Winter adds to ordeal of cancer patients

February 16, 2012 at 12:00a.m.

By Cynthia Billhartz Gregorian

St. Louis Post-Dispatch

ST. LOUIS

For a lot of people, weathering the winter is no fun. Cold weather. Shorter days. More colds and flu.

Weathering it all with cancer is worse.

Before Jerry Miller was diagnosed with Stage 3B colon cancer last summer, he walked pretty much everywhere, year-round. And he loved it.

“My car was stolen 12 years ago, and I never bothered to replace it,” said Miller, 44, of St. Louis.

Not anymore. In addition to fatigue and weakness, chemotherapy has wreaked havoc on his immune system and caused extreme cold sensitivity in his hands, feet and other parts of his body. Now, he relies on friends to drive him everywhere. He’s also had to cut back on socializing to avoid germs.

There’s little data on how many cancer patients are treated for viral and bacterial infections each year. But health care experts report that the rate of infection among them during winter is higher than other times of the year. Cancer patients are more likely to wind up in the hospital at this time of year than someone who has a healthy immune system, said Dr. Ericka Hayes, assistant professor in pediatric infectious diseases at Washington University.

According to Dr. Aamina Akhtar, infectious disease specialist at St. Anthony’s Medical Center, people who have HIV/AIDS, those who take immunosuppressant drugs to prevent their bodies from rejecting transplanted organs and those with diabetes also run a high risk of contracting infections.

Transmission rates of germs increase during the winter, because we spend more time indoors, Akhtar said. “That’s why they need to avoid places where people congregate, like malls.”

Miller was diagnosed with cancer in July. In August, the upper half of his colon was surgically removed. It contained a malignant mass the size of his fist. Cancer cells had spread from the innermost layer of his colon to outer layers and to four nearby lymph nodes. In October, after surviving a life-threatening bacterial infection, he began getting chemotherapy every other week.

His blood counts are checked between infusions and again immediately before each one. When his white blood cell counts plunge, Miller is hyper-vigilant about avoiding germs.

Methods to prevent infection among cancer patients have improved in the past decade. Patients are vaccinated against flu and pneumonia and injected with drugs that boost their blood counts.

But they’re still highly susceptible to other viral infections and particularly bacterial infections like strep throat.

Miller could wear a surgical mask when his immunity is low, but he said it looks stupid. So other than going to work, he mostly stays home.

He slathers his hands in sanitizer gel constantly. When friends see him, they inquire about his blood counts before hugging him.

That’s what Miller misses most when his counts are low. Hugs.

“I tell friends, ’You can come over if you are not sick and haven’t been around anyone who is sick. And even if you aren’t sick, you can’t touch me or anything in my house, and you cannot use my bathroom. You’ll sit on the couch and not move,’” he said, laughing.

Teresa Deshields, manager of psycho-oncology services at Siteman Cancer Center, encourages patients to stay as active as possible, because research has shown that those with social support have better medical outcomes than those without.

“But then you have an oncologist telling them they need to be careful about being around people, that they’re very vulnerable,” Deshields said. “We’re sometimes working at cross purposes.”

She recommends that friends and family members step up and take on the onus of protecting the patient.

“When people wear a mask, the whole idea is to protect the patient, but the public doesn’t think that. They think (the patient is) contagious,” she said. “Family and friends can wear the mask if they have a cold. Or they could offer to connect by Skype or phone if someone is sick. Just whatever they can do to keep the patient engaged.”