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Cancer, COVID-19 may make holiday travel even more challenging

Travel
Travel is a common concern for many cancer patients, especially those with compromised immune systems.

Holiday travel—whether you’re going across town or across the country by plane, train or automobile—requires a lot more thought this year, especially for cancer patients. Travel is a common concern for many cancer patients, especially those with compromised immune systems or attached medical devices that make navigating crowded terminals more difficult. This year’s added concerns around COVID-19 make the decision on whether to make a trip to a family gathering or holiday event that much harder.

Or for some, that much easier. The U.S. Center for Disease Control (CDC) has issued this alert to would-be travelers: “Travel increases the chance of getting and spreading the virus that causes COVID-19. Staying home is the best way to protect yourself and others. If you must travel, be informed of the risks involved.”

Some cancer patients have to travel— for treatments or other essential needs. Others may feel the need to get away, or can’t imagine making it through the holidays without taking part in the annual family get-together. But it’s now more important than ever for cancer patients to weigh the benefits of travel against the risks, says Jeffrey Metts, MD, MPH, Chief of Medicine at Cancer Treatment Centers of America® (CTCA), Atlanta.

“That’s something they have to weigh on a personal level, how meaningful that is to them,” he says. “If that’s the case and they make the decision to travel, then I think it’s about trying to travel as safely as they can.”

Safety, Dr. Metts says, means social distancing (staying at least six feet apart from others where possible), wearing a mask and washing your hands frequently. It’s the same advice the world has been living with for months, but it takes on added urgency away from home, as you spend time in crowded terminals or attend large gatherings with friends and relatives who aren’t part of your normal household.

The first step you should take before booking a trip is to talk with your care team about your plans. This will give your doctors and care team an opportunity to discuss potential concerns about your travel and to make recommendations—or advise you of necessary restrictions—should you travel.

Patients actively undergoing cancer treatments and those who have cancers that make them more likely to be immune-compromised are at higher risk if they are infected by COVID-19, Metts says. Examples include blood cancers, such as leukemia or lymphoma, and certain types of pancreatic cancer.

Cancer patients at lower risk include those with fairly stable diseases, such as a slow-growing prostate cancer, or who have handled cancer treatment well, or who have completed treatment.

While many travelers have to fly, Metts says those who travel by car have a lower risk of being exposed to the COVID-19 virus.

“To me, the bigger concern about air travel is navigating through the airport—the varying degrees to which people embrace or don’t embrace social distancing and masking. When you’re around a larger group of people, the risk goes up,” Mett says. “You might say traveling by car is going to be safer than going through an airport, assuming that you’re in a small group in your car and that no one in the car has COVID.”

Making your way through airport security

Going through Transportation Security Administration (TSA) checkpoints may present physical and emotional challenges for many cancer patients. Having an ostomy bag touched by security personnel or being asked to lift clothing in a crowded airport to expose ports, drains or bandages may prove embarrassing or traumatic for some.

The TSA offers help to passengers with medical conditions and disabilities through the TSA Cares program, complete with a toll-free helpline, 855-787-2227. Travelers can call to ask about alternative screening options for specific conditions, or to arrange for a trained passenger support specialist to help them through the security process.

The TSA offers these tips for people calling the helpline:

  • Be specific about the type of assistance you need.
  • Call 72 hours before your scheduled flight.
  • Know the helpline’s hours of operation. The line is open weekdays from 8 a.m. to 11 p.m., and from 9 a.m. to 8 p.m. on weekends and holidays.
  • Take advantage of TSA Cares’ social media platforms. Live assistance is available 365 days a year via Twitter using the handle, @AskTSA—weekdays from 8 a.m. to 10 p.m., and from 9 a.m.to 7 p.m. on weekends and holidays. Travelers may also send questions to TSA via Facebook Messenger on the agency’s Facebook page.
  • Notify TSA if a private screening was not made available to you, since all airports should have that capability.

TSA notification cards

Those who don’t call ahead, and who don’t want to discuss their medical condition in front of strangers, have another option: TSA notification cards. A traveler’s medical condition is written on the card and handed to the TSA officer. The card is designed as a way to inconspicuously alert TSA personnel of the traveler’s medical condition, allowing for the screening to take place in private. The card does not exempt anyone from being screened, and it won’t necessarily expedite the screening process, but it offers a discreet, respectful way to notify officers at the checkpoint that additional accommodations are needed.

Tips during airport screenings

The TSA offers these additional tips for cancer patients:

  • Before the screening process begins, let a TSA officer know if you have an external medical device, such as a port, a feeding tube, an insulin pump or an ostomy bag, and where it’s located. You may provide the officer with the TSA notification card, or other medical documentation if you prefer.
  • TSA has standardized screening procedures for various medical conditions and disabilities, including allowing a passenger with an ostomy bag to perform his or her own pat-down. The passenger’s hands would then be tested for traces of explosives. The passenger may still be required to undergo a standard pat-down on areas of the body that are not connected to the ostomy bag. TSA provides information specific to various situations.
  • If you want a companion or caregiver traveling with you to remain with you during the screening, let the TSA officer know. TSA gives you the right to have your travel companion witness your screening.
  • Breast prostheses and mastectomy bras are considered medically necessary and may be worn during screening. Patients will not be asked to remove them.

Air travel

Here are some tips to make your air travel easier:

  • Request a wheelchair in the airport if you’re not able to do a lot of walking.
  • Ask to board the plane early, or to have assistance when boarding.
  • Place all your medicines and medical equipment in your carry-on bags.

The National Foundation for Cancer Research, while recommending against air travel for people with compromised immune systems, offers the following tips for cancer patients who do fly:

  • Wear a face mask at all times—in the airport and on the plane—and have extras available in case your mask is lost or damaged.
  • Protect your eyes with safety goggles, glasses or sunglasses.
  • Have disinfectant wipes and hand sanitizer handy. Even though many airlines follow deep-cleaning procedures between flights, it’s still a good practice to wipe down your own area, including the tray table.
  • Wear comfortable pants and a long-sleeve shirt during the flight for increased protection. Remove your clothes as soon as possible after you get to your destination and wash them before wearing them again.
  • Clean your hands frequently, especially after touching the surface of other places on the airplane and before eating or drinking.
  • Consider upgrading to business or first class, if possible, to give yourself more personal space and lower the risk of being infected.

Precautions for a holiday gathering

The holidays usually revolve around a specific event, such as Thanksgiving dinner or a Christmas Eve celebration. These times can be as dangerous for the spread of COVID-19 and other diseases as the actual time spent traveling. The CDC has reported that many COVID-19 infections have been spread in such small gatherings.

Metts offers these additional tips for holiday get-togethers:

  • Have the gathering outside instead of inside.
  • Make sure all participants are wearing masks and social distancing.
  • Anyone experiencing symptoms or feeling ill should not attend.

“We recognize that not everybody is going to be able to adhere to all of these things. It’s a huge strain on people to face isolation, particularly over the holidays,” Metts says. “Balancing depression and isolation is part of that equation. I think being around people is healthy, but doing it smart is an important part.”

General travel tips

If you’re a cancer patient, there are other things you should consider when making a trip:

Have your medical records with you, to provide quick and accurate information if you need to go to a hospital or see a doctor while on vacation. The records should include your medication list, with dosages, and the surgeries you’ve had.

Bring your medicines in their prescription bottles, and if possible, have at least an extra two-week’s supply of each medicine in case your trip gets lengthened for unanticipated reasons, like being asked to quarantine.

Stay hydrated and nourished. Drink plenty of water. Pack your own food and beverages. Carry snacks with you, such as crackers or energy bars, that you can turn to if your energy is running low or you’re feeling nauseous.

Be aware of lengthy sun exposure, such as sitting on the sunny side of the car or being outdoors, and use sunscreen or clothing that covers your skin. This is especially important for patients undergoing chemotherapy or radiation treatment, since they may have increased sensitivity to sunlight.

Get recipes for comfort foods for your holiday meals.