Cancer Patients: Travel Abroad Safely?

Travelling with cancer may require some extra planning and preparation. While most people with cancer can travel without problems, it is important to check whether you are fit to travel, as certain treatments can cause short-term physical problems and skin sensitivity. It is recommended to consult a doctor before travelling, as they can advise on any potential risks and precautions to take.

Cancer patients may need to consider the following when planning a trip: fitness to travel, the need for a travel companion, special equipment, vaccinations, and sufficient medication and medical supplies. Travel insurance is particularly important for those with cancer, and it can be more difficult to obtain.

Additionally, cancer patients should be aware of the potential for higher risks of blood clots, infection, lymphoedema, and sun sensitivity during travel. Planning a safe and pleasant journey is essential to ensure a positive travel experience.

Vaccinations and medication

Before travelling abroad, it is important to consult with your healthcare team about the necessary vaccinations and medication. Some countries require specific vaccinations for entry, and cancer treatments can interfere with certain types of vaccines. It is recommended to seek advice at least eight weeks before travelling.

Vaccinations

Live vaccines, which contain small amounts of a live virus or bacteria that has been weakened, are not suitable for individuals with weakened immune systems, including those undergoing cancer treatment. Live vaccines include the flu nasal spray, measles, mumps and rubella (MMR), oral typhoid capsule, and some types of cholera vaccine. Inactivated vaccines, which use a killed virus or bacteria, are generally safer for individuals with cancer but may be less effective if administered during cancer treatment. Examples of inactivated vaccines include diphtheria, tetanus, polio, human papilloma virus (HPV), Japanese encephalitis, and tick-borne encephalitis.

It is important to consult with your healthcare team before receiving any vaccinations. They can advise on the timing of vaccinations in relation to your cancer treatment and recommend alternative destinations if you are unable to receive the necessary vaccinations. Additionally, keeping up to date with routine vaccinations, such as the flu vaccine and coronavirus (COVID) vaccine, is recommended for individuals with cancer.

Medication

When travelling with medication, it is essential to keep the following in mind:

• Keep all medications in their original packaging and carry them in your hand luggage.
• Obtain a doctor's letter or export licence for prescription drugs, especially controlled substances.
• Carry additional medication to account for unforeseen events or delays.
• Check with the relevant embassies or consulates to clarify any restrictions on importing specific medications to your destination country.
• Confirm the availability of your medication at your destination and ensure compatibility with your usual brand.
• If medication needs to be kept cool, use a cool bag and confirm access to a refrigerator at your destination.

It is also important to be aware of the increased risk of blood clots, infections, lymphoedema (swelling), and sun sensitivity associated with cancer and its treatment. Taking preventative measures, such as wearing compression garments and sun protection, can help minimise these risks while travelling.

Travel insurance

However, finding travel insurance as a cancer patient can be challenging and expensive. Insurance companies assess your personal information to estimate how likely you are to claim on your insurance due to your condition. They may refuse to insure you, offer you a specialised policy, or provide insurance with higher premiums or excess.

• Be open about your health and ask travel insurance providers for their guidance. Their approach may vary depending on your individual circumstances.
• Shop around and compare different insurance companies and brokers. Some companies specialise in policies for people with pre-existing medical conditions, including cancer.
• Consider using an insurance broker who can help arrange a policy for you or provide a list of insurance companies with special policies for cancer patients.
• Prepare all the necessary information before applying for travel insurance, such as details about your cancer type and treatment, prognosis, and any follow-up care.
• Obtain a doctor's letter or certificate stating that you are fit to travel. This may be required by some insurance companies.
• Expect to answer questions about your cancer and be ready to provide detailed information.
• Review the policy carefully to ensure it covers everything you need, such as emergency medical care, repatriation, and coverage for travel companions.
• Consider the cost of insurance and any excess you may need to pay in the event of a claim.
• Check if there are any cancer-related exclusions in the policy and understand what is and isn't covered.
• Look for specialist guides and advice from cancer charities, such as Cancer Research UK and Macmillan, to help you navigate travel insurance as a cancer patient.

Physical effects of cancer and travelling

Travelling can be fun and fulfilling, but when you have cancer, you may have a few more things to think about. It is important to check whether you are fit to travel, and your doctor can advise you on this.

Cancer treatments such as radiotherapy and chemotherapy can cause short-term physical problems and increase your risk of blood clots, infection, lymphoedema (swelling) or sun sensitivity. These effects can limit the amount of travelling you can do or the type of activities you can do while away.

Skin sensitivity

Some cancer treatments can make your skin more sensitive to the sun. It is important to take extra care during and after treatment. Wear a wide-brimmed hat, use sunscreen with a high sun protection factor (SPF), wear clothing made of cotton or natural fibres, try to sit in the shade and avoid the sun between 11 am and 3 pm. If you have had radiotherapy, keep the affected area covered.

Fatigue

Fatigue is the most common side effect caused by cancer and cancer treatment. It is usually described as feeling tired, weak or exhausted and may not improve even with rest. It can occur occasionally and last a short time or could last several months after treatment.

Surgical site pain or scarring

Depending on the type of surgery performed, you may struggle with discomfort, lymphedema (swelling) and nerve pain. Surgical scars take time to heal and may be prominent or noticeable immediately after treatment.

Hormonal changes

Some chemotherapy treatments can cause premenopausal women to enter menopause abruptly. Some side effects that could last beyond treatment include hot flashes, joint symptoms, sexual health changes, sleep changes, headaches, weight gain and memory changes.

Changes in activity levels

You may find your range of motion or mobility is restricted after surgery, or you might stop exercising due to side effects from chemotherapy or radiation. Fatigue can also limit your ability to perform daily activities and move around, although this may improve with time and physical therapy.

Cardiovascular complications

Many cancer treatments can cause cardiovascular complications such as heart failure, myocardial ischemia/infarction, hypertension, thromboembolism and arrhythmias. If you experience any symptoms such as shortness of breath, lightheadedness or dizziness, chest pain, or swollen hands or feet, contact your healthcare team right away.

Neuropathy

Neuropathy, or nerve damage, can result from chemotherapy, radiation, surgery or a combination of these treatments. It can cause tingling or numbness, especially in the hands and feet.

Bone issues

Cancer treatments can cause your bones to become thinner, weaker, more fragile and more brittle. If you have osteoporosis, your doctor may recommend specific medications and physical therapy to strengthen your bones and reduce your risk of fractures.

Cognitive issues

Cognitive thinking and short-term memory loss are common side effects of cancer treatments. 75% of people with cancer have cognitive problems during treatment, and 35% have issues that continue for months after finishing treatment.

Healthcare abroad

The standard of healthcare and its availability varies across the world, both between and within countries. For instance, while urbanised areas of developed countries may have a wide range of healthcare services, remote locations, even in developed countries, may have very basic healthcare provisions. Therefore, it is important to research the level of healthcare services available at your destination. The relevant high commission, embassy, or consulate will be able to provide these details.

Emergency Medical Cover

The level of emergency medical cover available to UK citizens abroad varies, but there are three main types:

• European Economic Area (EEA) countries: UK residents can access state-provided medical treatment with a valid European Health Insurance Card (EHIC). This may require a financial contribution, and an EHIC does not cover repatriation costs.
• Reciprocal agreement countries: Countries with reciprocal agreements with the UK for emergency medical cover.
• Countries with no healthcare agreements: Most countries in the world, including Canada, India, the USA, and all countries in the Middle East and Africa, fall under this category.

Travel Insurance

Comprehensive travel insurance is strongly recommended for cancer patients travelling abroad, as the costs of medical treatment abroad can be very high. It may be difficult to obtain travel insurance as a cancer patient, as you are considered more likely to make a claim. Be prepared to provide detailed information about your condition and treatment when applying for travel insurance.

General Healthcare Advice

• Venous thromboembolism: Cancer patients are at a higher risk of developing blood clots, especially during long-haul travel. It is recommended to drink plenty of non-alcoholic fluids, take short walks every 1-2 hours, and perform leg exercises regularly during the flight.
• Lymphedema: Air travel can exacerbate lymphedema due to prolonged inactivity. It is recommended to wear compression garments and loose, comfortable clothing during the flight.
• Sun exposure: Cancer treatments can make your skin more sensitive to the sun, increasing the risk of sunburn and heat exhaustion. It is important to protect your skin with wide-brimmed hats, sunscreen, and loose, cotton clothing. Avoid sun exposure during the hottest parts of the day (11 am to 3 pm).
• Insect bites: Insect bites can lead to infections. Use insect repellent and insecticide sprays, and consider sleeping under a mosquito net.
• Food and water precautions: Contaminated food and water can cause diarrhoea and vomiting, which can be particularly dangerous for cancer patients. Boil or use bottled water for drinking and cleaning teeth, avoid ice and unpasteurised milk, and only eat freshly cooked, hot food.

Planning and preparing

Consult with your doctor

Before you make any travel plans, it is important to check with your doctor to see if it is safe for you to travel. They will be able to advise you on any potential risks and let you know if there are any precautions you need to take. For example, if you have recently had surgery, you may need to wait several weeks before flying. Your doctor can also advise you on whether you will need a travel companion or helper to accompany you and any special equipment you may require.

Get your medications in order

Make sure you have enough medication for your entire trip, plus some extra in case of delays. Keep your medications in their original packaging and bottles, and consider bringing a doctor's letter or export license, especially if you are travelling with controlled drugs. It is also a good idea to have a list of your medications, including dosages, with you at all times.

Research your destination

Find out if there are any specific vaccinations or other health requirements for your destination. Some countries may require you to have certain vaccinations before you are allowed entry. It is also important to be aware of the healthcare options available at your destination in case you need medical attention while travelling.

Contact your airline

If you have any special requirements, such as a wheelchair or priority boarding, contact your airline in advance to make the necessary arrangements. It is also a good idea to inform them of any medical devices you are travelling with, such as a port or ostomy bag.

Get travel insurance

Travel insurance is crucial when travelling with cancer. Be sure to disclose your medical history and any pre-existing conditions when applying for travel insurance. Depending on your circumstances, you may be offered insurance with higher premiums, an excess, or a cancer-related exclusion.

Prepare for sun exposure

Some cancer treatments can make your skin more sensitive to the sun, so be sure to pack sunscreen, a hat, and protective clothing if you will be spending time outdoors. Try to avoid the sun between 11 am and 3 pm, and seek shade whenever possible.

Plan for potential health issues

Cancer and its treatments can increase your risk of certain health issues, such as blood clots, infection, and lymphoedema (swelling). Take precautions to minimise these risks, such as wearing compression garments and moving around frequently during long flights to prevent blood clots. Also, be sure to pack a first aid kit and any other supplies you may need to manage your condition while travelling.

Frequently asked questions