Lung Cancer & Flu Season: 6 Key Insights from an Expert

It’s possible to catch a cold or get the flu at any time of year. But the chances of becoming sick increase during cold and flu season. People get sick more often in fall and winter, especially in December, January and February.

For people with lung cancer, it can be especially hard to recover from a cold, the flu, or other illness that affects the respiratory system. Take steps now to avoid getting sick and know what to do if you do get sick during treatment. if you are experiencing cold, flu, RSV, or COVID-19 symptoms, always talk with your doctor about what they recommend.

Facts about respiratory viruses

Unless you know that you were exposed to a specific illness, it can be hard to be sure what illness might be causing symptoms. Here are some quick facts from the Centers for Disease Control and Prevention (CDC):

• Influenza (flu virus) and the common cold are different viruses.
• Colds and the flu are contagious, which means they can be spread between people.
• Colds and the flu have many of the same symptoms.
• Other common respiratory illnesses that can be spread are COVID-19 and RSV.

What people with lung cancer should know

For this Q&A, Dr. Charu Aggarwal offered advice about cold and flu season for people with lung cancer. Dr. Aggarwal, MD, MPH, FASCO, is an American Society of Clinical Oncology (ASCO) expert and the Leslye M. Heisler Professor for Lung Cancer Excellence at Penn Medicine.

Q: What is most important for people with lung cancer to know about colds, the flu, RSV, and COVID-19?

Dr. Aggarwal:  I think the most important thing to know is that patients with lung cancer are at higher risk for these illnesses. Usually, our patients with lung cancer — by virtue of their age, underlying lung disease, and the fact that they may be on treatments that make them immunocompromised — tend to have higher incidence of infections. And our patients should just be more aware that they’re at high risk.

Q: Why can these illnesses have a greater impact on people with lung cancer?

Dr. Aggarwal: These illnesses affect the lung parenchyma (the part of the lungs responsible for gas exchange). And the lung parenchyma is often compromised in patients with lung cancer, either because they have had radiation or from the lung cancer itself. This reduces lung function. And many of our patients with lung cancer may also have chronic obstructive pulmonary disease (COPD, a lung disease that makes it difficult to breathe). So, these illnesses can be much more serious in lung cancer as compared to other cancers.

Q: What can people with cancer do to avoid getting sick?

Dr. Aggarwal: First and foremost, general precautions are important, like regularly washing your hands. It’s smart to wear a mask in crowded situations, airplanes, or places that might not have good ventilation. I still advise my patients who are on active treatment to mask up. If they have grandkids who are visiting who are sick or have other family members who are sick, try and avoid contact or create some space and distance.

But most importantly, remain up to date on vaccinations. This is flu season, so we want all our patients to get the flu shot. Remain up to date on the COVID-19 booster. But also, don’t forget about other vaccines, like pneumococcal and shingles, to ensure good health during this season.

Q: What should people with cancer do if they think they might be sick?

Dr. Aggarwal: Telling their care team of their symptoms right away is extremely important. A fever should never be taken lightly, especially in somebody who’s on active treatment. This requires a workup with imaging and lab work just to ensure that there are no other coexisting conditions, like neutropenia (low white blood cell count). So, prompt attention to symptoms is most important and alerting the team.

Q: Can you still get chemo if you have a respiratory illness? What about other treatments?

Dr. Aggarwal: It all depends on severity. I would say, if somebody’s sick, we would likely hold treatment to give the body some time to recover. But this is something that the care team needs to assess with their patient.

Q: How do people with cancer get treated for respiratory illnesses?

Dr. Aggarwal: It depends on what the underlying diagnosis is. If it’s a cold, we recommend treatment for symptoms. If it’s the flu, we would treat with anti-influenza medications. And if it’s COVID-19, we would base the treatment on the severity of the illness, as well as the coexisting conditions, to see if we need to come in with anti-viral therapy.

Dr. Aggarwal is an Associate Editor on ASCO’s Patient Information Editorial Board.