Dr. Li Yu Chung of the Hong Kong United Oncology Centre explains the risk of shingles in cancer patients and methods of prevention.
A weakened immune system can trigger shingles, commonly known as herpes zoster, with cancer patients at particularly high risk. Dr. Li Yu-chung, a specialist in clinical oncology at the United Cancer Centre in Hong Kong, stated in an interview with the Hong Kong Herald that cancer patients undergoing chemotherapy may experience a decline in their immune system, making them more susceptible to shingles. However, many patients clinically overlook the symptoms of shingles, even mistaking them for cancer-related pain or treatment reactions, thus missing the golden treatment period. Dr. Li emphasized that cancer patients should seek medical attention as soon as possible if they have any suspicions, and vaccination is an effective way to prevent shingles.
The report can be viewed on Sing Tao Daily:"Cancer patients have a higher risk of developing shingles and experiencing complications; early vaccination can reduce symptoms and discomfort."
Understanding Shingles (Herpes Zoster)
What is shingles?
Shingles, commonly known as herpes zoster, is a disease caused by the varicella-zoster virus. After the chickenpox symptoms heal, the virus remains dormant in nerve cells. When immunity declines, the virus can reactivate and invade the skin along nerve pathways, causing shingles symptoms, including severe pain and blisters on the skin.
The prevalence of live snakes
It is estimated that about one in three people in Hong Kong has had chickenpox, meaning that the majority of Hong Kong residents carry the varicella-zoster virus. Shingles is more common in people aged 50 or above, and the risk increases with age, likely due to weakened immunity.
Cancer patients have a significantly increased risk of developing shingles.
The risk is 40% higher than that of the average person.
Dr. Li Yu Chung, Jacky cited an Australian study indicating that cancer patients have a 40% increased risk of developing shingles compared to the general population. The study further found that hematologic malignancies have the highest risk, being three times higher than those without cancer, while the risk of developing solid tumors such as lung cancer, breast cancer, and prostate cancer is also 30% higher.
Why are cancer patients more prone to shingles?
Dr. Li explained that cancer patients are physically weak and have lower immunity than healthy individuals, making them more susceptible to shingles. Different types of cancer and treatment methods can increase the risk of shingles.
Patients with hematologic malignancies are at particularly high risk
. Patients with hematologic malignancies such as lymphoma and leukemia have a higher risk of developing shingles than patients with solid tumors because their condition interferes with the function of white blood cells and their ability to suppress the shingles virus is also weaker.
Cancer treatments weaken the immune system.
Chemotherapy, immunotherapy, and other treatments can further weaken the immune system, increasing the risk of shingles and even worsening the condition. Patients receiving these treatments need to pay special attention to shingles prevention.
Cancer patients often experience more severe symptoms of shingles.
If a cancer patient develops shingles, their condition is often more severe than that of an average person.
- The pain lasts for a longer period :the pain and blisters persist for a longer time, with blisters generally lasting more than 7 days.
- More severe nerve damage :The nerve damage is also quite severe, and there is a possibility of developing post-traumatic neuralgia as a sequela.
- Increased risk of infection: Improper handling can increase the risk of bacterial infection in the wound, which is especially dangerous for patients undergoing cancer treatment.
Easily overlooked symptoms of shingles
Real-life cases where symptoms were mistakenly attributed to cancer.
Dr. Li Yu Chung, Jacky shared a clinical case: A 70-year-old cancer patient experienced bone pain symptoms, which were initially thought to be due to lung metastasis from the cancer. However, it turned out to be shingles, but this was only discovered when blisters appeared, at which point the patient sought medical attention. By then, the crucial 72-hour window for effective antiviral treatment had passed, affecting the patient's recovery.
Common symptoms of shingles
Dr. Li reminds that cancer patients should be aware of the following symptoms of shingles:
- Local pain: Tingling, burning, or paralysis usually occurs along one side of the nerve line
- Sensitive skin: The skin of the affected area is particularly sensitive and can feel pain with a light touch
- Rashes and blisters: A rash will appear 1-3 days after the pain, followed by blisters
- Systemic symptoms: May be accompanied by fever, tiredness, headache and other symptoms
Because the symptoms are similar to pain caused by cancer or treatment side effects, patients may easily overlook or misinterpret them; therefore, any suspicion should prompt a visit to the doctor as soon as possible.
The importance of seizing the golden period for treatment.
Treatment is most effective within 72 hours.
Early detection and intervention are crucial in preventing the worsening of shingles symptoms. Dr. Li Yu Chung emphasizes that taking oral antiviral medication within 72 hours of symptom onset can:
- Shorten the duration of blister formation in shingles.
- Reduce the degree of pain
- Reduce the risk of complications
- Reduce the chance of sequelae of neuralgia
The serious consequences of delayed treatment.
Without early diagnosis and treatment, the following risks may increase:
- Postherpetic neuralgia:The most common complication is pain, which can last for months or even years.
- Encephalitis: The virus invades the brain and may be life-threatening
- Facial paralysis: If the virus affects the facial nerves, it may cause paralysis of the facial muscles
- Vision problems: Ocular shingles may affect vision and even blindness
- Bacterial infection: Blisters are susceptible to bacterial infection after rupture, especially dangerous for cancer patients with low immunity
Dr. Li advises that anyone experiencing symptoms suggestive of shingles should seek medical attention promptly and not delay treatment.
Effective methods for preventing shingles in cancer patients.
Injecting the shingles vaccine (shingles shot)
The most effective way to prevent shingles is to get a shingles vaccination. Dr. Li Yu Chung recommends that cancer patients get vaccinated before starting chemotherapy to reduce the risk of developing shingles due to a weakened immune system caused by chemotherapy.
The advantages of the new generation of recombinant vaccines
In recent years, the medical community has advocated for high-risk groups to receive the new generation of recombinant shingles vaccine to reduce the severity of the disease and minimize the risk of complications.
Target population for vaccination
- People aged 50 or older
- High-risk individuals aged 18 or older (including cancer patients)
The U.S. Centers for Disease Control and Prevention (CDC) also recommends that people aged 50 and older, as well as immunocompromised individuals aged 19 and older, receive the new generation of recombinant vaccines.
Vaccine characteristics
- Inactive antigen vaccine: Safer, people with weak immune systems can also be vaccinated
- Vaccination times: 2 doses of vaccine are required
- Vaccination interval：For people with weakened immune systems, the two doses can be administered one month apart.
- Long protection period: The protection period is at least 11 years
- High protection rate：The overall protection rate is approximately 87.7%.
Comparison of new and old vaccines
Compared to older vaccines, the new generation of recombinant vaccines offers significant advantages:
Old vaccines (live vaccines)
- It is a live vaccine.
- There is a possibility of experiencing mild shingles symptoms.
- People with insufficient immune function should not be vaccinated
- Not suitable for cancer patients
New vaccine (recombinant vaccine)
- Inactivated vaccine
- It will not cause shingles.
- Individuals with compromised immune systems can be safely vaccinated.
- Suitable for cancer patients
- Better protection effect
Everyday preventive measures
In addition to vaccination, Dr. Li Yu Chung, Jacky suggests that cancer patients should also focus on boosting their immunity in their daily lives:
balanced diet
- Ensure adequate nutrition from a balanced diet
- If you lack appetite, you can eat less and eat more
- Take nutritional milk powder to supplement nutrition
- Consume sufficient protein, vitamins, and minerals.
Adequate rest
- Maintain adequate sleep time
- Avoid overwork
- Proper nap and rest
Stress management
- Proper management of stress
- Keep in a good mood
- Conduct relaxing leisure activities
- Seek support from family and friends
These measures help boost immunity and prevent shingles.
Frequently Asked Questions
- Do all cancer patients need to be vaccinated against shingles?
- Dr. Li Yu Chung, Jacky advises cancer patients, especially those preparing for treatments that weaken the immune system such as chemotherapy and immunotherapy, to consider getting the shingles vaccine. However, each patient's situation is different, and they should consult their attending physician to determine if vaccination is appropriate and to understand any precautions. Patients with hematological cancers are at particularly high risk and should prioritize getting vaccinated.
- Can I receive the shingles vaccine during cancer treatment?
- The new generation recombinant shingles vaccine is a non-live vaccine, and can be safely administered to cancer patients with weakened immune systems. It is generally recommended to receive the vaccine before starting chemotherapy, but the specific timing of vaccination should be determined by the attending physician based on the patient's treatment plan and overall health condition.
- How to distinguish between pain caused by shingles and pain caused by cancer?
- Shingles typically causes pain along a single nerve pathway, and the affected skin becomes particularly sensitive. Red rashes and blisters usually appear 1-3 days later. However, because the symptoms are similar to those of cancer pain, patients can easily confuse the two. Dr. Lee advises that any new or changing pain should be reported to a doctor as soon as possible so that a professional diagnosis can be made, and treatment should not be delayed by self-diagnosis.
- How long does the protection from the shingles vaccine last?
- The new generation recombinant shingles vaccine provides protection for at least 11 years, with an overall efficacy rate of nearly 87.7%. Compared to the old vaccine, the new vaccine offers longer-lasting and more effective protection. Even individuals who have previously had shingles can reduce the risk of recurrence after vaccination.
- What are the side effects of the shingles vaccine?
- Common side effects of the new generation of recombinant vaccines include pain, redness, and swelling at the injection site, fatigue, muscle pain, and headache, which are usually mild and temporary. Because it is a non-live vaccine, it does not cause shingles. Dr. Lee reminds patients that there are different options for preventing and treating shingles, each with its own effectiveness and side effects. Patients should discuss these options with their attending physician to choose the most suitable treatment plan.
Comprehensive cancer treatment support from Hong Kong United Oncology Centre.
Professional medical team
Dr. Li Yu-chung, a specialist in clinical oncology at the Hong Kong United Oncology Centre, holds professional qualifications including a Bachelor of Medicine and Bachelor of Surgery from the University of Hong Kong, Fellowship of the Royal College of Radiologists (UK), Fellowship of the Hong Kong College of Radiologists, and Fellowship of the Hong Kong Academy of Medicine (Radiology). He has accumulated extensive clinical experience in cancer treatment and complication management.
Comprehensive cancer treatment services
The center provides one-stop cancer treatment services, including：
- Chemotherapy treatment plan
- Targeted therapy and immunotherapy
- Radiology
- Cancer genetic testing
- Supportive treatment and symptom management
- Drug Subsidy Scheme
Shingles prevention and treatment services
Regarding the risk of shingles in cancer patients, the center provides:
- Vaccination consultation：Assess whether the patient is suitable for receiving the shingles vaccine.
- Vaccination service：Offering vaccination with the next generation recombinant shingles vaccine.
- Early diagnosis：Recognize the symptoms of shingles and seize the golden opportunity for treatment.
- Antiviral therapy: Start oral antiviral treatment within 72 hours
- Pain management: Treatment of acute pain and prevention of sequelae neuralgia
- Treatment of complications: Dealing with complications such as bacterial infections
Patient-centered care services
The Hong Kong United Oncology Centre adheres to the philosophy of "patient-centered care" and provides comprehensive support:
- WhatsApp direct contact: Establish an independent group with the attending doctor to answer questions in real time
- 24-hour support: You can also contact the medical team during non-office hours
- Follow up regularly: Closely monitor treatment response and side effect management
- Personalized care: Develop a treatment plan according to each patient's situation
- Psychological support: Assist patients and their families in facing the treatment process
Cancer patients should pay attention to shingles prevention.
Dr. Li Yu Chung, Jacky summarized that cancer patients have a 40% higher risk of developing shingles due to weakened immunity, and their symptoms are more severe, leading to a higher likelihood of complications and long-term effects. Because the symptoms of shingles can easily be confused with cancer-related pain, patients often delay treatment, missing the crucial 72-hour window for effective treatment.
Prevention is better than cure, and Dr. Li advises cancer patients:
- Consider vaccination with a new generation of recombinant snake vaccine before starting chemotherapy
- Maintain a balanced diet and adequate rest to improve immunity
- Pay attention to the symptoms of raw snakes and seek medical attention as soon as possible if you have any doubts.
- Discuss with the attending doctor the most suitable prevention and treatment plan
Modern medicine has made significant progress in the prevention and treatment of shingles. Cancer patients, by taking preventive measures, seeking early diagnosis, and receiving timely treatment, can effectively reduce the discomfort and risks associated with shingles, allowing them to focus on cancer treatment and improve their quality of life.
Contact us
If you or your family members would like to learn more about cancer treatment, shingles prevention, or vaccination services, please feel free to contact the Hong Kong United Oncology Centre. Our professional team will provide you with detailed medical advice and assist in developing the most suitable treatment and prevention plan.
- Telephone：+852 2386 8002
- WhatsApp：+852 5518 2992
- Email：Enquiry@hkuoc.hk
- Address: Rooms 01-06, 20th Floor, 238 Nathan Road, Kowloon (MTR Jordan Station Exit E)
Consultation time：
- Monday to Friday: 9:00am–6:00pm
- Saturday: 9:00am–1:00pm
- Sundays and Public holidays: Closed
Let us protect your health together and provide comprehensive support for your anti-cancer journey.