8 Tips for travelling abroad with cancer

Take some time to think about where to go on your travels. Although you may be able to go anywhere you like, some types of cancer treatment and surgery weaken your immune system and mean that you cannot have certain travel vaccinations. For example, typhoid vaccinations can sometimes cause adverse effects such as feeling very unwell.  As a result, there may be some destinations your GP may advice you not to travel to until you are well again.

If you’re planning on travelling to a far-flung destination, you may need immunisation from certain infections before you go. In order to give them time to build up a level of protection in your body, many travel vaccinations need to be administered several weeks before your departure date. Your doctor or nurse will be able to tell you if you need any vaccinations and when you’ll need to have them.

As we mentioned above, there are some travel vaccinations that you can’t have if you are undergoing or have recently had treatments for cancer as they can damage your immune system. These are ‘live’ vaccines – those which contain small amounts of a live virus or bacteria – and without the protection your immune system would normally provide, they can be harmful.

If you are currently having chemotherapy or any other immunosuppressive cancer treatment (or have had this in the last six months), or if you have had a transplant, your immune system will be too weak to have a live vaccine. In the UK, live vaccines include those for yellow fever, BCG (tuberculosis), oral typhoid, shingles, measles, rubella (German measles) and the MMR jab (for measles, mumps and rubella). Travelling to certain countries requires you to have up-to-date immunisation against some of these infections, such as Brazil and yellow fever, at the time of publication of this article.

Other vaccinations are known as ‘inactivated’ as they contain a killed virus or bacteria. These are safe to have if you have a weakened immune system, although they may not work as well as they should. Inactivated vaccines include flu, hepatitis A and B, rabies, cholera, typhoid, the combined vaccine for diphtheria, tetanus and polio, meningitis, tick born encephalitis and Japanese encephalitis.

Travelling to certain areas in some tropical countries can also mean protecting yourself against malaria and other diseases that are spread by mosquitos, such as dengue fever and the zika virus. Rather than an injection, anti-malarial medication comes in the form of tablets that you may need to start taking before your trip, during your trip and for several weeks afterwards. Your doctor can tell you whether you need to take them, and if so, when to start and when to stop.

You can also use the Travel Health Pro website to find out which vaccinations or tablets you need, if any, to visit your chosen destination. Cancer Research UK also has some useful information about travel vaccinations.

When you have an unpredictable condition like cancer, having specialist travel insurance in place that covers you for any unexpected medical expenses is a must. Without insurance, you could be liable to pay the cost of any emergency treatment you might need while you are away, as well as the cost to get you home again if you cannot travel as planned. Depending on where you go, these costs can be extremely high, particularly in countries such as USA, Canada and China.

You may have found it difficult to find a standard travel insurance company who will cover you when you have cancer. Medical travel insurance providers such as Free Spirit specialise in travel insurance for those of any age who have existing medical conditions or disabilities. Our cancer travel insurance is specifically designed to cover all types of cancer, including prostate cancer, cervical cancer and skin cancer. With an excellent knowledge and understanding of all types of cancer, we hope to be able to offer cover to suit your personal circumstances.

Aside from the most important purpose of travel insurance – to ensure you receive the appropriate care and treatment should you need it and to cover the costs – our travel insurance for cancer covers you for many other aspects of your trip. For example, you needn’t worry if you have an accident or lose your travel documents or luggage while you’re away, or even if your health deteriorates before your trip and you are too ill to go. Our specialist travel insurance for cancer will cover you. Free Spirit also covers you if you lose your medication up to £500 (up to £250 with ‘Super’ cover) whilst travelling so that you can purchase replacements if you need to.

When you apply for specialist holiday insurance, you will need to go through a medical screening either online or over the telephone. Most providers use a medical screening system that will ask you a few simple questions about your specific cancer.

For example, for breast cancer, we will ask you the following questions:

• Has the cancer ever spread beyond the breast?
• How long ago was the initial diagnosis of breast cancer made?
• Are you currently having any treatment or is any planned?

Please note, other medical screening questions will be asked depending on the type of cancer and the answers you provide.

If you have cancer and you feel well, chances are that you can travel by air without any issues. However, the changeable oxygen levels and air pressure of aeroplane cabins at altitude can cause problems for some people with cancer, and may mean that they cannot travel by air.

Macmillan Cancer Support lists the following as potential barriers to air travel for those with cancer:

• breathlessness
• anaemia
• low blood platelet count
• brain tumour
• having any kind of surgery, particularly to the eye, chest or bowel, and
• ear or sinus problems (www.macmillan.org.uk).

Even if none of these apply to you, check with your doctor or specialist nurse before booking any flights. If they are happy for you to fly to and from your destination, ask them for a letter you can take with you on your flights, detailing your condition and any medication you need to take on board with you.

Talk to your airline. Nearly all airlines have specialist medical teams who can pre-arrange any assistance or extra facilities you may need, so make sure you book with one who can provide this. Get in touch with them in plenty of time before you’re due to fly, so that they can organise what you need, such as an in-flight oxygen supply, early boarding and help with your bags or getting you to your departure gate.

Sitting still for extended periods of time can make developing deep vein thrombosis (DVT) more likely, which is why air travel is a risk factor, particularly long flights. DVT is the development of blood clots in the body’s deep veins, and usually occurs in the legs.

Cancer also increases the risk of blood clots, and some types of cancer and some cancer treatments carry higher risks than others. Wearing flight socks or support stockings while you’re in the air will help to minimise your risk of DVT, by exerting enough pressure to keep the blood circulating in your legs.

There are a huge variety of medications for cancer. Some medications treat the cancer itself and others alleviate the symptoms, such as pain and nausea. You may have a combination of medications you need to take for your condition.

Although they can be prescribed to treat cancer, some medications are subject to extra legislation; these are often known as ‘controlled drugs’. Strong painkillers such as diamorphine and other opiate-based painkillers are controlled drugs and as such, you may need to take proof of your prescription and condition with you. There are also limits to the amount of controlled drugs you can take into certain countries without an export licence. Ask your doctor or specialist nurse about the best way to take your cancer medications abroad. You can also check the list of current controlled drugs on The Home Office website and find out more about travelling with controlled drugs on NHS Choices.

Controlled drugs should be carried in your hand luggage, in their original packaging as prescribed by your doctor and alongside your doctor’s letter. You should also carry any liquid medications in your hand luggage as the baggage hold gets very cold and could damage them.

No matter what kind of cancer medication you take, it’s worth taking two copies of a letter from your doctor about your condition, your prescribed medication and doses with you on your trip, one in English and one in the language of the country you are visiting, as well as local emergency contact numbers. These will come in useful if you lose any of your medication or if you need to see a doctor while you’re away.