Is it safe to go on a trip during chemotherapy?

Often yes, if you time it around your cycle and your team agrees. The National Cancer Institute puts going on trips on its short list of things to keep doing during treatment, alongside 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 that during a chemotherapy cycle there are stretches when your neutrophils, a type of white cell, drop particularly low and 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, and when is my next blood test due. Then plan travel for the days when your count is recovering, not falling.

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, keep hot food hot and cold food cold, and either peel raw fruits and vegetables or wash them very well.
• If you have a catheter or port, keep the skin around it clean and dry, and check it daily 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, and keep it on paper as well as on your phone.

Pack more medicine than the trip requires in case of delays, keep it in its original labeled containers, and 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, and if you cannot get through to them fast, go to the nearest emergency department and tell them at once that you are on chemotherapy. The CDC uses that threshold for people in cancer treatment; NCI's infection page uses 100.5 °F — 38 °C is 100.4 °F; act at 100.4 °F —, and the CDC number is the one most centers now give patients. Do not take acetaminophen or ibuprofen first, because those can hide a fever and mask a serious problem. Other reasons to seek care the same day include chills, cough or sore throat, diarrhea, ear or sinus pain, a stiff neck, a skin rash, mouth sores or white coating 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

Talk with your care team before booking anything, and ask specifically about your destination. International travel raises questions about vaccines, and some vaccines are not safe while your immune system is suppressed. Long flights and altitude may matter if you are anemic or short of breath.

Check what your health insurance covers away from home, and whether you need travel medical coverage. If you are flying, tell the airline in advance if you need a wheelchair or extra time boarding, and 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