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by Badash M

Traveling With Cancer

Image for traveling with cancer People who are actively undergoing cancer therapies or whose immune systems or overall health has been compromised by cancer treatments may choose to travel for a variety of reasons: business, vacation, even treatment. The key to traveling with cancer is to make travel preparations that will promote comfort, safeguard your health, and maintain your treatment goals as much as possible. Here are some tips to help make your trip smoother.

Before You Travel

Checking With Your Doctor

Before you travel, be sure to discuss your plans with your doctor. This is especially important if you have recently been diagnosed with cancer or are still suffering side effects of treatment or chemotherapy. Your doctor’s opinion on when and whether you should travel is very important. If your doctor recommends against travel, be sure you understand the reasons for that recommendation.

Choosing Your Destination

Vacationers should carefully consider potential health hazards when choosing a destination. Think about what kind of medical care is at your destination. You want to make sure that you can get care if you need it.
  • If you are undergoing radiation or chemotherapy, avoid sun-intensive locations, as certain treatments can make the skin highly sensitive to sunlight. Check with your doctor about precautions you should take when exposed to the sun.
  • If your treatment has resulted in severe anemia, check with your doctor before flying or visiting high-altitude locations.

Researching Important Numbers

If you are traveling abroad, bring the emergency numbers for each city you will be visiting, as well as the numbers for the American consulate and embassy.
You should also ask your doctor for referrals to medical centers where the staff speak English. In addition, it would be helpful if you and your traveling companion learn important words in the country's language. Words such as doctor, hospital, and cancer can help you to get assistance faster in an emergency.

Getting Vaccinated

Check vaccination requirements. Some vaccines needed for entry into certain countries may be contraindicated for patients with cancer. People with cancer who are receiving immunosuppressive therapies (eg, chemotherapy, immunotherapy) should not receive live vaccines, and inactivated vaccines may produce a weaker response, thus diminishing effectiveness.
Patients who had their spleen removed will have lower resistance to infection as well. In some cases, it may require traveling with antibiotics or avoidance of certain areas where an infection (like malaria) is common.
In some cancer treatments (like bone marrow or stem cell transplants), revaccination may be required six months after the last treatment. It is possible that previous immunity is lost during treatment.

Getting Medical Documentation

Before your trip, contact your doctor to obtain the following:
  • A letter from your doctor on hospital stationary describing your diagnosis and treatment plan
  • A recent prescription signed by your doctor in case you need a refill
  • Copies of your most recent blood tests and lab test results
  • Contact information of your doctor (name, address, emergency number, and office phone and fax number)
You may also want to get a medical alert bracelet to inform people that you have cancer.

Packing Your Medications

The following preparations will help you, as well as medical and airline personnel:
  • Keep your medicine in the original prescription bottles, which includes the prescription date, pharmacy, and physician name.
  • Bring an ample supply of your primary medicines, as well as any necessary medicines to treat side effects.
  • Before traveling, discuss with your doctor whether you need to take long-term antibiotic therapy to protect you from bacterial infection, such as diarrhea, which can seriously affect your health.
  • Keep a list of all your medicines, including dosages and dosing schedules, and any drug allergies. If you are traveling with a companion, provide him with a copy.

Checking Your Health Insurance

  • Before you leave, check with your health insurance company to determine whether your plan will cover health costs incurred while traveling. If not, you should purchase travel health insurance.
  • You may also want to consider purchasing emergency medical evacuation insurance. If you have a medical emergency, the costs of obtaining an emergency flight or ambulance may be expensive, and services may need to be paid in cash.

During Travel

In the Air

A risk for all airline travelers on long flights is developing deep-vein thrombosis (DVT). DVT is a blood clot that forms in the deep veins of the lower body, primarily the legs. The clot can migrate to the lungs causing potentially catastrophic complications, including pulmonary embolism or death.
Cancer patients are susceptible to blood clots, so walking around once every hour to increase circulation is encouraged. Your doctor may also recommend taking a blood thinner before the flight and wearing compression stockings. Discuss this with your doctor especially if you will be on a flight for longer than eight hours.
Also, while you are on the plane, remember to stay hydrated. Drink plenty of bottled water. It is also a good idea to bring meal replacement drinks and snacks in case you will not be served a meal on the plane. In general, you are able to bring food items that are wrapped through the security checkpoint. There may be restrictions however, and you should arrive well ahead of schedule in case of long lines. Before you leave, check the Transportation Security Administrations website for information on food and drink restrictions, and traveling with a medical condition.
Remember, too, that if you do not feel well on the plane, alert the crew right away. They are trained to assist in medical emergencies.

On the Ground

When you arrive at your destination, take these precautions to optimize your stay:
  • Avoid infections, which put stress on your immune system. Drink only bottled water, and eat only hot, well-cooked foods prepared in clean, sanitary facilities. You may want to consider bringing along meal-replacement drinks or snacks.
  • If you have lymphoma , you are at a higher risk for developing listeriosis, an illness caused by food contaminated with listeria bacteria. Avoid unpasteurized dairy products, deli meats, and any food that may not be cooked properly.
  • Know and respect your body’s limits. Your treatment may make you tired, weak, or nauseous, so do not overschedule your day. Consider traveling with a companion who makes you feel comfortable and is willing to help out when you need it.

At Home

Once you return home, you should see your doctor for a check-up. Make this appointment before you leave for your destination.
Be sure to tell your doctor if you have any unusual symptoms. These may even occur months after you return. In some cases, you may need to see a doctor who specializes in travel medicine.

When Traveling for Treatment

Sometimes travel is not due to vacation or business—it is simply a necessity to obtain treatment. If treatment is distant and costly for you, there are organizations that provide help when traveling for appointments. Some examples include:
  • Corporate Angel Network —This organization provides free airline transportation on unused corporate seats to people who are traveling for cancer treatment.
  • American Cancer Society (ACS) —In 31 US cities, the ACS has Hope Lodges. These lodges provide free, private rooms to patients and their families.
The website Joe's House also provides information about lodging for people undergoing cancer treatment.

RESOURCES

American Cancer Society
http://www.cancer.org/
National Cancer Institute
http://www.nci.nih.gov/

CANADIAN RESOURCES

Canadian Cancer Society
http://www.cancer.ca/
Health Canada
http://www.hc-sc.gc.ca/

References

Avery RK. Immunization in adult immunocompromised patients: which to use, and which to avoid. Cleve Clin J Med. 2001;68:337-348.
Corporate Angel Network. Corporate Angel Network website. Available at: http://www.corpangelnetwork.org/. Accessed December 27, 2012.
Deep vein thrombosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated December 26, 2012. Accessed December 27, 2012.
Hope Lodge. American Cancer Society website. Available at: http://www.cancer.org/treatment/supportprogramsservices/hopelodge/index. Accessed December 27, 2012.
Eat Right and Stay Active While Traveling. American Cancer Society website. Available at: http://www.cancer.org/cancer/news/features/eat-right-and-stay-active-while-traveling. Updated December 12, 2012. Accessed December 27, 2012.
Joe's House. Joe's House website. Available at: http://joeshouse.org/. Accessed December 27, 2012.
Literiosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 31, 2012. Accessed December 27, 2012.
Perdue C, Noble S. Foreign Travel for Advanced Cancer Patients: A Guide for Healthcare Professionals. Postgrad Med J. 2007;83(981):437-444.
Transportation Security Administration website. Available at: http://www.tsa.gov/. Accessed December 27, 2012.
Traveling with Cancer. American Society of Clinical Oncology website. Available at: http://www.cancer.net/all-about-cancer/cancernet-feature-articles/quality-life/traveling-cancer. Updated April 20, 2012. Accessed December 27, 2012.
Traveling with Cancer. Cancer Treatment Centers of America website. Available at: http://www.cancercenter.com/newsletters/may%5F2009%5Fnewsletter.cfm. Updated May 2009. Accessed December 27, 2012.

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