18: Travel & Prostate Cancer

TRAVEL & PROSTATE CANCER 18

There are many reasons men choose to travel before, during and after cancer, whether it is for a holiday or a family emergency. Whilst travel is possible most of the time, there are some extra things to think about if you have cancer.

Initial Considerations

• Are you fit to travel? o You should ask your doctor if you are at a good point in your treatment journey to travel o Do you feel up to travelling? • Will you need any special medicines or equipment? • Think about travel insurance o This may be difficult, so start to look for appropriate insurance providers early o This may be more costly

Common Questions o You may need to provide the company with a letter from your doctor o 1. Can I live without my prostate? Yes, a man can live without his prostate. You MUST tell the insurance company even if your cancer treatment is active surveillance

The whole prostate may be removed for o Shop around to get a reasonable quote but check what they cover cancer or part of it when it is enlarged and Travelling in the UK causing symptoms. 2. What conditions other than cancer can affect the prostate?• Take a doctor’s letter with you, which summarises your condition and treatments • Note your NHS number • Benign (non-cancerous) enlargement called BPH • Take contact details of your key worker • Prostatitis - infection or inflammation of the prostate. • Carry a copy of your latest prescription with your current medication listed 3. Do biological women have a prostate? • A list of any allergies you may have No. 4. How big can the prostate get?• If you have mobility problems, take your Blue Badge with you There is no real upper limit. • A small sized prostate has a volume of 30-40ml • A medium sized prostate has a volume of 40-80ml • A large sized prostate has a volume greater than 80ml.

Travelling abroad with medication

• Carry a copy of your latest prescription with you - include generic names • Know your allergies if you have any • Take enough medicines to last you the entire holiday • Check the expiry date of the medication for the whole trip • If you are on hormones, ask your GP to change your preparation to either a 3 monthly or a 6 monthly preparation to give you time between injections to travel • Carry all your medication in labelled containers to minimise the risk of problems with customs • It is useful to carry 2 sets of medications with you. Keep one in your hand luggage and the other in the suitcase in case one gets lost • Keep a copy of a doctor’s letter on you in case you need to explain your medication at customs • Think about when to take your medicines whilst abroad – think about sticking to a routine or perhaps the same time as you took them at home • Some countries have restrictions on taking drugs like morphine, so you may need to check with the airline and the relevant embassy about the rules in advance of travelling

Travelling abroad with equipment

• If you have problems with your waterworks, such as incontinence following surgery, then you may be using pads regularly. Remember to pack enough for the entire trip.

Carry some in your hand luggage and extra in your suitcase • If you have a catheter, take enough to last you the whole trip. You may need to carry a doctor’s letter explaining what the equipment is for. Make sure you have some in your hand luggage. Don’t forget to pack drainage bags • If you are performing self-catheterisation, it is useful to carry a doctor’s letter explaining this • Pack spares of all your equipment

Safety when travelling

• If you are travelling very soon after a scan involving a radioactive tracer (for example a Bone or PET scan), then you may still have minute doses of radiation in your body after the scan. This can be picked up by sensitive airport radiation monitors.

Take your scan appointment letter with you to show the staff that any activation is due to the drug that has been injected • If you have had brachytherapy, then the seeds may set off the sensitive radiation sensors. You should have been given a card, which you should carry with you • Taking a flight shortly after surgery can increase your risk of getting a blood clot in your legs, called a deep vein thrombosis (DVT). Having a pelvic cancer, like prostate cancer, can also increase the risk of getting a DVT, especially on a long-distance flight, car, train or bus journey. Consider the following: o Ask your specialist if it is safe to travel o Consider compression stockings – you may need to check if you can wear these with your specialist o Take regular exercise such as walking up and down aisles. If you are on a long car journey, plan frequent trips to stretch your legs and walk around o Drink plenty of water regularly o Minimise your intake of alcohol • Drugs like chemotherapy increase your risk of getting an infection o Check with your specialist about the best time to travel o Wash your hands regularly Common Questions o 1. Can I live without my prostate? Carry a hand sanitiser and use it regularly when you touch surfaces such as door handles and cash machines Yes, a man can live without his prostate. The whole prostate may be removed for cancer or part of it when it is enlarged and • You may be more sensitive in the sun whilst on holiday due to treatments o causing symptoms. Think about protecting your skin with high sun protection factor (SPF) creams 2. What conditions other than cancer can affect the prostate? of at least SPF 30 and apply them generously 15-30 minutes before going out in the sun • Benign (non-cancerous) enlargement called BPH t SPF 15 offers approximately 93% protection against UV rays • Prostatitis - infection or inflammation of the prostate. t SPF 30 offers approximately 96% protection against UV rays 3. Do biological women have a prostate? t SPF 60 offers approximately 98% protection against UV rays

No. o Protect your lips with a lip balm with SPF of at least 30 o Wear a wide brimmed hat in the sun 4. How big can the prostate get? There is no real upper limit. o • A small sized prostate has a volume Cover as much of your skin as possible, especially areas like your shoulders that can burn easily • of 30-40ml A medium sized prostate has a volume o Wear loose clothing of 40-80ml o • A large sized prostate has a volume greater than 80ml. Wear sunglasses to protect your eyes from UV radiation – wraparound sunglasses are safer

o Try to avoid the sun by sitting in the shade, especially when the sun is at its strongest between 11am and 3pm • If you have waterwork problems such as urgency, it may be useful to sit in an aisle seat and in a row nearer the toilets on flights and trains. You can also get a Toilet Card, which is a card that should give you access to toilets in shops and service organisations that are not normally available to the public o Prostate Cancer UK has an Urgent Toilet Card o Macmillan offers a Toilet Card o The Urology Foundation has a pee card o Bladder and Bowel UK has a Just Can’t Wait Card

Eating & Drinking Safely on Holiday

• Drink clean water • Where possible, drink only bottled water and check that the seal has not been tampered with • Avoid ice cubes in drinks • Avoid unpasteurised milk • Avoid ice creams as they may have been made with unpasteurised milk • Only eat cooked food • Avoid eating street foods unless you know that they have been cooked fresh in front of you • Try not to eat leftovers or reheated food • Avoid eating foods that have been exposed to flies • Dry packaged and factory sealed foods such as crisps are usually safe to eat • Ensure fruits are washed in clean and safe water before you eat them • Avoid salads

Other Practical Points

• Speak to your doctor about whether you need vaccinations and if they are safe to have, depending on where you are travelling to • Take a first aid kit • If you are going to a tropical country that places you at a high risk of insect bites, then consider the following:

o Take insect repellent sprays and creams with you o Use a plug-in repellent in your room, especially at night o Cover your legs and arms at night o Sleep under a mosquito net • Keep a copy of your prescription, your doctor’s letter summarising your condition and treatments and travel insurance documents on you in your hand luggage and separately in your suitcase • Alternatively store your medical information in your smartphone but also keep hard copies • Keep a list of close family or friends and your key worker with your passport in case you fall ill, and they need to be contacted

Common Questions

1. Can I live without my prostate? Yes, a man can live without his prostate. The whole prostate may be removed for cancer or part of it when it is enlarged and causing symptoms. 2. What conditions other than cancer can affect the prostate? • Benign (non-cancerous) enlargement called BPH • Prostatitis - infection or inflammation of the prostate. 3. Do biological women have a prostate? No. 4. How big can the prostate get? There is no real upper limit. • A small sized prostate has a volume of 30-40ml • A medium sized prostate has a volume of 40-80ml • A large sized prostate has a volume greater than 80ml.