Winter may bring relief from summer heat, but cold weather can also usher in risks for people who have cancer. From an increased risk of hypothermia to being more prone to catching a cold, you may face challenges during winter months while undergoing cancer treatment.
Understanding how cold weather affects your condition can help you protect yourself throughout the season.
1. Hypothermia
People with cancer — especially those undergoing treatment — often experience fatigue, anemia, and dehydration, which can make it harder to regulate your temperature and increase your risk of hypothermia, says Scott Capozza, a physical therapist for the multidisciplinary Smilow Cancer Hospital Survivorship Clinic at Yale Cancer Center in Connecticut and Yale New Haven Hospital’s first dedicated outpatient physical therapist in oncology rehabilitation.
Hypothermia occurs when your body temperature dips below 95 degrees F. Although it typically sets in after long exposure to extremely cold temperatures, it can occur when you are exposed to temperatures as high as 40 degrees F. Hypothermia can cause confusion, memory loss, and other issues that can pose risks.
“Hypothermia can slow reaction times and reduce sensation, making walking and movement more dangerous, increasing the risk of falls and other injuries,” Capozza says.
If you have anemia, in which your red blood cell count is low, your cold tolerance may also be low. This can make it trickier to maintain a safe body temperature.
To reduce your risk of hypothermia with cancer, Capozza suggests taking these steps.
Stay indoors if it’s extremely cold outside.
Dress appropriately for the weather and wearing layers of warm clothes, gloves, a scarf, a hat, and warm socks with boots.
Stay dry, as being wet and chilled can also cause hypothermia.
Drink warm fluids.
Seek immediate treatment for early signs of hypothermia, such as shivering, confusion, or slowed movements.
2. Neuropathy
Cancer treatment such as chemotherapy, radiation, and surgery can cause peripheral neuropathy, a type of nerve damage that can make it more difficult to feel sensations such as heat or cold. This is especially a concern in colder months, when you might be more susceptible to hypothermia and frostbite.
“Peripheral neuropathy — which can manifest as numbness or pain symptoms affecting hands, feet, fingers, and toes — can affect an individual's mobility, functioning, and how they can perceive surfaces they walk on,” says Erin Roesch, MD, a breast medical oncologist with Cleveland Clinic in Ohio.
In addition to increasing your risk of falling, neuropathy also can make you unaware of damage to your extremities in cold weather, says Sonja Hegeman, NP, the assistant director of cancer survivorship at Massey Cancer Center in Richmond, Virginia. Because neuropathy dulls sensations, you may not realize how cold your toes and fingers become, which can make you more prone to frostbite.
Here are some tips to lower your risk of falls and injury from neuropathy.
Wear shoes with adequate support, cushioning, and tread.
Avoid or be careful with sharp objects.
Use assistive devices, such as a cane, and hold handrails when needed.
Protect your hands and feet when outside in cold weather.
Set your hot water heater to no more than 120 degrees F to avoid scalding when washing your hands.
A physical therapist can help you improve balance, strength, and safety, Capozza says.
3. Dehydration
Although dehydration is often associated with warmer months, you can get dehydrated in winter, when you might not be drinking enough water and are getting dried out by indoor heating. It’s also more common if you have cancer.
“Cancer treatments and medications can cause significant fluid loss through vomiting, diarrhea, and excessive sweating, all of which can quickly lead to dehydration,” Capozza says.
Dehydration symptoms include weakness, fatigue, dark urine, dry mouth, and headaches. Left untreated, dehydration can cause severe complications like shock, kidney failure, or even death, Capozza says.
To lower your risk of dehydration and its complications with cancer, consider these tips:
Drink plenty of fluids, especially small amounts often.
Eat water-rich foods such as fruits, vegetables, soups, and yogurt.
Avoid alcohol and caffeine.
Monitor symptoms such as fatigue, lightheadedness, and nausea.
Keep your lips moist with balm or moisturizers to avoid cracking and bleeding.
Talk with your medical team about possible side effects of treatment and ways to address these.
Seek medical attention right away for persistent vomiting or diarrhea.
4. Viral Illnesses
Dropping temperatures often signal the rise of viral illnesses such as the flu, COVID-19, or the common cold. They can be an additional concern if you are also managing cancer.
“Cancer treatment can suppress [white] blood [cell] counts, weaken the immune system, and as a result make it more difficult for a patient undergoing treatment to fight off an infection,” Dr. Roesch says.
Hegeman adds that having cancer means you may catch these viruses more easily and have a higher risk of complications such as pneumonia. Cold weather is a double whammy, as cold air also makes it harder for your body to fight off viruses.
There are numerous ways to avoid catching a viral infection during cold weather months, including:
Wash your hands with soap and water.
Get the vaccinations that your healthcare provider recommends.
Avoid sick people and crowded places.
Wear a mask when out and about.
Keep wounds and cuts clean and dry.
Practice food-safety techniques, such as washing fresh fruits and vegetables and avoiding buffets and self-serve food stations.
5. Falling on Ice
Walking on icy and wet surfaces increases your risk of slipping and falling. The side effects of cancer treatment may make that even more dangerous.
“Many cancer treatments can affect and lower bone density over time, which can lead to an increased risk of fracture,” Roesch says.
If you have muscle weakness or balance issues, slipping and falling also raises the chance of strains, in addition to broken bones, Capozza says. Any of these injuries may mean a hospital stay and loss of independence, Hegeman says.
Serious bleeding and bruising can also come with a fall, especially if you have a blood-related cancer such as leukemia or lymphoma.
There are a few ways to reduce your risk of falling, including:
Wear supportive and protective footwear with good traction.
Avoid icy and slippery surfaces.
Take small steps, almost side to side, to maintain your center of gravity.
Stay inside on wet days or when it is icy.
Use an assistive device such as a cane or walker.
Hold onto any available railings.
The Takeaway
Cold weather risks such as hypothermia and catching a cold may be more pronounced if you have cancer, as a result of your condition and treatment.
Exposure to cold weather makes you susceptible to hypothermia, if your body has trouble regulating its temperature. If cancer treatment also causes neuropathy, making it harder to feel hot or cold, your risk increases.
Health conditions and slippery surfaces can make it easier for you to fall. If cancer treatment already has weakened your bones, fractures may be more possible.
Tips for staying safe in cold weather when you have cancer include avoiding extreme temperatures, wearing proper clothing and footwear, and staying properly hydrated.
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Resources
Cancer Patients Face Special Challenges in Winter Weather. City of Hope. October 16, 2024.
Duong H et al. Hypothermia. StatPearls. January 19, 2024.
Conor E. Steuer, MD, is medical oncologist specializing in the care of aerodigestive cancers, mesothelioma, and thymic malignancies and an assistant professor in the department of hematology and medical oncology at the Emory University School of Medicine in Atlanta. He joined the clinical staff at Emory's Winship Cancer Institute as a practicing physician in July 2015. He currently serves as chair of the Lung and Aerodigestive Malignancies Working Group and is a member of the Discovery and Developmental Therapeutics Research Program at Winship.
Dr. Steuer received his medical degree from the New York University School of Medicine in 2009. He completed his postdoctoral training as a fellow in the department of hematology and medical oncology at the Emory University School of Medicine, where he was chief fellow in his final year.
He has been active in research including in clinical trial development, database analyses, and investigation of molecular biomarkers. He is interested in investigating the molecular biology and genomics of thoracic and head and neck tumors in order to be able to further the care of these patient populations. Additionally, he has taken an interest in utilizing national databases to perform clinical outcomes research, as well as further investigate rare forms of thoracic cancers.
Steuer's work has been published in many leading journals, such as Cancer, the Journal of Thoracic Oncology, and Lung Cancer, and has been presented at multiple international conferences.
Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.
McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.
