Deciding to travel
During active Cancer therapies or ongoing illness it is important to assess the risks and benefits of travel. It may often be necessary to advise a delay to the planned journey if the patient has recently completed, is currently undergoing, or due to start certain treatments e.g. Chemotherapy. Do not automatically cancel a pre-arranged holiday, however as often simple re-arrangements can be made to allow a holiday to take place. Radiotherapy and be planned before the holiday and started on return - this doesn't delay the treatment because there may well be a week or so gap between the planning and start. There may be other hidden factors to consider when planning a trip such as addition expenditure in order to facilitate the safe travel of a patient with ongoing healthcare needs. The resultant financial cost may prove prohibitive and such issues may require further exploration. Relative and Carer may have to intervene if the patient has an unrealistic insight in their capability to travel. False expectations may be born out of a lack of understanding regarding the true nature of their illness. Alternatively, the patient may be denying the seriousness of their condition. Such situations require sensitive handling and excellent communication.
For a patient with advanced cancer, a holiday may represent more than “taking a break” and there can be any number of reasons for the choice of destination. If the patient is deemed too ill to make their intended journey, the healthcare professional should be prepared to discuss alternatives rather than simply giving a negative response. For example:
- Rather than the patient travelling to visit family, is it possible that family could visit the patient instead?
- If there is concern that the patient’s chosen destination is a country or area lacking in suitable medical facilities, consider an alternative that has a better standard of healthcare.
- If the chosen destination involves an arduous journey, is there a more accessible alternative?
- If the patient is deemed too unwell to holiday abroad, is there an acceptable destination within your own country?
Some patients may be tempted to partake in some of the numerous complementary / alternative therapies practiced throughout the world. Extreme caution should be taken. It would be difficult for the patient to establish whether a practitioner is adequately trained, has appropriate insurance or whether they are affiliated to a governing body. Furthermore, some herbal remedies may contain substances that interact with the patients prescribed medication. The patient should not take such remedies without discussion with their cancer specialist.
When you should not fly
Most people who have had cancer can travel without problems. But there are times when it is best not to fly because of changes in pressure or the amount of oxygen in the cabin of the plane. Check with your doctor that you can fly. Or contact the medical officer of the airline you are flying with. You shouldn’t fly if you
- Have had surgery for a Brain Tumour in the last few months
- Have a brain tumour and the pressure in your skull ( Intracranial Pressure) could be higher than normal
- Have had high dose chemotherapy or a bone marrow or stem cell transplant in the past 6 to 12 months
- Have a low level of platelets in your blood
- Are breathless
- Are anaemic
You should not fly straight after surgery or a laparoscopy because you may have air trapped in your body. When you fly, the air can expand and cause an increase in pressure inside the body. After 10 days, this should have all dissolved away, so you will be able to fly. If you have had surgery very recently though, it is always a good idea to check with your surgeon before planning your trip.
If you’ve had bowel or chest surgery, you will need to wait at least 4 weeks. Do check with your surgeon – 4 weeks is only a guide.
Brain surgery is another special case. The skull is a fixed size, so changes in pressure inside the skull can have serious effects. If you’ve had brain tumour surgery within the past few months, you need to talk to your brain surgeon before you make any definite plans.
If your platelets are low
Platelets are blood cells that help your blood to clot. Your platelet count can be lowered by cancer treatment. To be safe to fly, your platelet count should be above 40,000 per cubic ml of blood. You will need to check this with your doctor.
BT Buddies would like to thank Dr. Simon Noble, Senior Lecturer and Honorary Consultant in Palliative Medicine and Colin Perdue, Clinical Nurse Specialist for granting us permission to reproduce this article.