Influenza Vaccinations and Metabolic Syndrome

February 3, 2010

It is flu season, and a new study published in the American Journal of Preventive Medicine serves as a reminder to the family and caregivers of cancer survivors in both the active treatment phase and the long-term survivorship phase. Let’s back up a few clicks and establish a few underlying truths here. Cancer survivors, at whatever stage of survivorship, should be vigilant about their health (that’s why the CT Challenge exists). Also, many survivors are at higher risk for decreased health, and that decreased health can come in many forms. On this blog, I have discussed research that suggests survivors of different varieties are at higher risk for second or recurring cancers, cardiovascular disease, and multiple other diseases or complications. One area, we have not discussed is infectious diseases. But of course, survivors are at risk for getting the seasonal influenza or the highly publicized, H1N1. Researchers from MD Anderson Cancer Center in Texas set out to check on survivors both in active treatment and long-term survivorship and the family members of those cancer survivors. The researchers were specifically checking on the influenza vaccination habits of the survivors and the family members of the survivors.

What’s the good news? The proportion of those vaccinated was substantially higher among survivors. What’s the bad news? The proportion of cancer survivors vaccinated was higher WHEN COMPARED TO FAMILY MEMBERS. Well, then, I guess it is fine for the cancer survivors who have been vaccinated if their family members are not vaccinated. But this is a concerning statistic if (1) the survivor is not vaccinated, or (2) if the family member(s) gets sick and puts extra burden on the survivor’s family, or (3) the family member gets sick and takes the survivor to treatment and infects OTHER survivors in the treatment center. To reduce the health risks to survivors and to reduce the potential extra burden of the seasonal flu, family members of survivors should be sure to get vaccinated each year!

What is Metabolic Syndrome?

Metabolic syndrome is grouping of risk factors that put persons at higher risk for cardiovascular disease, diabetes, and liver disease. The American Heart Association defines metabolic syndrome as a condition when at least three of the following are present: elevated waist circumference, elevated triglycerides, reduced HDL, elevated blood pressure, or elevated fasting glucose.

Why does this matter for cancer survivors?

Because some cancers, specifically breast and prostate cancers, are driven by sex hormones, the therapy for them is often hormone-modifying. Emerging evidence suggests that cancer survivors who have been treated with hormone modifying therapy may be at higher risk for developing metabolic syndrome; therefore, those survivors may be at higher risk for diabetes, liver disease, or cardiovascular disease. A recent review in the American Journal of Medicine says, “It is therefore important that physicians caring for cancer survivors take the opportunity to intervene in ways that can promote good health and quality of life post-cancer.” This is a great message for physicians, but what does it mean for cancer survivors? How does a cancer survivor “intervene” for him- or herself? Survivors should be ready to advocate for themselves, especially if they have been treated with hormone modifying therapy. These survivors should ask their physicians to be sure they are closely monitoring lipid profiles, liver enzymes, and markers of glycemic function. Furthermore, early prevention tactics should be taken. You guessed it! Exercise and dietary modifications are highest on the list. Survivors should discuss with their physician the best exercise plan and dietary modifications for their unique situations.