Table of ContentsView AllTable of ContentsAir Travel With CancerMedications and DevicesGetting AroundReducing Blood ClotsOxygen NeedsAir Pressure ChangesInfection ConcernsCancer FatigueTravel Insurance
Table of ContentsView All
View All
Table of Contents
Air Travel With Cancer
Medications and Devices
Getting Around
Reducing Blood Clots
Oxygen Needs
Air Pressure Changes
Infection Concerns
Cancer Fatigue
Travel Insurance
Flying on commercial airlines is usually very safe for people with cancer who are stable, reasonably healed from any surgeries, and do not have a very low white blood cell count or platelet level due tochemotherapy. That said, it’s important for anyone with cancer to talk to an oncologist before scheduling any air travel to discuss potential concerns about oxygen levels or pressure changes during flight, or the need for preventive measures against blood clots. Here we will look at these concerns, common questions people have about medications or medical devices while flying, and general measures that can help you prepare for seamless travel.
Erik Witsoe / EyeEm / Getty Images
Timing
Many people wonder about the best time to travel during treatment, and the answer will be different for everyone.
Air travel should be avoided if at all possible for at least two weeks after surgery for a number of reasons (and much longer in some situations such as after brain surgery). In general, any incisions should be well healed and any drains removed.
With chemotherapy, the best time to fly will depend on the particular chemotherapy regimen you are on, as well as other factors such as side effects you are experiencing and more. With some protocols, the chemotherapy nadir (when blood counts are at their lowest) occurs around 10 days to 14 days after an infusion, and an oncologist may recommend travel either earlier or later for this reason.A low white blood cell count can increase infection risk, a low red blood cell count (anemia) can make you more tired, and a low platelet count (thrombocytopenia) can increase the risk of bleeding. With high dose chemotherapy, such as with some leukemias, air travel may be discouraged throughout the duration of treatment.
General Information
The Air Carrier Access Act of 1986 prohibits discrimination on domestic flights in the United States on the basis of disability. While there are some “horror stories” that spread through the news regarding transportation security administration (TSA) agents and “pat downs,” TSA agents should typically be ready to assist those with disabilities due to cancer with courtesy and respect. TSA recommends calling their helpline 72 hours before travel to discuss the screening process.
Medications and Medical Devices
Many people with cancer will need to travel with medications or medical devices. In addition to making sure that you have an adequate supply of medications (with at least a few extra days worth in case of delays or changes due to weather), there are several other things you should consider.
Oral Medications
Carry all medications on board in a carry-on rather than checking them with your luggage. This includes any medications you use for side effects such as anti-nausea drugs or pain medications. Keep all medications in their original containers. Though it’s recommended that you bring enough medications for your entire trip plus unexpected delays, many insurance companies have a limit on the number of pills you will be prescribed at one time. If this is an issue, talk with the pharmacist responsible for prescribing your medications.
Medications that cannot go through theX-ray machineare allowed, but you will need to talk to the TSA agent and this may require a pat down.
If you have medications in liquid form, containers containing more than 3 ounces are allowed but you will need to remove the medication from your bag and mention it to the TSA agent before going through security.
Medications and Travel Outside the U.S.
Keep in mind that drug approval varies among countries and that your particular medication may not be available where you are traveling.
It’s also very important to make sure that your medication is legal in the countries you are visiting.
For example, drugs containing pseudoephedrine (such as Sudafed) are illegal in Japan. Amphetamines such as Adderall are illegal in Japan and Saudi Arabia. Narcotics may be illegal or restricted, for example, codeine is illegal in Greece and Hong Kong. Some countries (such as Costa Rica) require that you have a healthcare provider’s note describing the medications and only bring enough for your stay. When traveling overseas, make sure to check out the laws, as exceptions arenotmade, even for people with cancer.
Traveling With Syringes
If needed for a medical condition, you may carry syringes and injectable medications on board the plane.It’s advisable to carry a healthcare provider’s letter indicating the necessity of carrying these medications since some checkpoints may require a healthcare provider’s recommendation (on letterhead stationery).
Medical Marijuana/CBD Oil
Though marijuana is now legal in many states, it is still illegal under TSA law (and federal law) even with a healthcare provider’s note, and could be risky. This is true for CBD oil as well. While the TSA does not search for marijuana, if detected they defer to local law enforcement. People with cancer should not travel with medical marijuana outside of the United States.
Chemotherapy Ports/PIC Lines/Ostomy Ports
If you have a port, ostomy, or other medical device, you will need to tell the TSA agent before going through screening. In some cases, a pat down may be required.
Head Coverings
Most of the time you will be allowed to wear a wig, scarf, or other head covering as you go through security as these are considered medical items, but may be subject to a pat down. You can request a private screening if you would like.
Breast Prostheses
Breast prostheses do not need to be removed, though you will need to tell the TSA agent before screening and rarely a pat down will be required.
Getting Around in the Airport and Boarding
Most airports provide transportation services beyond the security checkpoint. Check with the airports you will be visiting to see what services are available.
Advance Seating
Airlines usually announce advance seating for people with disabilities along with first class passengers. If you need assistance with boarding, this option may be helpful. That said, if you are able to move around it may be a good idea to instead move around and board towards the end of boarding, especially if you have a long flight. Prolonged sitting raises the risk of developing blood clots.
Reducing the Risk of Blood Clots
If you’ve had blood clots in the past, it’s crucial to talk to a healthcare provider about whether you should fly, and if so, what other measures you should take.
Oxygen Needs at Increased Altitudes
Flying results in a statistically significant decrease in oxygen saturation in the blood.
Even though cabins are pressurized on commercial flights, oxygen levels are similar to being at an elevation of 5,000 to 8,000 feet.
Oxygen levels may be lower than this on small planes. For those who are healthy, the body accommodates to this lower oxygen saturation quite well. But for those who have compromised lung function due to respiratory ailments,COPD,lung cancer, orlung metastases from other cancers, this can pose a problem.
If you suffer from a respiratory condition you may require supplemental oxygen for flyingevenif you do not require oxygen on the ground. Talk to a healthcare provider before flying. They may be able to make recommendations or offer tests to determine if you will require oxygen in flight. While commercial airliners carry oxygen, this is reserved for emergencies.
Estimating Your Need for Oxygen When Flying
For people who have COPD and cancer, or who aren’t certain whether oxygen may be required, a healthcare provider may be able to make a prediction based on specific tests. Researchers have developed a pre-flight algorithm that can be used to predict whether or not you may need in-flight oxygen.Since it’s been found that people with respiratory disease tend to underestimate their potential need for oxygen when flying, this is a helpful approach for making the decision more objective.
Traveling With Oxygen
Some airlines—but not all—allow portable oxygen to be carried on board the aircraft. According to TSA, if you are able to disconnect from oxygen it’s recommended that you check your oxygen as checked baggage.
While checking your oxygen is the ideal method of transport, if you require oxygen when on the ground it’s likely that you will require oxygen to an even a greater degree while flying.
If you plan on using portable oxygen in flight it’s important to call the airline ahead of time to understand any restrictions. It’s also necessary to check with the manufacturer of your oxygen concentrator to see if it is approved for flying.
As airlines differ in their regulations, it is important to check with your airline before flying, leave plenty of time to purchase or rent an approved oxygen device if needed and to receive a healthcare provider’s statement that you require in-flight oxygen.
Just as scuba divers may experience problems due to air pressure under water, changes in air pressure as a result of the increased elevation in flight can potentially cause problems for some people.
It’s estimated that gasses in body cavities can expand up to 30% with flying on a commercial airline.
For this reason, healthcare providers recommend not flying for a period of time after certain procedures. For example, it’s advisable not to fly for 10 days after a colonoscopy, for two weeks to four weeks after chest surgery, and up to six weeks after brain surgery.
Changes in air pressure can also cause swelling in the hands and feet. People withlymphedema, such as after breast cancer surgery, should talk to their healthcare providers before flying as to recommendations.Overall, wearing loose-fitting clothing and staying well hydrated is important in minimizing discomfort at an increased altitude.
Fortunately, the absolute risk is much lower (about one passenger infected for each ill passenger that boards the plane) and there are some things you can do to avoid exposure. Carrying hand sanitizer is one (of course, less than three ounces) that can be used to wipe down the tray table, seatbelt buckle, and bathroom doors. If you note someone coughing or sneezing, you could also let the flight attendant know that you are a cancer passenger and have him or her ask if anyone is willing to trade seats with you. Wearing a mask is also an option.
Flying During Chemotherapy (Between Chemotherapy Infusions)
If your white blood cell count is low due tochemotherapyor your cancer itself, talk to a healthcare provider about whether or not you should wear a mask. Also, ask them for recommendations about the right mask since some may offer more protection against germs than others.Chemotherapy-induced neutropeniaa low level of the type of white blood cells called neutrophils that fight infections) can be a challenge when traveling in many ways.
How to Lower Your Infection Risk During Chemotherapy
Vaccinations
Vaccinations may be required for travel to certain regions of the world. Live vaccines, such as the MMR, yellow fever vaccine, and oral typhoid can be dangerous for those who are immunocompromised. In contrast, some immunizations may be recommended, such as the injectable flu vaccine. It’s important to note that even if immunizations are considered okay, they may be less effective or ineffective for people undergoing treatment for cancer.
When you think about your upcoming trip you may picture yourself traveling as you did before cancer. Yetcancer fatigue, whether it is the fatigue the majority of people experience during treatment or that annoying fatigue that persists long after treatment is done, may leave you exhausted unless you plan for extra rest during your journey. You may find it helpful to write down the activities you wish to take part in at your destination, and then prioritize them as:
If you list out your planned activities in this way you will be more likely to participate in the activities you most wish to do, and will hopefully feel less guilty when you need to take a day or two and just rest.
Tips for Coping with Cancer Fatigue
A Word From Verywell
Remember that flying is only one part of your journey. Take the time to think through lodging, transportation, and other issues ahead of time so you are prepared to enjoy your time away.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moore DC.Drug-induced neutropenia: A focus on rituximab-induced late-onset neutropenia.P T. 2016;41(12):765-768.Transportation Security Administration.Disabilities and medical conditions.Transportation Security Administration.Medical marijuana.Stoller JK.Patient education: Supplemental oxygen on commercial airlines.UpToDate.Edvardsen A, Akerø A, Christensen CC, Ryg M, Skjønsberg OH.Air travel and chronic obstructive pulmonary disease: A new algorithm for pre-flight evaluation.Thorax. 2012;67(11):964-9. doi:10.1136/thoraxjnl-2012-201855OxygenToGo.Delta air lines process.Delta.POC approval and battery approval request.Bagshaw M, Illig P.The aircraft cabin environment.Travel Medicine. 2019;429-436. doi:10.1016/B978-0-323-54696-6.00047-1Perdue C, Noble S.Foreign travel for advanced cancer patients: A guide for healthcare professionals.Postgrad Med J. 2007;83(981):437-444. doi:10.1136/pgmj.2006.054593Phillips M, Saria M, Eisenberg A, Kelly DF, Barkhoudarian G.Safety of commercial airflight in patients with brain tumors: A case series.J Neurooncol. 2018;139(3):617-623. doi:10.1007/s11060-018-2905-6Breastcancer.org.Lymphedema.Mangili A, Gendreau MA.Transmission of infectious diseases during commercial air travel.The Lancet. 2005;365(9463):989-996. doi:10.1016/s0140-6736(05)71089-8Hertzberg VS, Weiss H, Elon L, Si W, Norris SL.Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights.Proc Natl Acad Sci USA. 2018;115(14):3623-3627. doi:10.1073/pnas.1711611115Lustberg MB.Management of neutropenia in cancer patients.Clin Adv Hematol Oncol. 2012;10(12):825-6.Ariza-heredia EJ, Chemaly RF.Practical review of immunizations in adult patients with cancer.Hum Vaccin Immunother. 2015;11(11):2606-14. doi:10.1080/21645515.2015.1062189Additional ReadingJosephs L, et al.Managing patients with stable respiratory disease planning air travel: A primary care summary of the British Thoracic Society recommendations.Prim Care Respir J. 2013;22(2):234-8. doi:10.4104/pcrj.2013.00046Thibeault C, Evans A.AsMA medical guidelines for air travel: Airline special services.Aerosp Med Hum Perf. 2015;86(7):657-8. doi:10.3357/AMHP.4224.2015
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moore DC.Drug-induced neutropenia: A focus on rituximab-induced late-onset neutropenia.P T. 2016;41(12):765-768.Transportation Security Administration.Disabilities and medical conditions.Transportation Security Administration.Medical marijuana.Stoller JK.Patient education: Supplemental oxygen on commercial airlines.UpToDate.Edvardsen A, Akerø A, Christensen CC, Ryg M, Skjønsberg OH.Air travel and chronic obstructive pulmonary disease: A new algorithm for pre-flight evaluation.Thorax. 2012;67(11):964-9. doi:10.1136/thoraxjnl-2012-201855OxygenToGo.Delta air lines process.Delta.POC approval and battery approval request.Bagshaw M, Illig P.The aircraft cabin environment.Travel Medicine. 2019;429-436. doi:10.1016/B978-0-323-54696-6.00047-1Perdue C, Noble S.Foreign travel for advanced cancer patients: A guide for healthcare professionals.Postgrad Med J. 2007;83(981):437-444. doi:10.1136/pgmj.2006.054593Phillips M, Saria M, Eisenberg A, Kelly DF, Barkhoudarian G.Safety of commercial airflight in patients with brain tumors: A case series.J Neurooncol. 2018;139(3):617-623. doi:10.1007/s11060-018-2905-6Breastcancer.org.Lymphedema.Mangili A, Gendreau MA.Transmission of infectious diseases during commercial air travel.The Lancet. 2005;365(9463):989-996. doi:10.1016/s0140-6736(05)71089-8Hertzberg VS, Weiss H, Elon L, Si W, Norris SL.Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights.Proc Natl Acad Sci USA. 2018;115(14):3623-3627. doi:10.1073/pnas.1711611115Lustberg MB.Management of neutropenia in cancer patients.Clin Adv Hematol Oncol. 2012;10(12):825-6.Ariza-heredia EJ, Chemaly RF.Practical review of immunizations in adult patients with cancer.Hum Vaccin Immunother. 2015;11(11):2606-14. doi:10.1080/21645515.2015.1062189Additional ReadingJosephs L, et al.Managing patients with stable respiratory disease planning air travel: A primary care summary of the British Thoracic Society recommendations.Prim Care Respir J. 2013;22(2):234-8. doi:10.4104/pcrj.2013.00046Thibeault C, Evans A.AsMA medical guidelines for air travel: Airline special services.Aerosp Med Hum Perf. 2015;86(7):657-8. doi:10.3357/AMHP.4224.2015
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Moore DC.Drug-induced neutropenia: A focus on rituximab-induced late-onset neutropenia.P T. 2016;41(12):765-768.Transportation Security Administration.Disabilities and medical conditions.Transportation Security Administration.Medical marijuana.Stoller JK.Patient education: Supplemental oxygen on commercial airlines.UpToDate.Edvardsen A, Akerø A, Christensen CC, Ryg M, Skjønsberg OH.Air travel and chronic obstructive pulmonary disease: A new algorithm for pre-flight evaluation.Thorax. 2012;67(11):964-9. doi:10.1136/thoraxjnl-2012-201855OxygenToGo.Delta air lines process.Delta.POC approval and battery approval request.Bagshaw M, Illig P.The aircraft cabin environment.Travel Medicine. 2019;429-436. doi:10.1016/B978-0-323-54696-6.00047-1Perdue C, Noble S.Foreign travel for advanced cancer patients: A guide for healthcare professionals.Postgrad Med J. 2007;83(981):437-444. doi:10.1136/pgmj.2006.054593Phillips M, Saria M, Eisenberg A, Kelly DF, Barkhoudarian G.Safety of commercial airflight in patients with brain tumors: A case series.J Neurooncol. 2018;139(3):617-623. doi:10.1007/s11060-018-2905-6Breastcancer.org.Lymphedema.Mangili A, Gendreau MA.Transmission of infectious diseases during commercial air travel.The Lancet. 2005;365(9463):989-996. doi:10.1016/s0140-6736(05)71089-8Hertzberg VS, Weiss H, Elon L, Si W, Norris SL.Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights.Proc Natl Acad Sci USA. 2018;115(14):3623-3627. doi:10.1073/pnas.1711611115Lustberg MB.Management of neutropenia in cancer patients.Clin Adv Hematol Oncol. 2012;10(12):825-6.Ariza-heredia EJ, Chemaly RF.Practical review of immunizations in adult patients with cancer.Hum Vaccin Immunother. 2015;11(11):2606-14. doi:10.1080/21645515.2015.1062189
Moore DC.Drug-induced neutropenia: A focus on rituximab-induced late-onset neutropenia.P T. 2016;41(12):765-768.
Transportation Security Administration.Disabilities and medical conditions.
Transportation Security Administration.Medical marijuana.
Stoller JK.Patient education: Supplemental oxygen on commercial airlines.UpToDate.
Edvardsen A, Akerø A, Christensen CC, Ryg M, Skjønsberg OH.Air travel and chronic obstructive pulmonary disease: A new algorithm for pre-flight evaluation.Thorax. 2012;67(11):964-9. doi:10.1136/thoraxjnl-2012-201855
OxygenToGo.Delta air lines process.
Delta.POC approval and battery approval request.
Bagshaw M, Illig P.The aircraft cabin environment.Travel Medicine. 2019;429-436. doi:10.1016/B978-0-323-54696-6.00047-1
Perdue C, Noble S.Foreign travel for advanced cancer patients: A guide for healthcare professionals.Postgrad Med J. 2007;83(981):437-444. doi:10.1136/pgmj.2006.054593
Phillips M, Saria M, Eisenberg A, Kelly DF, Barkhoudarian G.Safety of commercial airflight in patients with brain tumors: A case series.J Neurooncol. 2018;139(3):617-623. doi:10.1007/s11060-018-2905-6
Breastcancer.org.Lymphedema.
Mangili A, Gendreau MA.Transmission of infectious diseases during commercial air travel.The Lancet. 2005;365(9463):989-996. doi:10.1016/s0140-6736(05)71089-8
Hertzberg VS, Weiss H, Elon L, Si W, Norris SL.Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights.Proc Natl Acad Sci USA. 2018;115(14):3623-3627. doi:10.1073/pnas.1711611115
Lustberg MB.Management of neutropenia in cancer patients.Clin Adv Hematol Oncol. 2012;10(12):825-6.
Ariza-heredia EJ, Chemaly RF.Practical review of immunizations in adult patients with cancer.Hum Vaccin Immunother. 2015;11(11):2606-14. doi:10.1080/21645515.2015.1062189
Josephs L, et al.Managing patients with stable respiratory disease planning air travel: A primary care summary of the British Thoracic Society recommendations.Prim Care Respir J. 2013;22(2):234-8. doi:10.4104/pcrj.2013.00046Thibeault C, Evans A.AsMA medical guidelines for air travel: Airline special services.Aerosp Med Hum Perf. 2015;86(7):657-8. doi:10.3357/AMHP.4224.2015
Josephs L, et al.Managing patients with stable respiratory disease planning air travel: A primary care summary of the British Thoracic Society recommendations.Prim Care Respir J. 2013;22(2):234-8. doi:10.4104/pcrj.2013.00046
Thibeault C, Evans A.AsMA medical guidelines for air travel: Airline special services.Aerosp Med Hum Perf. 2015;86(7):657-8. doi:10.3357/AMHP.4224.2015
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