Question asked by: 
Date asked: 
Feb 2016
What precautions should I take before a holiday?
Preparation is key
Response by Dr Vicki Barber, GP

A – Establish your safest time if you're having chemo. Ovarian cancer is often treated by cycles of chemo and you may have neutropenia and therefore be more prone to infection at different times in your cycle. Your oncologist will be able to help you with this.

B – If you're traveling in the UK, you can potentially have treatment at any local NHS clinic or GP surgery whether it is an emergency or not. If you need ongoing injections etc., these can be arranged with another hospital or facility in advance.

C – If you are traveling abroad, the European Health Insurance Card entitles you to the same treatment as a resident of the European country you're going to and does cover ongoing health problems. Injections and treatment are also possible on this card. It doesn't cover medical repatriation though.

D – Obtain a copy of your medical summary; your GP can provide you with a print out. Hospital letters can be useful too. Most clinics send you copies automatically after your appointments or these can be obtained from your surgery. Consider translating any important information into the language of the country you're going to. From the 1st of April 2016, you can register with your GP to access your record online. You will need a password and you will be able to see your summary record. This will list your medication, medical problems and allergies. You may be able to see your consultations, hospital letters and full test results depending on what your GP's arrangements are

E – Vaccinations need time to create immunity and should be discussed with your practice nurse as soon as you're planning your trip. If you are having chemo, you are unlikely to be able to have live vaccines e.g. MMR or yellow fever. But you can still have inactivated ones e.g. Hep A, although they may not work as well.

F – Ovarian cancer is associated with a higher risk of Deep Vein Thrombosis. Travel over four hours on a plane or restricted coach etc. is riskier. You can have heparin injections to counter this and you should also speak to your oncologist.

G – Flights too soon after surgery can cause a change in intra-abdominal pressure, check with your surgeon.

H – Anaemia as a result of chemo can cause shortness of breath. Oxygen levels drop at altitude. If you are considerably anaemic and need oxygen, you can travel but check with your oxygen supplier and your airline.

I – Make sure you have valid travel insurance that includes repatriation in case of illness.

H – It may be worth you taking antibiotics with you if you are immunosuppressed. You may have to obtain a private prescription for these from your GP if they are specifically for travel.

I – Have a travel kit for over the counter medications for diarrhoea, travel sickness, temperatures etc.

During your holiday wear comfortable, loose clothes for travel. The typical ovarian cancer operation scar benefits from loose clothing with elasticated waists, which help lower the risk of DVT. If you've had lymph nodes removed, you are at risk of lymphoedema. Your cancer nurse specialist should be able to help you with special stockings.

Make sure you keep hydrated as this reduces your risk of deep vein thrombosis. Avoid water or ice unless it is bottled and/or you know its source. Don't go barefoot to avoid cuts to feet and infection risk. If in doubt, take a thermometer and check your temperature is less than 38c if you're worried about infection. Carry identification (such as a passport), insurance card and brief medical notes around with you. A medic alert bracelet or necklace with a summary on can be useful.