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Anyone who has ever had chicken pox is susceptible to Herpes Zoster, more commonly known as shingles. Shingles is caused by the chickenpox virus that lies dormant in the spinal cord throughout life and is only reactivated when the body’s immune system becomes compromised or weakened. It is characterized by a painful, blistering rash confined to one side of the body and normally to a single small patch of the skin. This is because once reactivated the viral particles travel along a single nerve to the section of skin associated with that nerve and once there the virus causes the skin to blister and rash.

In its early stages, shingles can cause tiredness and fatigue, general malaise, and sometimes mild depression. Once the rash appears this can be extremely painful and seriously affects the patient’s quality of life. The reactivation of the chickenpox virus is usually associated with a marked decrease in the body’s natural resistance i.e. the ability of the immune system to protect the body. Secondary infections and certain drugs, such as those administered during cancer chemotherapy, can both cause a person to become immunocompromised, as can high doses of radiotherapy. Thus shingles can often be a side effect of cancer therapies and in severe cases it can seriously compromise the wellbeing of the patient.

People with specific forms of cancer are particularly susceptible to shingles because these cancers directly affect the functioning of the immune system. In these people shingles can often develop before a diagnosis of cancer is even made meaning that shingles acts as a diagnostic symptom. That is why it is so important that the underlying cause of the shingles be discovered in every patient. In fact, around five percent of people who develop shingles later discover that they have an undiagnosed form of cancer that may have remained undetected for a considerable amount of time had they not developed shingles.

The shingles rash itself is harmless and will clear up in time, but the other effects can be devastating. If left untreated, shingles can spread to internal organs and especially the lungs, the central nervous system and occasionally the brain. Antivirals such as Acyclovir can be prescribed to fight off infection and to prevent any reactivation of the chickenpox virus, but only if the prescribed antiviral doesn’t interfere with other anti-cancer medications. For someone already being treated for cancer with an already weakened immune system, shingles can be life threatening and even cause death.

See also: wasting syndrome