Of all the times in your life when you feel the need for a holiday, coping with breast cancer is close to the top of the list. But gone are the carefree days of packing the suitcases and heading off into holiday-land. Now we have to think about medications, high insurance premiums and factor 50 (yes 50!) sunscreen. But fear not, pop the kettle on, make a nice cup of (green) tea and here are my top tips for planning your well-deserved holiday.
1. Medical advice. Always talk to your oncologist if you are planning a holiday during or shortly after your treatment. He/she will be able to advice whether and when you can go. Don’t rule out a holiday mid-treatment: your oncologist may agree to it. I know of people who did go abroad during their treatment.
2. Where to go? If your holiday was not booked before your diagnosis and you are now thinking of booking a holiday for during or after treatment, consider your limitations. It is worth considering things such as:
– The length of the flight
– Can you cope with airports and transfers?
– The quality of healthcare in the country you wish to visit
– The length of the journey
– If you need to have injections (you can’t have live ones for 6 months after chemo)
– Cost of travel insurance
– Your energy levels and what activities you will be doing
3. Flying. If you are flying then you need to think about:
a. Risk of lymphoedema from flying – the Cancer Research UK website says “Research suggests that flying does not increase the risk of lymphoedema developing.” But it suggests “When on a flight, move around as much as you can. Circle your ankles and move your legs and arms while you are sitting. It will all help lymph fluid to circulate. Deep breathing can also help.”
b. If you have developed lymphoedema before you travel then you will need to speak to your specialist about flying – you may need to wear your compression garment.
c. Talk to your oncologist about whether your chemotherapy treatment increases any chance of a blood clot (DVT) from flying and if so what precautions you need to take.
d. Your prosthesis – take a look at the Breast Cancer Care website for advice on traveling with a prosthesis.
e. If you are on tamoxifen it can slightly increase the chance of a blot clot so do all the anti-DVT exercises on your flight like clenching and unclenching your fists, moving your legs and walking up and down the aisle. More advice is on the NHS website.
4. Holiday insurance. You must get travel insurance if you are going abroad but a lot of people struggle to find reasonably priced travel insurance having been through (or during) breast cancer treatment. There are places out there which can provide quotes. I bought mine through www.insurancewith.com which was set up by a lady who struggled to find reasonable travel insurance without all the intrusive questioning when she had breast cancer. Read her story here.
5. EHIC. If you are traveling to Europe then remember to take your EHIC with you.
6. Local medical facilities. Find out where local healthcare facilities are close to where you will be staying.
7. Vaccinations. If you are travelling to somewhere for where you need vaccinations, check with your oncologist about whether it is ok to have these during or after chemo: some vaccinations carry a tiny amount of the live bacteria and these are not recommended within six months of chemo while your immunity is still poor.
8. Lymphoedema risk. If you are at risk of lymphoedema then you should think about :
a. If you are travelling to somewhere for where you need vaccinations do not have injections in your at-risk arm.
b. Take insect repellent to avoid the risk of insect bites (which can become infected and then lead to lymphoedema).
c. Take a water spray to keep your arm cool.
d. Carry a travel size first aid kit with antiseptic wipes, antiseptic cream, plasters and antihistamines to help deal with any minor injuries and prevent an infection.
e. Wear a medical ID bracelet to make it clear no BP, IV, needles in your at-risk arm.
f. Ask your GP to prescribe some antibiotics for you to take in case you hurt your arm and it gets infected.
g. Wear a high factor sun screen to avoid sun burn – which can lead to lymphoedema.
9. Chemo sensitive skin. If you have recently finished chemo, or still going through it, your skin will be more sensitive to the sun. As a result, you will need to take more than usual precautions in the sun:
a. Wear a high factor sun screen which protects against UVA and UVB rays.
b. Consider sensitive skin brands, paraben free or organic products which are gentler on your skin.
c. Cover up, stay in the shade and avoid the midday sun. You are susceptible to burning more easily.
d. Don’t forget to cover your head if you have thinned or no hair.
10. Post radiotherapy sensitivity. If you have just completed radiotherapy then there are other precautions to take in the sun. The area where you have been zapped will need to be covered from the sun. Use a high factor (50) sun screen even under clothes because some fabrics do not block the sun.
11. Swimming in the pool or sea? Check with your chemo nurses, radiotherapy nurses or oncologist for their advice about swimming on holiday if you have just completed, or are still going through treatment. The chlorine and salt can irritate your sensitive skin.
12. Post rads skin cream. If you have recently completed your rads then make sure you pack your skin cream that you have been using for the zapped area, plus any medications you have been prescribed. I used E45 and Aloe Vera gel.
13. Medication. Remember to take all your medicines and pack them in your hand luggage.
14. Taking Medicine abroad. The NHS website has some useful information about taking medications abroad.
I wrote this section whilst sitting on a sun lounger in Majorca (in the shade of course, with factor 50 slathered all over me): the warmth on my skin, the trees gently rustling in the warm breeze, not a cloud in the cobalt blue sky, the children playing in the pool, and a glass of rose next to me. I finished radiotherapy two and a half weeks ago, and chemo ended six weeks before that. For the first time in a very long time I am feeling relaxed and cautiously optimistic. And I am telling you all this so that if you are reading this during chemo, or during rads, just after your diagnosis or at any point on your breast cancer journey, you need to know that there will be a time when you feel physically and emotionally stronger: when you can venture out into the world again – be it a villa in Majorca, an all-inclusive in the Caribbean, the holiday of a lifetime in Africa, trekking across South America, a weekend in Blackpool, a break to the Lakes, a night away from the kids or camping in Devon.
HELPFUL RESOURCES AND MORE INFORMATION
Live Better With Cancer have some excellent advice for planning your trip during or after cancer treatment.
Packing list for a holiday abroad
· High factor, sensitive skin, paraben free or organic sun screen
· Aloe Vera gel, E45 cream or one of the other good moisturisers for the zapped areas.
· EHIC card
· Travel insurance
· Mini travel first aid kit (wound wipes, antiseptic cream, plasters, antihistamines)
· Hand cream
· Body moisturiser
· Medications (such as tamoxifen)
· Insect repellent