Postby roadrunner » Sat Dec 04, 2021 2:28 pm
JMRWife: I kept a really close watch on my WBCs (as a rough measure of my immune system and its likely response to vaccines) throughout chemo. I assume you get regular CBC tests. For many vaccines, lymphocytes are I believe a better marker than neutrophils (that we cancer patients usually watch more closely because they are the main defense against bacteria/sepsis (lymphocytes provide the main defense against viruses, though of course things are more complex than that)).
If your numbers aren’t terrible (as they usually aren’t for FOLFOX (except perhaps at nadir)), you’ll probably be in decent shape after the booster (keep in mind that 50% of organ transplant folks even get a response). But there’s still a greater risk of a poor response. Since you can’t really avoid exposure, If I were you I’d feel good about the booster, but not ironclad. If you get an exposure or symptoms, I’d be very aggressive early about going in and seeking tests and treatments, including monoclonal antibodies, the Merck pill (Monupiravir (efficacy is not great but every little bit helps/some side effects, esp. for pregnant women, FDA approved but awaiting CDC)) or even better the Pfizer pill (Paxlovid (a little farther from approval but better in trials)). It also may be a good idea to reboost after you finish chemo. That is something to discuss with an immunologist. Honestly, while I’ve done it myself, asking an oncologist about vaccine response is almost like asking a cardiologist which chemo to use ; )
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23