery deliveries, household help, and transportation to doctors. They have gone from raising $3,000 to $300,000 in a year and working with 1 hospital to working with 21 hospitals. This is a simple but amazing story of the impact having breast cancer can have on not only the individual going through the experience, but other family and friends. Additionally, it speaks to the power of groups of individuals who come together to fight a needy cause.

If you would like to read more about this story you can read about it in “O” the Oprah Winfrey Magazine, October 2006, p.222-230.

Or if you wish to read the book by Katherine Russell Rich you can check at your local bookstore or on the internet. It is The Red Devil: To Hell with Cancer – and Back. It was published in 1999 by Crown Books. The ISBN # is 0609603213

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Other New Advances in Drug Therapies for Cancer

Individuals with cancer and family members often want to know that there are new drugs being developed and approved for all types of cancer. All drugs used for chemotherapy for individuals must be approved by the Food and Drug Administration (FDA). It is not uncommon for a chemotherapy agent to be approved the first time for 1 or 2 types of cancer. At a later date the drug may be approved for other “indications” or treatment for other types of cancer.

An example of a drug that has recently been approved for a new indication is Taxotere® made by Sanofi-Aventis. It was approved on October 17, 2006 for use in combination with cisplatin and fluorouracil for the induction treatment of patients with inoperable, locally advanced squamous cell carcinoma of the head and neck (SCCHN)
More information may be obtained at www.fda.gov/cder/foi/label/2006/020449s039lbl.pdf

On October 11, 2006 the FDA also granted approval for a labeling extension for bevacizumab (Avastin®, Genentech, Inc.). This has been approved to be administered in combination with carboplatin and paclitaxel for the initial systemic treatment of patients with inoperable, locally advanced, recurrent, or metastatic, non-squamous, non-small cell lung cancer. More information may be obtained at www.fda.gov/cder/foi/label/2006/125085s085lbl.pdf

A new drug called vorinostat (Zolina™ by Merck & Co.) was approved by the FDA on October 6, 2006.This drug is a histone deacetylase inhibitor for the treatment of cutaneous (skin) manifestations of cutaneous T-cell lymphoma (CTCL) in patients with progressive, or recurrent disease on or following 2 systemic therapies. More information may be obtained at www.fda.gov/cder/foi/label/2006/02/021991lbl.pdf

Introgen Therapeutics, Inc. has started reporting data from clinical studies of a drug called Advexin p53. This drug can be used in patients with cancers of the head and neck, lung, breast, and esophagus. Advexin works by shrinking tumors, halts tumor growth and improves symptoms in patients with multiple types of cancers that have an abnormal p53. tumor suppressor function. More information may be obtained at www.introgen.com or calling 512-708-9310.

If you have an interest in obtaining cancer news via the internet you may try some of the following sites:

Cancer News by CancerSource
http://csweb03.cancersource.com/NewsFeatures/News/index.cfm?DiseaseID=1

Cancer Statistics by the American Cancer Society
http://www.cancer.org/docroot/stt/stt_0.asp

Cancer Treatment News by the Cancer Consultants
http://www.cancerconsultants.com/index.php

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Promising New Drugs Being Studied

New Drug for Chronic Myelocytic Leukemia (CML)

Genta Inc. has received permission from the Food and Drug Administration to test at the University of Pennsylvania heir drug calledG4460 on patients. This new drug uses antisense technology o target an oncogene known as c-myb that regulates key functions in cancer cells. The study will evaluate dosing regimens, safety, and biologic activity in patients with CML. Other potential uses for this drug may include melanoma, neuroblastoma and cancers of the breast, pancreas, and colon. You may get more information at www.genta.com

New Platinum Drugs Being Studied

Poniard Pharmaceuticals has a new drug called Picoplatin. This is a new generation of platinum therapy that provides a different and improved safety profile. It is being tested in phase I and phase II clinical trials for the treatment of small cell lung cancer, colorectal and hormone refractory prostate cancers. This will hopefully overcome platinum resistance associated with the treatment of solid tumors. You may obtain more information at http://www.poniard.com or call 206-286-2517

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How Can I Find A Research Study To Be In?

Studies that are designed to test new treatments on humans are called Clinical Trials. Clinical trials are used to test treatments for cancer. Some are developed for specific symptoms. Before enrolling in a study be sure you talk to your doctor and see if s/he recommends it. Be sure to carefully weigh the benefits and risks of the trial. This is not done to scare you but to be sure you have the best treatment.

There are several ways to learn about clinical trials and how to be enrolled:
1. Always talk to your physician first. S/he may already know about clinical trials.
2. The National Comprehensive Cancer Center Network (NCCN) at www.nccn.org. (select “network hospital”) to find a center in your town or nearby
3. Some hospitals websites have a link for clinical trials.
4. On the internet go to www.clinicaltrials.gov. This site is sponsored by the U.S. National Institutes of Health.

If you are interested in being in a clinical trial but are concerned you will be a “guinea pig” for research, do not worry. All studies are carefully and thoughtfully designed. All studies MUST undergo internal review at the hospital and be approved by an Institutional Review Board. Moreover, the U.S. Food and Drug Administration strictly regulates and monitors how clinical trials are conducted. You also are protected because you cannot be enrolled in the study until you review and sign a consent form. This form should describe the purpose of the study, the treatment you will receive, possible side effects of treatment, and risks and benefits. By signing the form you are indicating you understand the study and agree to participate. If you do not understand then do NOT sign the form

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What Is A Clinical Trial?

Clinical trials are studies designed to test new therapies on humans. All different types of treatment are studied by this method (e.g. radiation therapy, chemotherapy, biological agents, medical devices and more).

Research initially starts in a laboratory and on animals. If these studies can show benefits with minimal risk they are tested in humans to determine effectiveness and safety. The studies done in humans are conducted in 3 phases:

Phase I trials are used to determine the appropriate dose and schedule of the treatment. Additionally, the researchers begin to determine the side effects associated with the therapy.

Phase II trials are used to test the treatment on subjects to determine the effectiveness of the treatment.

Phase III trials are used to test the treatment on a group of individuals with a particular type of cancer. The new therapy will be compared to the current standard treatment for that type of cancer. Thus, ½ the subjects will get the new therapy and ½ will receive the standard treatment. Subjects who are enrolled in Phase III will be randomized (like the flip of a coin) to one of the 2 groups. The subject cannot select which of the 2 treatments they want.

Individuals with cancer often have questions about whether or not they should agree to be in a study. Sometimes the study may not have a direct benefit for you, but may benefit thousands of other people who also have your disease. It is important for you to thoroughly understand the study. If you do not understand then you should talk to your doctors and nurses and let them know you do not understand. It may also be helpful to carry a little spiral notebook and you can write all the answers to your questions in the notebook.

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Major Risk Factors for Breast Cancer

As with any disease there are certain risk factors associated with breast cancer.

A risk factor is anything that increases your chance of getting a disease such as cancer.
However, just because you have 1 or 2 of the risk factors does not mean you will necessarily get breast cancer. There are different types of risk factors. Some factors like a person’s age cannot be changed. Other risk factors are linked to the environment and some are linked to personal choices (e.g. smoking, diet).

For breast cancer the main risk factor for developing breast cancer is simply being a woman. This factor cannot be changed. It is important to point out that men can develop breast cancer but it is rare because men have less breast cells than women. Another risk factor you cannot change is your age. The risk of breast cancer increases as you get older - 78% of women with invasive breast cancer are age 50 or older when they are diagnosed. Genetics is also a risk factor. Women may inherit a mutated gene from a parent that makes them at an increased risk for breast cancer. Breast cancer is higher among women whose close blood relatives have this disease.

Other risk factors include: 1) having an abnormal breast biopsy, 2) previous chest radiation,
3) starting menstruation at an early age (before age 12), 4) women who have had no children or had their first child after age 30, 5) long-term use of postmenopausal hormone therapy,
6) obesity and high-fat diets.

Because some of these factors cannot be changed (e.g., age, gender) it is especially important for women to perform breast self examinations monthly, have a physician perform a clinical breast examination annually, and have a mammogram annually after the age of 40 years.

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Breast Cancer Awareness Month

October is considered to be Breast Cancer Awareness Month. Many cancer related organizations and hospitals plan activities for community members, individuals with cancer and their families. This is a time to celebrate the progress that has been made in terms of diagnosing and treating breast cancer and a time for providing information and hope for the future.

The National Breast Cancer Awareness Month (NCBA) has educated women for 20 years about early breast cancer, detection, diagnosis, and treatment. NCBA has several key messages.

The most important one has been early detection through annual mammography for women over 40 years old. Mammography screenings provide the best chance for detecting breast cancer early. It is also important for women to do breast self examination (BSE).

The American Cancer Society (ACS) recommends the following guidelines for healthy women:

1) Women should have yearly mammograms starting at age 40 years old.

2) Women should have a clinical breast examination as part of their physical in their 20’s and 30’s and every year once they turn 40 years old.

3) Women should know how their breasts feel and report any breast changes. They should perform breast self examination monthly.

4) Women who are at risk (e.g., have a family history of breast cancer) should discuss with their physicians when to start mammograms and other possible tests (e.g., breast ultrasound or MRI).

ACS also provides a mammogram reminder. You fill out the form on the ACS site with a month and day then the ACS will send you a reminder each year to schedule your mammogram.
For further information there are several credible organizations you can contact. These are listed below.

National Breast Cancer Coalition
1-800-622-2838
www.stopbreastcancer.org

Susan G. Komen Breast Cancer Foundation
1-800-462-9273
www.komen.org

American Cancer Society
1-800-227-2345
www.cancer.org







 

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Should Cancer Survivors Receive The Pneumonia Vaccine?

The most common type of bacteria that causes pneumonia is called streptococcus pneumoniae. The most common type pneumonia in the United States is pneumococcal pneumonia. This can be a very serious disease. Pneumococcal pneumonia may cause high fever, cough, and stabbing chest pain. There is currently a pneumococcal vaccine called Pneumovax. Like the flu vaccine which decreases the chances of getting influenza, the Pneumovax can reduce the chances of getting pneumococcal pneumonia. The vaccine will not prevent viral pneumonia or pneumonia caused by other bacteria. The Pneumovax differs from the flu shot because it is only given once every 5 years.

Now that it is October the question arises as to whether individuals with cancer and their families should get the Pneumovax. This is an important question to discuss every year in the Fall. It is essential that individuals with cancer discuss this with their own health care providers (e.g. oncologists or primary care provider) so that the decision may be based on their individual case.

Individuals with cancer (especially if undergoing treatment) should be evaluated as to whether they have had the Pneumovax in the past 5 years and whether the individual has a history of pneumonia. Individuals CAN be given the Pneumovax and flu shot at the same time, but in different arms. However, you should NOT get the Pneumovax if you have a fever or feel sick.

The Pneumovax may cause soreness, redness, and swelling at the vaccine site as well as fever, muscle aches and malaise.

If you would like more information regarding the flu shot you can contact the Centers for Disease Control and Prevention at 800-232-4636 or email to NIPINFO@cdc.gov on the intranet at http://www.cdc.gov/nip/publications/VIS/vis-ppv.pdf or
http://www.immunize.org/catg.d/p2011b.htm

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This Weeks' Best of Health Matters

The Health Matters HealthBlog Network consists of a dozen independent and unfiltered medical professionals blogging about the topics that matter to you. Each week, Healthline's Editors select the three top posts from the network to share with all of our readers in one convenient post. We hope you'll enjoy them!

Infertility Stress Reduction Tips
If you, or someone you know, has struggled with infertility you know what a stressful time that can be. Visit The ART of Conception where expert Carl “Rusty” Herbert MD offers some tips for getting through these rough patches … read more

What Should Cancer Patients and Family Do About the Flu Vaccine?
Vaccinations can be a lifesaver. Most vaccines contain inactive viruses, but others contain a small amount of a live virus. Tune into Cyndy King’s Cancer Treatment and Survivorship blog to learn what people undergoing cancer treatment that can compromise their immunity should do…read more.

Throw a Stronger Punch (or Push a Car or Stroller)
People don’t always realize how many times a day they are hurting their backs. Read on to learn more about what Dr. Jolie Bookspan of the Fitness Fixer blog says is one of the most common misconceptions in fitness….read more.

Additionally, we're pleased to announce the launch of two new blogs this week! Freedom from Smoking with expert Lowell Kleinman, MD and Straight Talk from the ER with expert Robert L. Norris, MD.

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The Best of the Medical Blogosphere

Regular readers of blogs know that it is common for bloggers to read and link to other bloggers, especially if they are talking abut a similar topic. Each week a member of the medical blogosphere hosts "Grand Rounds." This is a good way to find bloggers talking about health information. I wanted to give a note of thanks to the host of this week's Grand Rounds for including my post "What Should Cancer Patients and Family Do About the Flu Vaccine?" in his review of the best of the medical blogosphere this past week. To read this week's favorite posts click here:
RDoctor Medical

To learn more about Grand Rounds click here: http://blogborygmi.blogspot.com/2004/09/grand-rounds-submission-guidelines.html

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Can Individuals With Cancer Be Around Vaccinated Children?

In the United States most children and adolescents receive childhood vaccinations on a regular schedule based on recommendations by the Centers for Disease Control and Prevention (CDC). These vaccinations start at birth and include:

• Hepatitis A and B
• Diptheria
• Tetanus
• Pertussis (DPT)
• Inactivated polio
• Measles, mumps and rubella (MMR)
• Varicella (chickenpox)
• Influenza (killed or live vaccine)
• Pneumococcal
  

All of the vaccines listed above are inactivated or "killed" vaccines EXCEPT for varicella (chickenpox) or the "live" influenza or "flu" shot which is called FluMist. These 2 vaccines are "live" vaccines which are made from a weakened virus. Even though it is rare when a child (or adult) is given 1 of these 2 live vaccines, they could transmit the disease to susceptible people (like individuals with cancer).

It is important if you are an individual with cancer and a family member or someone living in your household is to be or has been vaccinated that you check with your physician to see if you should avoid contact with the vaccinated person.

If you would like more information you can contact the Centers for Disease Control and Prevention by phone 800-232-4636 by email at NPINFO@cdc.gov or mail to:
NIP Inquiries
Mailstop E-05
1600 Clifton Road, NE
Atlanta, GA 30333

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What Should Cancer Patients and Family Do About the Flu Vaccine?

Now that it is October the question arises as to whether individuals with cancer and their families should get the flu shot. This is an important question to discuss every year in the Fall. It is essential that individuals with cancer discuss this with their own health care providers (e.g. oncologists or primary care provider) so that the decision may be based on their individual case. And there are individuals who cannot have it because they have an allergy to eggs or a history of Guillain-Barre syndrome or previous reaction to a flu shot.

Influenza (flu) is a contagious virus that occurs every year. The peak season is generally from January through March. The most common symptoms of the flu are:

fever
chills
cough
headache,
muscle aches
sore throat

Individuals who have weakened immune systems may get sicker if they get the flu than normal healthy individuals. They may even have to be hospitalized. This can be very serious because your body may not be able to fight off the flu virus. Thus, most individuals with cancer (especially if you are undergoing treatment) should receive the flu shot each year.

The best time to get the flu shot is NOW (October or November). You want to receive the flu shot well before January. The shot will usually protect you from the flu for 2 weeks after the shot and up to a year. Even if you have your health care provider gives you a flu shot you can still catch the flu, but getting the shot will reduce the chances of getting the flu and will reduce symptoms if you do get the flu.

People often ask if they will get the flu when they get the shot. There are 2 types of flu vaccine. The one called the "flu shot" is an inactivated (killed) form of the influenza virus. This is the type of shot you will need. The second vaccine is a new Flumist. It is a nasal spray of Live vaccine. This is only for healthy individuals between 5-49 years old. You will not get the flu but you may have some mild symptoms:
Soreness, redness, or swelling at the injection site
Muscle aches
Fever

The next important question is should the family members of cancer survivors get a flu shot. Again, it is crucial that you discuss this with your physicians and your family members' physicians to be sure there are no reasons that your family members should NOT have the vaccine. In general, it is recommended that other members of your family should receive the flu shot to lessen the chances of getting the flu and giving it to the individual with cancer. Any pregnant family members should call their obstetrician before getting the flu shot. It is important your family members get the Killed vaccine rather than the live vaccine.

If you would like more information regarding the flu shot you can contact the Centers for Disease Control and Prevention at 800-232-2522 or on the internet at http://www.cdc.gov/flu/about/qa/flushot.htm

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