NEPA Vital Signs - Winter Spring 2019 - 7

WINTER/SPRING 2019

Is Travel Out of the Question?
hen beginning/undergoing cancer treatment, many
patients are concerned about how their diagnosis and
treatment may affect their daily activities and way of life.

Although it is not the first thing most consider, some patients might be wondering what their diagnosis means
for their ability to travel away from home. Whether it is a pre-scheduled vacation or a "can't miss it" event like
a wedding, there are several factors that should be examined when someone living with cancer is considering
domestic or international travel. In general, this is a conversation that should always be had between a patient,
their treating doctor, and sometimes a travel medicine specialist. However, there are a few considerations that
may help patients in navigating such a conversation and thinking about which questions they want to ask.

Deciding to delay: four scenarios
In some cases, choosing to pursue significant travel plans may mean delaying surgical, radiation or chemotherapy
treatments for cancer. In very general considerations of whether such a delay would be reasonable, it may be
helpful to consider a few of the following scenarios:

SCENARIO I: Active treatment or high risk
for complications

with these diagnoses should generally begin treatment
sooner rather than later, even if this means having to
Patients who are actively receiving radiation or che- cancel plans to travel.
motherapy treatment should generally not stop their
treatment so that they can take a trip. Similarly, patients
whose cancer puts them at risk of serious complications SCENARIO III: Initiating treatment for less
like severe immune suppression, spinal cord compression, time sensitive cancers
or spread of the cancer to the brain or other critical organs
Conversely, delaying the start of treatment by a few
should also prioritize their treatment over travel plans. weeks might NOT make a significant difference in a few
other types of cancer. Patients with lower risk prostate
cancer2 and patients receiving radiation therapy as
SCENARIO II: Initiating treatment for time adjunctive therapy for early stage breast cancer7 may have
sensitive cancers
more leeway in deciding to attend to other plans before
Research has shown that starting treatment promptly immediately starting their treatment. Again, always check
after receiving a diagnosis may be more important for with your treating oncologist first.
some types of cancers than others. One misconception
about certain types of cancer is that if your diagnosis is
at an early stage, it is not as important to begin treatment SCENARIO IV: Immune system suppression
promptly. To the contrary, in many early stage cancers,
The disease of cancer itself and many of the drugs
outcomes can be less favorable if treatment is delayed used to treat it can lower the immune system's ability
because the cancer may have more opportunity to increase to fight off infections. Some patients with immune supin size and spread to other parts of the body, which can pression may wish to delay travel until their immune
make it much more difficult to manage and treat.6
system has regained function. In general, immune compromise tends to be longer lasting following treatments
Delaying treatment may increase the risk of unfavorable for blood-borne cancers (like leukemia) than for solid
outcomes for localized small cell lung cancer 1, head and tumors, but this can vary widely based on individual
neck cancers 5, cervical cancer3, and anal cancer 4. Patients factors and treatment regimens.5 Depending on how and

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VITAL SIGNS
NEPA Vital Signs - Winter Spring 2019

Table of Contents for the Digital Edition of NEPA Vital Signs - Winter Spring 2019
