Traveling With Cancer: A Guide for Oncologists in the Modern World

PURPOSE: Travel for patients with cancer has become more achievable because of gains in quality of life and overall survival. The risk assessment of these patients is complex, and there is a paucity of data to which clinicians can refer. We present the challenges of traveling with cancer and a review of the literature. METHODS: A review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. A search using the terms ”cancer,” “advanced cancer,” ”metastases,” “brain edema,” “lymphoedema,” “pneumothorax,” ”pleural effusion,” “pericardial effusion,” pneumonitis,” “hypoxia,” “end-of-life,” and “shunt,” combined with “flying” and “air travel,” was conducted. The PubMed and Cochrane databases were searched for English-language studies up to December 2018. Studies, case reports, or guidelines referring to travel in the context of adult patients with malignancies were included. A total of 745 published articles were identified; 16 studies were included. An inclusive approach to data extraction was used. RESULTS: There were no specific criteria to deem a patient with cancer fit to travel. Neurologic, respiratory, and cardiac implications, and time from recent surgery or procedure need to be considered There was a lack of high-quality studies to inform decisions, but the British Thoracic Society and Aerospace Medical Association Medical Guidelines included recommendations for fitness to fly for patients with cancer. CONCLUSION: In the absence of large prospective studies, individual fitness to travel should be assessed on a case-by-case basis, bearing in mind that maximizing a patient’s ability to safely travel is an important goal for many individuals with cancer.