Protecting Your Cancer Patients From the Plague

Kate Hitchcock, MD, PhD

Disclosures

June 16, 2021

I was working up a new patient the other day who had gone through his diagnostic process at another facility. I wanted to look down his pharynx with a flexible scope and so asked if he'd been vaccinated against COVID-19. He said no. I told him I'd be happy to set that up for him but he initially declined, saying that a non-doc in his primary care physician's office had told him he shouldn't get the vaccine because he was within a couple weeks of starting radiosensitizing chemotherapy for his oropharynx cancer.

I quickly called that office to find out if they had seen vaccine guidance I had missed — I have perpetual FOMO in that regard. "Nope," said the doc, "I'd definitely recommend that he get the vaccine. Let me find out what happened."

It turns out he has an anti-vaccination nurse on his staff who has been told that she cannot promote that agenda at work but likes to try to find ways to work around the rule. From the sound of things, promoting pseudoscience is about to get her canned.

Back with my patient, I explained that his whole team agreed that not only was the vaccine safe for him but that I'd recommend it to him even more than to other people (my extended family was fully vaccinated at the earliest opportunity, for the record). He was a thoughtful man and although he didn't have an extensive biology background, we were able to talk about the available evidence in such a way that he was ready to proceed, thank goodness.

But how I wish I had this paper from the May 28 issue of JAMA Oncology demonstrating that patients under cancer treatment get good results from the vaccine and should therefore proceed with it if at all possible. Those receiving chemotherapy and immunotherapy together appear to end up with a lower response, as you might expect. Nothing in Dr Massarweh's capable discussion of his team's findings seems to suggest that there is any risk in proceeding with giving them the vaccine, though perhaps with a check-back later for a booster once we collectively figure out how that is going to work. He even goes so far as to say that vaccinating patients under treatment should be a "top priority." He heartwarmingly continues to remind us that "patients with cancer, like the population at large, should continue wearing masks and practicing social distancing."

Tremendous thanks to this whole team for their great accomplishment in completing this work under what must have been incredible time pressure.

How have you been handling vaccine discussions with your cancer patients?

Please join the discussion below, but if you need to communicate with me offline you can reach me at OncBlogMedscape@gmail.com.

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About Dr Kate Hitchcock
Kate Hitchcock, MD, PhD, is a radiation oncologist, biomedical engineer, and retired aircraft carrier driver who grew up as a Wyoming cowgirl. When she is not at the hospital, you can find her with Carolyn, Mary, Tyler, Nick, Marlee, and Colby the barking dog, enjoying the natural splendor of the great state of Florida. She thinks you should visit sometime and try to solve the puzzle of why the natives have so carefully shunted all of the tourists toward the House of Mouse. Connect with her on Twitter: @hitchcock_kate

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