What everyone should know about cancer and cold weather

Cold weather can create health issues for many people, but some are more susceptible than others. In particular, cold can be especially difficult for cancer patients.

"Cancer, in general, puts a lot of stress on the body, and when we have stress on the body, we have trouble regulating other parts of our normal physiology," Dr. Nicholas Rohs, an oncologist at Mount Sinai in New York City, told AccuWeather.

Rohs said advising his patients about problems that can arise during cold weather is a regular part of his treatment routine.

It's not necessarily cancer itself that causes cold sensitivities -- it's therapies and side effects, Rohs said, that create problems, although cancer stresses out the entire system which puts a patient at a higher risk in general.

"People with really advanced cancers that are taking a really big toll on their body can have trouble regulating their own temperature," Rohs explained. "Inflammatory markers are flying around that can adjust how we are able to accommodate to our surroundings."

Chemotherapy and cold weather can be dangerous

Cold impacts can vary depending on the type of drug a patient is receiving. "Oxaliplatin is a very common chemotherapy medication we give," Rohs said. "That medication has a side effect called cold-induced neuropathy."

Patients being treated with Oxaliplatin who suffer cold-induced neuropathy can experience "numbness, tingling in their fingers, toes and even other parts of their bodies," Rohs said, adding that the condition "can get so bad they can be numb so they may not sense cold as well. But Oxaliplatin has this cold-induced neuropathy where when I give it to my patients they have hypersensitivity to cold to even a level where my patients say, 'I grabbed a sort of cold spoon and I couldn't hold it. I went to open my fridge and I couldn't.' And if it's really bad, people can be in an air-conditioned room and feel super uncomfortable because of it."

Neuropathy is when the nerves malfunction, causing numbness or weakness. These patients experience cold temperatures, which can cause numbness, tingling, pain and muscle weakness. Neuropathies frequently start in the hands and feet but can affect other parts of the body as well. Rohs says this can cause them to be more prone to frostbite because they might not realize how cold their hands and fingers are getting in cold weather.

"If you have bad neuropathies -- and I actually have neuropathies not related to chemotherapy in my feet, I could go walk around in the snow for five or 10 minutes and not feel it the same way that a normal person would -- that can be really dangerous. If you can't sense the danger, you can't get away from it, so for people who have really significant neuropathies, they definitely need to be really thoughtful about wearing good cold-weather gear."

Rohs advises his patients to wear gloves and layers, so they can adjust to temperatures as they go in and out of buildings and different settings.

Julene Diedrich, a Marshfield Clinic nurse practitioner in Oncology tells Shine365, "We even tell these patients to avoid cold drinks or ice."

Cancer patients at higher risk of flu, cold, pneumonia and other viruses and infections

Chemotherapy can also compromise the immune system, making a patient extremely vulnerable to viruses or infections, which means common illnesses like the cold, flu or pneumonia can be life-threatening.

Rohs said someone who is not receiving chemotherapy might "easily fend off" a case of the common cold or flu, but "somebody who has a low blood count [a side effect of chemotherapy] might not be able to do the same. Patients receiving chemotherapy can also be susceptible to bacterial infection," he said. "They can get really robust pneumonia and things like that that they can't easily fight off."

One of the most common side effects of chemotherapy is that it attacks quickly dividing blood cells. Those cells include white and red blood cells. After a chemo treatment, patients often have lower white blood cell counts, particularly neutrophils, which are the first cells to arrive on the scene when someone experiences a bacterial infection. That's what lowers a patient's immunity. Having low red blood cell counts can make people feel colder and be more susceptible to cold.

"You don't have those red blood cells to circulate everything that you need and your body. If it's more anemic, your blood vessels in your peripheral part of your body -- the outsides of your body -- will clamp down more, so you can have more blood in your central areas because those are clearly more critical to us," Rohs said. "Our lungs, our heart -- all of these things are in the middle of our body."

If the body is going into a state in which it's really cold, the circulatory system is going to shunt blood to the middle of our body, Rohs continued. "So when we're anemic, our body will try and keep most of the blood pool where it's most critical so you're likely to have cold fingers, toes, things like that."

Some patients can also be prone to cold-induced asthma, which occurs when lungs react to the temperature by narrowing, making it tougher to breathe.

"Patients who already have breathing issues, going out into the cold can be particularly irritating to their lungs and cause them to feel like their more short of breath and actually make them more short of breath because they can't breathe as well," Rohs said.

Cancer patients more prone to serious injury from an icy fall

In addition to treatment-induced issues, cancer patients often lose large amounts of weight, Rohs told AccuWeather. "Things like 20, 30 pounds for months so that's our biggest insulator," he said, adding that bodies that have lost a lot of weight due to chemotherapy can "have a lot of trouble regulating temperature."

Weight isn't just an insulator; it's padding that protects bones at a time when they are at their most fragile. Many cancer treatments cause bone loss also. Hormonal therapies often used to treat breast cancer can strip bone density, which is called osteoporosis. Osteopenia occurs when the body doesn't make new bone as quickly as it reabsorbs old bone. Both conditions put cancer patients at a high risk of becoming seriously injured when slipping and falling on ice. Rohs says a bone fracture can be devastating for a cancer patient whose body is already under tremendous stress.

"People have trouble adjusting to such an abrupt change in their physical health so they'll say, 'Well, I can still walk out to the street. Oh, it's a little icy, I do that all the time,' and they're more likely to fall and also when we talk about those neuropathies ...You might not be able to feel as steady on your feet, so you're more likely to slip and fall."

He added,"[If] we're having a snowstorm in New York I say. 'Hey -- stay home!' It's not the end of the world for many of my patients."

Bottom line, if you or someone you know is undergoing chemotherapy or other cancer treatments, pay particular attention to the weather forecast, so you can dress appropriately for the temperature.

“I tell my patients, you know, wear gloves, bring layers so that you can adjust to temperatures as you go in and out of buildings, or just different settings.”

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