“Most people can tolerate the changes in cabin pressure and oxygen levels during a flight without developing any medical issues,” notes Aaroe. “But people with certain sensitivities might feel those adjustments more acutely.”
If you have a brain tumor, for instance, you might be more prone to seizures or brain swelling. And, if you’re anemic, you might be more susceptible to dizziness or fainting.
“You also don’t know what the people around you might have going on, in terms of respiratory and gastrointestinal infections,” adds Aaroe. “Cruise ships in particular are frequently in the news for outbreaks of gastrointestinal viruses that can spread like wildfire once they’ve gained a foothold.”
2. Is there a ‘best time’ for me to travel?
If you’re receiving chemotherapy, there may be certain periods during which you’re at the highest risk of developing anemia or an infection, or times when you might be expected to have more side effects. So, if you’ve already been cleared to travel, ask your doctor what your best options are in terms of timing.
“Patients taking the oral chemotherapy drug temozolomide usually see their blood counts reach their lowest points about 21 days into each cycle,” says Aaroe. “Most won’t have any significant issues as a result. But those who do may want to weigh this in their travel plans. Patients usually also prefer not to travel during the period that they are actively receiving chemotherapy, due to nausea and fatigue.”
3. Will I need any vaccinations?
In addition to COVID-19, your travel destination may have its own set of exposure risks. The Zika virus, for instance, is still prevalent in many Central and South American countries. Ebola continues to circulate on the African continent. And tuberculosis remains an issue worldwide, despite global efforts to eradicate it.
Be sure you’re up to date on all your vaccinations before you leave. And ask your doctor which others you might need — and how far in advance — to give you the most protection.
“When I was about 13, my family moved to China for a few years,” recalls Aaroe. “I got so many shots before we left that I literally couldn’t move my arm for a few days. But I also didn’t get sick with any of those illnesses while we were there. Vaccinations work.”
4. What should I carry with me at all times in the event of an emergency?
It’s always a good idea to bring extra medication on a trip, just in case you should face unexpected delays or accidentally drop a pill down the sink.
But be sure to carry both fast-acting and regular medications with you. That way, you won’t ever have to miss a dose due to an extended layover. You also won’t run the risk of not having access to any of the specialized medications you need.
“Many brain tumor patients take an oral medication daily to prevent or control their seizures,” Aaroe explains. “But there are also several fast-acting therapies — such as lorazepam, intranasal sprays and even suppositories — that can stop seizures in the moment when administered. And those are substances that a standard first-aid kit may not contain.”
The most important item to bring with you is a summary of your condition and guidance on what to do if you should become incapacitated. This is especially important if you’re traveling alone, but could also come in handy in an emergency, especially if it’s difficult for your caregiver to relay your history to a flight attendant or a tour guide.
Include clear instructions in your health summary, such as:
give me this amount of that medication if X happens, followed 15 minutes later by this much of that one
call this person right away at a particular phone number, or
take me to the nearest hospital immediately and show them these documents
“One of my patients had his summary translated into several other languages, including the main language spoken at his destination,” noted Aaroe. “That was a very prudent and proactive thing to do.”
Also, consider bringing:
a doctor’s authorization confirming that you’ve been cleared to travel
notes from your last doctor's visit
digital images of your most recent scans on a DVD or thumb drive
“A picture is worth a thousand words,” adds Aaroe. “And MRIs are thousands of pictures. So, if you bring along copies of your latest scans and something happens, doctors will be able to compare them directly to your current scans and see if anything has changed.”
It’s also a good idea to make sure you’ve downloaded the myChart app on your mobile device before traveling – and that you remember how to log in. That way, you’ll be able to pull up any notes or medical records needed and communicate with your care team while you’re away.
5. Will I need any special documentation for my medications?
“Some medications are easier to travel with than others,” Aaroe notes. “If you’re taking opiates or methadone for cancer-related pain, for instance, you might need a doctor’s note in some countries explaining why you’re receiving those things.”
Most airports have services available to help you with these issues, especially if you call in advance. But it will probably still take you a little more time to get through security, so plan accordingly.
6. Is there anything special I should do during a flight to minimize my risk of problems?
Any time you’re sitting for a prolonged period — whether it’s in a plane, train or car — your risk of developing blood clots in your legs increases. These clots — also known as deep vein thrombosis (DVT) — can be fatal if they break loose and travel to your lungs.
So, ask your oncologist if you should wear compression hose while traveling or do anything else to reduce your risk of DVT.
“The Centers for Disease Control (CDC) recommends getting up and moving around every 2 to 3 hours while driving or flying,” Aaroe notes. “Even if you’re sitting down, there are exercises you can do to improve your circulation. You can raise and lower your heels, for instance, roll your ankles around, or tighten and release your leg muscles.”
Call your doctor immediately upon arrival if you show any symptoms of DVT. These include:
swelling in the legs
pain or tenderness
fast heart rate
7. Should I warn anyone about my condition or wait until something happens?
No one is obligated to divulge their medical history to anyone, but whether you alert a flight attendant or tour guide is entirely up to you. It all depends on the situation and your comfort level.
“There’s no one-size-fits-all approach,” says Aaroe. “I don’t think it’s strictly necessary to tell anyone, as long as your medical summary is handy and accessible if something happens. But ask your doctor to be sure. Travel is perfectly safe for cancer patients most of the time, and we want you to enjoy your life. But you never know exactly what might happen, so it’s good to be prepared.”