How cancer can affect travel This information is an extract from the booklet Travel and cancer. You may find the full booklet helpful. We can send you a free copy – see page 8.
Contents • • • • •
Things to think about if you are travelling Cancer treatment Travelling during treatment Cancer and air travel Medical conditions
There are many different reasons why you might want to travel. You may want to go away to relax, see new places, meet friends or family, or perhaps to work. Travelling can be a positive and fulfilling experience. But when you have cancer, there are a few more things you will have to think about when planning a trip. It’s important that you (and any health professionals looking after you) think about any possible health problems and check thoroughly whether you are fit to travel. With careful planning, you’ll be able to look forward to and enjoy your trip.
‘When they tell you you have cancer, your mind goes off because you are trying to put all of your affairs in order. I thought, “Wow, I want to get out there and see places I haven’t been to. I want to travel”.’ Alan
Questions about cancer? Ask Macmillan 0808 808 00 00 www.macmillan.org.uk
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How cancer can affect travel
Things to think about if you are travelling Cancer is not a single disease with a single cause and a single type of treatment. If you, or someone close to you, has only recently been diagnosed with cancer, you may still be learning more about the condition. Cancer and its treatments can have physical effects that may limit your ability to travel. For example: • Lung cancer can cause a cough or breathlessness. • A cancer that’s spread into the lymph glands may cause parts of the body to swell up. This happens because the flow of lymph fluid is blocked (this is known as lymphoedema). • Cancer in a bone may make the bone weak. It can increase the chance of the bone breaking (a fracture). It’s important to speak to your doctor before you make any plans to travel. They can tell you whether your cancer or its treatment could make travelling unsafe. They will tell you how you need to prepare if you do travel. We can send you information about your type of cancer. Call our cancer support specialists on 0808 808 00 00.
Cancer treatment Common treatments for cancer include surgery, radiotherapy, chemotherapy, biological therapy and hormonal therapy. The aim of treatment will either be to cure a cancer, to prevent cancer coming back, or to control its symptoms for as long as possible and to improve quality of life. Cancer treatments may cause short-term physical problems, such as sickness or diarrhoea. Some treatments can make your skin more sensitive to the sun. Occasionally, treatments can cause long-term physical problems, such as lymphoedema. Some treatments, such as chemotherapy and radiotherapy, can make you very tired (fatigued) both during and after treatment. Tiredness may limit the travelling you can do or the amount of activity you can manage while you’re away.
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How cancer can affect travel
You may find our booklet Coping with fatigue useful. It has helpful tips on how to plan activities and save energy.
How surgery can affect travel Some types of surgery for cancer may cause permanent changes to the body. For example: • Treatment for colon cancer can include removing part of the bowel and creating an ileostomy or colostomy. This won’t stop you from travelling, but you will have to think carefully about your trip. Most hospitals have specially trained nurses, called stoma care nurses, who can help you after your treatment. For more information on travel insurance, travel certificates and dietary issues you may have while you’re away, see the full version of our booklet Travel and cancer. • Breast cancer treatment may involve removing a breast (mastectomy). You should still be able to travel, but we can help you find organisations that supply bras, swimsuits and holiday clothes for women who’ve had a mastectomy. Contact our cancer support specialists on 0808 808 00 00 or use our online organisation search at macmillan. org.uk/organisationsearch If you’ve had any type of surgery or have any physical condition that could affect your ability to travel, there are many organisations that can help and support you. If you would like access to some of these, you can order the full version of our booklet Travel and cancer.
Travelling during treatment You may be able to have a holiday while you’re still in the middle of treatment – for example, between courses of chemotherapy treatment. In this situation, it’s very important to discuss your treatment with your cancer specialist beforehand. They can help you plan the best time for your holiday to make sure it doesn’t interrupt your treatment. You can talk through any possible problems and how you may be able to deal with them.
Questions about cancer? Ask Macmillan 0808 808 00 00 www.macmillan.org.uk
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How cancer can affect travel
We can send you more information about cancer treatments and their side effects.
You may only want to travel within the UK during your treatment and for some time after treatment, because it may be difficult to get insurance for a holiday abroad. For more information on getting travel insurance, you can order our booklet Getting travel insurance when you have been affected by cancer.
‘I had two week-long holidays in between chemo sessions, but only in the UK. My oncologist was quite happy for me to do this, but made sure I had details of the nearest A&E hospital and a local GP, and to continue taking my temperature and being vigilant with avoiding infections.’ Jacqui
Cancer and air travel Some people with cancer may, under particular circumstances, be advised not to travel by air. This is because oxygen levels and air pressure change at high altitudes. You may be advised not to fly if you: • are breathless • are anaemic (have a low number of red blood cells) • are at risk of developing increased pressure or swelling in the brain (cerebral oedema) due to a brain tumour • have recently had surgery to your chest • have recently had brain surgery • have problems with your ears or sinuses – pressure changes may make your symptoms worse
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How cancer can affect travel
• have recently had surgery or a medical procedure. This is because flying can introduce gas into the body that may expand to cause pain and stretch your wound. Speak to your cancer specialist about how long you should avoid air travel for after surgery. For more information about air travel, such as help at the airport, body scanning and airport security, see our booklet Travel and cancer.
Medical conditions Low immunity If leukaemia, lymphoma or recent cancer treatment have given you a weak immune system, you may need to take a supply of antibiotics with you. Your GP can give you a prescription but they may want to speak to your cancer specialist before they do this.
Blood clots Travelling, especially flying, can increase the risk of developing a blood clot. Some people with cancer have a higher risk of developing a blood clot (deep vein thrombosis or DVT). There are a number of possible reasons for this. People with cancer often have slightly higher numbers of cells in their blood that help it clot (platelets). People with cancer may also have slightly higher amounts of clotting factors. Clotting factors are proteins that are produced naturally in the body and work with the platelets to form blood clots and prevent bleeding. The risk of developing a blood clot is higher in people with particular types of cancer. Some types of lung, stomach or bowel cancers produce a substance called mucin, which can raise the risk of clots. People with acute myeloid leukaemia (AML) or pancreatic, ovarian or womb cancers have a slightly raised risk too. Some cancer treatments can increase the risk of blood clots. This includes some types of hormonal therapy, such as tamoxifen for breast cancer and stilboestrol for prostate cancer. It also includes some types of biological therapy, including thalidomide or lenalidomide for multiple myeloma.
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How cancer can affect travel
If you’re worried you may be at risk of developing a blood clot when you travel, talk to your cancer specialist. They can advise you on whether you need to have treatment to help prevent blood clots. Tips to prevent blood clots • Ask your cancer specialist whether you should wear special compression socks when travelling. • Wear loose-fitting, comfortable clothing. • Drink plenty of water during flights. Don’t drink too many caffeinated or alcoholic drinks, as they can make you dehydrated. • On any type of journey, it’s helpful to walk around or do regular leg exercises.
Lymphoedema People with lymphoedema (swelling of a part of the body) may find that travelling on long flights (more than around four hours) temporarily makes it worse. This is due to low cabin pressure, poorer air quality and keeping still for long periods during the journey. The tips below and on the next page may help prevent any problems. You can get a leaflet with more detailed information about travel and lymphoedema from the Lymphoedema Support Network – visit lymphoedema.org or call 020 7351 4480. We have a booklet called Understanding lymphoedema, which we can send you.
You can also get more information about lymphoedema from the Macmillan Lymphoedema Academy at macmillanlymphoedema-academy.org.uk Tips for before you travel • Don’t have vaccinations in a limb that’s affected with lymphoedema. If you have had surgery or radiotherapy to your armpit, it may be best to avoid vaccinations in that arm even if you have no signs of lymphoedema. • Talk to your doctor about taking antibiotics with you in case you get an infection.
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How cancer can affect travel
• Wear a compression sleeve if the flight is over four hours, even if you haven’t worn one before. Tips for during your journey • If you have to or plan to wear a compression sleeve or stocking, have it checked to make sure it fits properly. Wear it throughout your journey and for a few hours after landing. • If you have lymphoedema in a leg, wear well-fitting, supportive shoes. Don’t take them off during the journey as this can increase swelling. • Wear loose clothing that doesn’t restrict the affected limb. • Don’t wear tight belts. • Gently exercise the limb and move around as much as possible while you’re travelling. Ask for an aisle seat so you can exercise the arm more easily. • If you do lymphatic drainage massage, try to do this frequently during the journey. • Drink plenty of water to prevent dehydration. • If your luggage is heavy, use a luggage trolley or ask a porter for help. This will avoid strain on your body, including your back and affected arm. Tips for once you have arrived • Avoid strenuous exercise that you’re not used to. Gentle, repetitive exercise of the affected limb (such as swimming or cycling) can be helpful. • Avoid sunburn. Don’t forget you can still burn through compression garments, particularly synthetic ones. Your lymphoedema nurse or specialist can advise you which garments offer the most sun protection. • If you have lymphoedema of the leg, never go barefoot. Always wear some sort of footwear – even in the sea. • Protect against insect bites during the day and at night by using insect repellent spray or cream that contains a high level of DEET (diethyl-m-toluamide). • Keep your skin clean and check it reguarly for any sign of infection. • Treat any cuts, scratches and bites quickly with an antiseptic such as Savlon® or TCP®.
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How cancer can affect travel
‘If I was travelling somewhere abroad away from major cities or resorts in a country whose language I did not speak, I would take with me a brief summary of my condition and current treatment in the language of that country, just in case of emergency.’ Janet
More information and support More than one in three of us will get cancer. For most of us it will be the toughest fight we ever face. And the feelings of isolation and loneliness that so many people experience make it even harder. But you don’t have to go through it alone. The Macmillan team is with you every step of the way. To order a copy of Travel and cancer, visit be.macmillan. org.uk or call 0808 808 00 00. We make every effort to ensure that the information we provide is accurate and up to date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication, or thirdparty information or websites included or referred to in it. © Macmillan Cancer Support 2013. Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ
REVISED IN FEBRUARY 2014 Planned review in 2015
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