Monday, July 15, 2024

Treating Shingles In Cancer Patients

What Is The Connection Between Shingles And Breast Cancer

New treatment for the pain of shingles

Though the shingles virus has no history of causing breast cancer, there are connections between the two.

First, its easy to assume that your symptoms from shingles might be breast cancer because of how and where shingles appear on the body. Shingles can develop on or near the breast and the rashes can be confused with cancer cells.

The second link to shingles and breast cancer is that if you have breast cancer, you have a higher chance of developing shingles. Newly diagnosed cancer patients are at a higher risk of developing shingles.

Can I Give Shingles To Others

No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:

  • Anyone who has never had chickenpox
  • Babies under 12 months old
  • Very sick people

Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.

Questions To Ask Your Doctor

  • Ive had chickenpox. Am I at risk of developing shingles?
  • What is the best treatment for my shingles?
  • The pain from shingles isnt going away. What can I do to make myself more comfortable?
  • Im on treatment for shingles. When should I call my doctor if things dont get better?
  • I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
  • Is the shingles vaccine right for me?
  • Are there any risks associated with the shingles vaccine?
  • Will my post-herpetic neuralgia ever go away?
  • If Ive never had the chickenpox, should I still get the shingles vaccination?

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Palbociclib And Hormone Therapy

In the UK palbociclib is always given alongside a hormone therapy drug.

You may have palbociclib with:

  • An aromatase inhibitor if you have not already had hormone therapy for locally advanced or secondary breast cancer
  • Fulvestrant if you have had hormone therapy for locally advanced or secondary breast cancer

Some people who had hormone therapy for primary breast cancer, and who now have locally advanced or secondary breast cancer, may be offered palbociclib with an aromatase inhibitor or fulvestrant. This will depend on their circumstances.

Taking palbociclib and an aromatase inhibitor

Palbociclib is taken as a capsule once a day for 21 days followed by a seven-day break. This is known as a cycle.

The cycle is then repeated.

An aromatase inhibitor drug is taken once a day continually throughout the cycle.

Taking palbociclib and fulvestrant

Palbociclib is taken as a capsule once a day for 21 days followed by a seven-day break. This is known as a cycle.

The cycle is then repeated.

Fulvestrant is given in two injections, one into the muscle of each buttock. They are usually given every 14 days for the first three doses, then every 28 days for as long as you are having palbociclib.

If you have not been through the menopause

Aromatase inhibitors and fulvestrant are suitable for women who have been through the menopause .

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The Link Between Cancer And Shingles

Pin on Shingles

Also called herpes zoster, shingles is a condition characterized by a painful rash on one side of the face or body. It’s caused by the reactivation of the varicella-zoster virus in the body .

People diagnosed with lung cancer and other solid tumor cancers are at a higher risk for developing shingles.

More specifically, the highest risk for shingles in people with solid tumor cancers includes those who:

The risk of developing shingles is also higher in people with blood-related cancers.

Both cancer and cancer treatments, including chemotherapy, impact your immune system and reduce your ability to fight off infections.

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Medicines And Food To Avoid When Taking Palbociclib

When taking palbociclib:

  • Do not take anything that contains St Johns Wort
  • Do not eat grapefruit or drink grapefruit juice

Some drugs should not be taken with palbociclib. These include some commonly prescribed antibiotics, antifungal and anti-epileptic drugs.

Tell your specialist about any prescribed or over-the-counter medicines you are taking.

If a healthcare professional, such as your GP or dentist, prescribes you a new drug, tell them youre taking palbociclib.

Always ask your treatment team before taking any herbal medicines or supplements.

Palbociclib contains lactose. If you know you are lactose intolerant discuss this with your treatment team.

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What Are Risk Factors For Shingles

A weakened immune system might wake up the virus. After youâve had chickenpox, youâre more likely to get shingles if you:

  • Are 50 or older
  • Are under a lot of stress
  • Have cancer, HIV, or another disease that lowers your bodyâs defenses
  • Have had a serious physical injury
  • Take long-term steroids or other medicines that can weaken your immune system

But many people who get shingles donât fit into any of these categories.

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What Is The Outcome For Someone Who Has Shingles

Most people get shingles once, but its possible to get it again.

If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.

For some people, the pain will last longer than the rash. When it does, its called postherpetic neuralgia , which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.

Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.

For anyone who has a shingles rash, the right self-care can help ease your discomfort. Youll find out what dermatologists recommend at, Shingles: Self-care.

ImageGetty Images

ReferencesCenters for Disease Control and Prevention . About shingles. Page last reviewed 10/17/2017. Last accessed 4/1/2019.

Dooling KL, Guo A, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Morb Mortal Wkly Rep 2018 67:103-8.

Madkan V, Sra K, et al. Human herpes viruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008: 1204-8.

Straus SE, Oxman MN. Varicella and herpes zoster. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1885-98.

What Are The Symptoms Of Shingles

Treatment for shingles pain

Early symptoms of shingles may include:

Other signs and symptoms that appear a few days after the early symptoms include:

  • An itching, tingling or burning feeling in an area of your skin.
  • Redness on your skin in the affected area.
  • Raised rash in a small area of your skin.
  • Fluid-filled blisters that break open then scab over.
  • Mild to severe pain in the area of skin affected.

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Is There An Increased Risk Of Shingles After Cancer

A friend of mine who had cancer a couple of years ago just got shingles. It piqued my interest into whether there was a link between cancer and shingles, as both conditions are associated with reduced immune function, and immune function may be further affected by cancer treatments.

I actually found a large study published just in June this year that looks at this very topic Herpes zoster risk after 21 specific cancers. Other smaller studies had suggested such an association and this latest study looked specifically at different types of cancer, the age of the patient, and the time after diagnosis of cancer.

Outlook For Armpit Pain

Armpit pain thats related to a muscle strain might be able to heal on its own after resting your muscles for a few days. If you have other symptoms, like swelling or the presence of a lump, you should see your doctor.

Doctors may refer you to a hematologist who specializes in lymph node disorders or a breast cancer specialist if cancer is suspected.

If you see a rash or other signs of skin problems under your arm, talk with a doctor about treatment or for a possible referral to a dermatologist.

If you suspect a lymph node disorder and have symptoms like fever or congestion, you may have a respiratory infection related to your lymph nodes.

In most cases, early treatment of any condition will lead to better outcomes. If the pain is a temporary muscle-related problem, getting a diagnosis can ease some anxiety too.

If you have armpit pain that lasts for more than a few days or there are other symptoms, like swelling or a rash, see a doctor right away.

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Can Other People Catch Shingles

This one is confusing! You can catch chickenpox from other people, but you can’t catch shingles from other people. You only get shingles from a reactivation of your own chickenpox infection in the past.

So if you have shingles, and you come into contact with somebody else, they cannot ‘catch’ your shingles. But if they have never had chickenpox, it is possible that they could catch chickenpox from you.

To put it another way, no, you don’t ‘catch’ shingles. It comes from a virus hiding out in your own body, not from someone else. But if you have shingles, you may be infectious, as it is possible for people to catch chickenpox from you.

Only people who have never had chickenpox are likely to be at risk of catching chickenpox from your shingles. People who have had chickenpox should be immune from catching it again. If the rash is in a covered area of skin, the risk of anyone with whom you are not in close contact catching chickenpox is very low.

Antiviral Medicines For Shingles

How To Test For Shingles Without Rash

Antiviral medicines used to treat shingles include aciclovir, famciclovir and valaciclovir. An antiviral medicine is not a cure for shingles, it does not kill the virus but works by stopping the virus from multiplying. So, it may limit the severity of symptoms of the shingles episode.

An antiviral medicine is most useful when started in the early stages of shingles . However, in some cases your doctor may still advise you have an antiviral medicine even if the rash is more than 72 hours old – particularly in elderly people with severe shingles, or if shingles affects an eye.

Antiviral medicines are not advised routinely for everybody with shingles. As a general rule, the following groups of people who develop shingles will normally be advised to take an antiviral medicine:

  • If you are over the age of 50. The older you are, the more risk there is of severe shingles or complications developing and the more likely you are to benefit from treatment.
  • If you are of any age and have any of the following:
  • Shingles that affects the eye or ear.
  • A poorly functioning immune system .
  • Shingles that affects any parts of the body apart from the trunk .
  • Moderate or severe pain.

If prescribed, a course of an antiviral medicine normally lasts seven days.

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Shingles In Cancer Patients: Who Is Most At Risk

Among patients with cancer, those with haematological cancers are at highest risk of developing herpes zoster , reports an Australian study in the Journal of Infectious Diseases. In patients with solid cancers, the risk of HZ is significantly higher among those receiving chemotherapy, the study also found.

GPs are familiar with the concept that people with cancer are more at risk of shingles. However, this new study provides much needed data on differences in risk associated with different types of cancer, and the receipt of cancer treatment itself, commented Professor Kristine Macartney, Director of the National Centre for Immunisation Research and Surveillance, and one of the study authors.

The research, based on data from the 45 and Up Study and involving 241,497 adults followed for more than eight years , found that people diagnosed with cancer had a significantly higher risk of HZ than those without cancer . The risk was highest in the first year after diagnosis. Compared with people without cancer, those with haematological cancer had a substantially higher risk of HZ than those with solid cancers . Among people with solid cancers, those receiving chemotherapy had a higher HZ risk than those who did not .

Which Comes First Chicken Or The Egg

One of the things that surprised me from this study was the number of years after a cancer diagnosis that shingles risk continued to increase up to 3 years after cancer diagnosis! This suggests that the weakened immune system is persisting all this time. But why doesnt shingles occur earlier, for example just after or during chemotherapy when immunity is at its lowest? More research is needed to figure this out.

While it is unclear from these data whether both cancer and shingles occur because of a general underlying immune weakness or whether the cancer and its treatment cause an immune issue which then leads to shingles, the timing factor may help. This time line suggests that it is more likely that cancer and/or its treatment may cause the immune issue which leads to zoster. If it was a generalized immune suppression, it would be less likely to have a specific time peak and end.

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Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later

After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.

What About A Shingles Vaccine

Shingles treatment with Internal Medicine Physician Dr. Brooks P. Trotter

Vaccines are available, but due to a lack of data, these vaccines are not yet recommended for use in the cancer patient group. Also in development is a shingles vaccine that uses an inactivated form of the virus.

These advances suggest that vaccines show promise as a way to prevent shingles and its complications in cancer patients. As always, we recommend those diagnosed with breast cancer consult your oncologist at the first sign of shingles.

The shingles vaccine is recommended for adults aged older than 50 years however, Zostax, a live-virus vaccine, may not be suitable for patients with immunodeficiency or immunosuppression, including those with cancer. The vaccine combines glycoprotein E with an adjuvant system that enhances immunologic response.Read More.

A 65-year-old female patient with breast pain, severe edema, irritation and itching in the left breast was admitted to the emergency department.

This patient had a history of breast cancer four years previously, which metastasized to the lungs and lymph nodes on her neck. This patient was treated with radiotherapy and chemotherapy and total mastectomy for several years. The breast often appeared swollen, erythematous and red, or inflamed.Read More.

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What Should You Expect If You Get Shingles

Shingles can be a very painful condition. If you think you have the symptoms of shingles, see your healthcare provider right away. Starting antiviral medications early can ease your discomfort and end symptoms earlier.

A better approach to shingles is to take action and do what you can to lessen your risk of getting it. If you’ve never had shingles in the past, talk to your healthcare provider about getting the shingles vaccine. If youve never had chickenpox, talk with your healthcare provider about getting the chickenpox vaccine.

Should You Get A Covid

Some experts recommend that it can be a good idea for people with autoimmune diseases to get the COVID-19 vaccine. This is because people who have autoimmune diseases may have weakened immune systems due to taking immunosuppressant medications to treat their conditions.

People with weakened immune systems may be more likely to get severe COVID-19, according to the . Experts say that the vaccine may be effective against the illness severity. Speak with your doctor to learn more about the COVID-19 vaccine to see if its right for you.

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Shingles Risk Increased For Cancer Patients

A new vaccine is safe for cancer patients but hard to find.

by Nancy Averett

Cancer patients facean approximately 40 percent higher risk of contracting shingles than those without cancer, according to a study by Australian researchers. The investigation, which was published Dec. 13 in The Journal of Infectious Diseases, found that the risk was far greater for patients with blood and bone marrow cancers, also called hematological malignancies, than those with solid organ tumors.

Theres been a reasonable amount of research that has shown if you have a cancer diagnosis, youre at increased risk of having shingles, says Bette Liu, senior author of the paper and an epidemiologist at the University of New South Wales, Sydney. Liu and her colleagues hoped to better understand which cancer types make a patient more vulnerable to shingles and whether the risk comes more from chemotherapy-related immune suppression or the cancer itself.

Liu and her colleagues analyzed the medical records of 241,497 adults, comparing cancer and shingles diagnoses over time and looking for where they overlapped. They found the risk of contracting shingles was 41 percent higher overall for cancer patients in the cohort compared to in patients without cancer. Broken down by cancer type, patients with hematological cancers faced a 374 percent higher risk, while patients with solid organ cancers faced a 30 percent higher risk.

Nancy Averett is a science journalist living in Cincinnati.

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