Travel and medical conditions
You may be travelling with a medical condition as a result of your cancer. There are things you can do to help prepare.
If leukaemia, lymphoma or recent cancer treatment has 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.
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.
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.
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.
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.
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 may help prevent any problems. You can get a leaflet with more detailed information about travel and lymphoedema from the Lymphoedema Support Network
You can also get more information about lymphoedema from the Macmillan Lymphoedema Academy.
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.
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 ®.
Bowel or bladder problems
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Many people affected by cancer have problems with their bladder or bowels. These may be either temporary or long term and can be due to treatment or the cancer itself. If you have changes in your bowel or bladder that mean you need to pass urine or bowel motions urgently or often, you will need to be close to a toilet and this can affect your travel plans. You may feel worried about going out, especially to somewhere new, if you have problems with bowel or bladder control. Planning ahead so that you are prepared can help you feel more confident.
Access to toilets
If you’re going somewhere you’re not familiar with, it’s a good idea to find out more about toilet facilities in your accomodation and in the area or country you are travelling to. It may be that they are very different to what you’d expect in the UK. This shouldn’t prevent you from travelling, but will help you plan ahead.
If travelling in the UK, many towns and counties keep information about the public toilets in their area as lists or maps. Often these are on local authority websites. Try putting the term ‘public toilets’ and the name of the place you plan to visit in a search engine to find out what’s available.
Carrying a Just Can’t Wait toilet card may help you get access to a toilet more quickly when you’re out. The card can be used in places such as shops and pubs, and states that the card-holder has a medical condition that requires urgent access to a toilet. You can get a Just Can’t Wait toilet card from the Bladder and Bowel Foundation or Disability Rights UK.
You can use disabled toilets too. These often offer more privacy, have a wash basin and more space if you need to change.
National Key Scheme for Toilets
This scheme offers people with a disability access to around 9,000 locked public toilets across the UK. You can buy a Radar NKS key for £4.50 (including postage and packaging) from Disability Rights UK. In Northern Ireland, these keys can be purchased at any local council office.
Take supplies with you
Pack a bag of the things you may need when travelling. This will help you feel more confident.
You may want to include:
wet wipes or baby wipes
barrier cream such as Cavilon ® or Sudocrem ®
pads and pants
a change of clothing
a sealable bag.
If you have bladder problems, you might find it helpful to take a portable urinal with you.
Talk to your cancer nurse or specialist for advice on travelling and ask whether any medications, for example, treatment for diarrhoea, may be helpful for you.