The lungs were not given the importance as they ought to be until the second wave of Covid 19 surfaced. They are often taken for granted. The wellness of the lungs is given priority only when any complication arises. Lungs are the vital organ in our body that converts the oxygen from the air which we inhale and transfer to the bloodstream. For many years healthcare professionals have stressed the importance of maintaining healthy lungs and advising people to quit smoking. However, many have not paid heed to this advice.

All of us are aware that the SARS-CoV-2 virus that causes COVID-19 disease obstructs the respiratory system majorly affecting the lungs. This infection is certainly testing our lungs. As lungs play a major role in the overall working of the body, it becomes very crucial to ensure lung health to put up a fight against this infectious disease.

COVID-19 can cause lung complications like pneumonia, acute respiratory distress, and in some fatal cases, total collapse of the lungs. In cases of pneumonia, the air sacs in the lungs are filled with fluid and the valves of the lungs get inflamed resulting in difficulty in breathing and severe cough. Many people recover from pneumonia without much effect on the lungs. But in cases of pneumonia due to Covid 19, people face severe breathing difficulties which take a longer time to recover putting an extra burden on the lungs. If pneumonia progresses it can lead to acute respiratory diseases in which more of the air sacs will get filled up with the fluid leaking from the blood vessels in the lungs. This can lead to severe shortness of breath.

As Covid 19 infection takes the respiratory route to enter a person, the burden on the lungs is phenomenal. This burden on the lungs increases among people who smoke. As the smoke moves into the respiratory tract, more soluble gases are adsorbed and particles are deposited in the airways and alveoli. This is the long run can lead to severe problems related to the lungs. Smoking can increase the chances of COPD among people leading to the faster decline of lung functioning. The chemicals in the cigarettes can also cause irreversible lung damage. In addition, smoking can destroy the cilia or tiny hairs that are present in the airways. These hairs keep dirt and mucus out of your lungs. When these cilia are destroyed, one can develop a chronic cough that is often seen in long-term or daily smokers.

Though there is no proof that smoking can make a person vulnerable to develop Covid 19 or the severity of the infection increases if the person is smoking, it is a known fact that both smoking and Covid 19 infection are putting an extra burden on the lungs. As the lungs of a smoker are already in a bad shape, Covid 19 can further worsen its health. Therefore, it is advised to quit smoking and take all precautions to safeguard the lungs.

Two functions determine the overall health of lung health – Lung capacity and lung function. While lung capacity is depending on the genes, making the lungs function properly is up to us. Here are a few tips you can follow to have healthy lungs.

Exercise – At least 30 minutes of exercise on a daily basis is imperative for adults to avoid any lung distress. Physical activity that makes you breathe heavily. It increases the flow of oxygen in your bloodstream that then increases airflow to your muscles, heart, and lungs. Running, brisk walking, cycling, swimming are the few suggested exercises.

Diet – Choice of food is very important for lung and immune system health. It is being noticed that people with underlying ailments have been affected badly due to corona. It could be due to Chronic inflammation. There is much food that assists the body with decreasing inflammation in the airways. Ensure to consume proper nutrition, particularly food high in antioxidants like fruits and vegetables.

Quit smoking – It is not only lung cancer but inhaling anything other than air into your lungs causes them to become inflamed. This can lead to mucus build-up which impacts the lung’s ability to process oxygen into the bloodstream. For a person already having lung damage, treatment becomes a factor and the recovery may get delayed.

Oral health – Maintain good oral health. Avoid the buildup of plaque and infection in the mouth. These infections could also affect the lungs. With Covid 19 second wave affecting both the young and older generations, the number of hospitalization and people needing oxygen support has been increased. We are at a juncture where paying attention to our lung health and working towards its betterment gains utmost importance.

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1. Can cancer patients take covid-19 vaccines?    

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, continues to have a serious impact on many people, including cancer patients, their families, and caregivers. Due to frequent hospital visits and increased exposure, vaccination for cancer patients has become imperative now. Individuals with cancer sadly have a higher risk of severe Covid infection because of their age, the disease, cancer treatment, and medical comorbidities.

Currently, vaccination for cancer patients has been recommended for all people with cancer and blood malignancies. These vaccines can be taken as long as the components of the vaccine suit the patient even while their immunity is down. However, the following points to be noted –

• These vaccines should not be taken if they do not suit one’s body (e.g., known allergic reaction, which is a contraindication)
• There could be an unknown safety situation which can rarely cause a problem
• Effectiveness may not be as much as in the general population due to a less immune reaction. Here the vaccine is given to give whatever benefit possible and with the intent to reduce the severity of covid-19 infection if it happens.

2. When to start and which are the most preferred vaccines for cancer patients? Can the vaccination lead to a change of plans in the cancer treatment of the patients?  

While starting your program of vaccination,  It is important to discuss with your oncologists and plan strategies for taking vaccines between the cycles of chemotherapy, targeted therapy, and immunotherapy. It is recommended to take any of the available vaccines as long as the blood counts are acceptable.

Cancer patients who are undergoing major surgery should ideally wait for a few days before going for vaccination. The best time for such patients to get vaccinated is before treatment, optimally 2 weeks before the start of chemotherapy. Furthermore, patients who have opted for radiotherapy can start their vaccination program anytime. Patients undergoing immunotherapy should opt. for vaccination at the earliest as toxicities and reactions can be severe if the covid infection happens along with chemotherapy/immunotherapy.

Other than the appropriateness and timing of the vaccination, there are no changes that the vaccination causes in the plan for cancer therapy. Vaccination can be recommended one week from the start of the chemotherapy cycle.

3. How long does immunity last?

 The expected immunity usually develops in 2-3 weeks after the second dose of vaccine and is effective beyond six months. As the vaccines and vaccination programs are relatively new. We are still awaiting further data on whether or not the immunity lasts beyond six months. However, considering the current scenario, where comorbid patients are at an increased risk of contracting the covid virus, vaccination is strongly recommended for all such patients. Cancer patients who have also recovered from covid-19 can also undergo vaccination without the fear of any complications.

4. What are the concerns of vaccination with regards to cancer patients?

A major concern is an uncertainty in the level of effectiveness of vaccination when immunity comes down during treatment. However, any level of effectiveness is better than status without covid-19 vaccination. Lymphoma patients can have lower vaccine responses as we do not know precisely the efficacy of the COVID vaccine for lymphoma when on active treatment. For cancer patients, despite the vaccination, it is ESSENTIAL to continue the practice of wearing a mask, social distancing, and maintaining hand hygiene as they are already immune-compromised and chances of re-infection are also high among them.

5. Is the Covid-19 vaccine safe in Bone Marrow Transplants?

Covid-19 vaccination is recommended at least two to four weeks before the planned transplant. We recommend most transplant patients delay all vaccines for at least three months following a stem cell or bone marrow transplant.

6. What are the vaccine’s side effects?

Currently, serious side effects are rare and compared to the benefit of protection, it would be negligible.    However, common side effects of vaccines are pain at the injection site, tiredness, headache, muscle pain, and fever. Chills, joint pain, nausea, injection site redness and swelling, swollen lymph nodes. 

7. Can one get ill with Covid-19 after vaccination?

It is possible that one can get sick post receiving a vaccine, but the good news is that it is likely to be less severe and people may not require hospitalization in such cases.

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