Is it safe to go on a trip during chemotherapy?

Often yes, if you time it around your cycle and your team agrees. This page is for people on chemotherapy who want to plan a trip safely. The National Cancer Institute puts going on trips on its short list of things to keep doing during treatment. The list also includes work, family, and activities you enjoy, as long as you feel well enough.

The real question is not whether travel is allowed. It is when in the chemotherapy cycle you go, and what happens if you get sick far from your hospital.

Time the trip to your white blood cell count

Chemotherapy lowers your white blood cells, which are the cells that fight infection. NCI is specific about this. During a chemotherapy cycle, there are stretches when your neutrophils, a type of white cell, drop particularly low. Then your risk of infection rises.

That low point is the window to avoid. Ask your oncology nurse two direct questions. Which days of my cycle is my count lowest? When is my next blood test due? Then plan the travel dates with your team, and steer clear of the days when your count is low.

Ask a second set of questions about the practicalities. Does the trip collide with an infusion date or a scan? Do you need a blood test while away, and can it be done at a lab near your destination? Will the results reach your team?

Infection precautions travel with you

The habits you use at home matter more on the road, because you will be in unfamiliar places and around more strangers.

• Wash your hands often with soap and warm water, especially before eating, and ask the people with you to do the same. Carry hand sanitizer for places without a sink.
• Stay away from anyone who is sick, and avoid crowds when your count is low.
• Avoid people who have just had a live vaccine, such as chicken pox, polio, or measles.
• Follow food safety rules. Make sure meat, fish, and eggs are well cooked. Wash raw fruits and vegetables very well.
• If you have a catheter or port, keep the skin around it clean and dry, and watch for redness or swelling.

The plan for getting sick away from home

Before you leave, find out where the nearest emergency department is and put its address in your phone. Carry a written summary of your diagnosis, your regimen, your drug allergies, and your oncologist's phone number. Keep it on paper as well as on your phone.

Pack enough medicine for the whole trip, plus extra in case of delays. Keep it in its original labeled containers. Keep it in your carry-on rather than checked luggage.

Call your oncology team immediately, at any hour, for a fever of 100.4 °F (38 °C) or higher. It is a medical emergency. If you cannot get through to them fast, go to the nearest emergency department. Tell them at once that you are on chemotherapy. Do not take aspirin, acetaminophen or ibuprofen for the fever until you have talked with your doctor or nurse. NCI warns that these medicines can mask a serious problem.

The CDC uses 100.4 °F for people getting chemotherapy. NCI's infection page uses 100.5 °F (38 °C). Use the lower number, and call as soon as you reach 100.4 °F.

CDC also says to call your doctor right away for signs of infection, and fever is sometimes the only sign. Other reasons to call right away include chills, cough or sore throat, diarrhea, ear or sinus pain, a stiff neck, a skin rash, mouth sores or a white coating in the mouth or on the tongue, redness or swelling where a catheter enters your body, and cloudy or bloody urine or pain passing it.

Do not skip this part of the plan

One last step ties the whole plan together. Talk with your care team before booking anything, and ask specifically about your destination. International travel raises questions about vaccines. The CDC says vaccines made from live viruses, such as MMR and varicella, may not be safe for people with weakened immune systems. The CDC suggests seeing a provider at least 4 to 6 weeks before you leave. If you are anemic or short of breath, ask whether flying or high altitude is a concern for you.

The CDC says to find out whether your health insurance covers care abroad, since you may have to pay medical bills yourself. Ask whether you need travel medical coverage. If you are flying, tell the airline in advance if you need a wheelchair or extra time boarding. Build rest into the itinerary rather than assuming your usual pace.

Sources

https://www.cancer.gov/about-cancer/coping/day-to-day/daily-routine

https://www.cancer.gov/about-cancer/treatment/side-effects/infection

https://www.cdc.gov/cancer-preventing-infections/patients/fever.html

https://www.cdc.gov/cancer-preventing-infections/patients/symptoms.html

https://wwwnc.cdc.gov/travel/page/weakened-immune-systems