One week before my brother was set to study business in Singapore this summer, Dr. Metchler delivered his alarming news.
After nearly a year of clear MRIs, Dr. Metchler was seeing something new. The images he’d received in May seemed to suggest a new growth of malignant cells deep inside David’s brain.
My memory of this moment is admittedly fuzzy, but I’m sure our faces betrayed the panic and sadness we felt as we jumped to what felt like an obvious conclusion: summer in Singapore was out.
But Dr. Metchler was going on. “So, we’ll have to get you into radiation right away so that you can recover in time.”
“In time for what?” my brother asked.
“In time for you to go to Singapore.”
Downstairs, radiologist Dr. Dheerendra Prasad laid it out for us. “Look. David’s going to have this cancer forever. It’s going to be part of his life. But we can’t let it keep him from living his life. If we can help him to do what he wants to do, we have to do it.”
Dr. Prasad has treated thousands of cancer patients on multiple continents. We trusted his advice.
The plan was to give my brother gamma knife radiation, which takes one day and uses radio waves to de-activate a tumor without invasive surgery. It wouldn’t be easy: Dr. Prasad would have to pull some strings, and David would have to undergo having a metal device screwed into his skull to ensure the procedure’s accuracy. They wouldn’t have another chance this summer to get it right.
But unbelievably, one week later, as promised, my brother was able to board his plane and leave the country.
On David’s wrist was a medical bracelet inscribed with his name, treatment details and emergency contact numbers; in his bag were chemotherapy capsules, anti-seizure pills, and the name and number of one of Dr. Prasad’s colleagues in Singapore. David had cleared the trip with his health insurance provider, and carried cash in case of emergencies. These totems were to keep him safe, even while he was out of his family’s sight.
Fortunately for us, they did. David returned home in top form, eager to share his stories and photos of the chattering monkeys, sleek skyscrapers and food stands he saw. It was clear that the trip had strengthened his health, not hampered it. Dr. Prasad knew what he was doing.
Over the two years since my brother’s cancer diagnosis, we have found that good communication, adequate preparation, and a healthy level of tolerance for calculated risk makes travel not only possible, but advisable for those suffering from cancer. It’s just important to remember, and accept, that travel will not be as easy as it once was—for the person with cancer and his or her travel buddies.
This became evident on David’s first trip following his diagnosis, as he headed out on a road trip with our father to celebrate the end of his first round of radiation treatments. Then as now, David, his team and our family worked hard to prepare for the journey, doubling up on radiation procedures and coming in on Saturdays to make sure he got the medical treatment he needed in time.
The plan was for father and son to head from our dad’s home in Utah, out to Southern California and up the rocky Pacific Coast, camping as we have all of our lives. Right away, they realized that things were different this time.
David, normally the hardiest and most easygoing member of any expedition, was constantly exhausted. My father lined up a string of motels for them instead, and over time, learned to adjust to my brother’s slower daily rhythms.
“We managed to have a really good time anyway,” my father said later. “The key to success [is] flexibility.”
Undaunted, David returned from his trip ready to travel again. (You can watch a video David created from footage of that first trip post-cancer on YouTube.) Though his dream of studying abroad was nixed by his need for U.S.-based treatment, he has still been able to visit friends in the States, and make shorter trips abroad to Thailand, Vietnam, Cambodia, Guatemala, the Bahamas (and of course, Singapore).
Each trip has required a special plan, prepared in advance with the help of David’s doctors. As he says, “You just look at the worst case scenario and work back from there with your doctor.”
For example, many health insurance companies require patients to pay out-of-pocket for overseas expenses, so David works to save up money, and obtains additional insurance to cover emergencies. New locations can mean new threats to a compromised immune system, so he’s switched to a healthier diet to be in the best possible shape. His brain cancer puts him at risk of a seizure, so he always carries his medical records and emergency contacts along.
It’s a lot to handle for this once-carefree twentysomething, but David, to his credit, tends to focus not on his new limitations, but what he can still do.
“I feel lucky because my chemo is in capsule form. It just goes in my bag and nobody has to ask any questions about it,” David says. “There are plenty of other treatments that don't allow people to travel.” (Note: see below for suggestions for traveling if you have limited mobility or other special needs.)
In fact, caregivers may experience more stress about the prospect of traveling with cancer than the patients themselves. After all, if you’re constantly on the hook for your loved ones’ health, what happens when they’re out of your sight? As my mom herself will admit, “I’ve [had] some fear about some of his trips.”
However, she’s quick to add, “Seeing his happiness in all the photos, and the excitement as he has described his adventures, has taught me to appreciate the value of these ‘breaks.’”
My brother and I also see his travels as an extension of his treatment.
“It’s so important to get off the grid, away from machines and hospitals and everything else, and just be,” David says.
If happiness and laughter are the best medicine, I think that supporting my brother’s travel has been well worth the work and worry involved. And I feel incredibly grateful that David’s doctors not only permitted us, but encouraged us, to help him make the journey.
A Guide to Resuming Daily Activities (for Bone Marrow Transplant patients)
Travel can present all kinds of challenges for cancer patients, especially those with weak immune systems, low energy levels, or limited mobility. Attending crowded events, coming into contact with new animals or even sitting in hot tubs may present new risks for cancer patients. In this article, Roswell Park pros detail more specific dos and don’ts of staying healthy, whether at home or on the road.
An excellent overview of all the precautions to take before traveling, from securing additional travel insurance to carefully packing medications.
The experience of coping with cancer can be exhausting for every member of the family, including young siblings and adult caregivers. Camp Mak-A-Dream hosts no-cost retreats for all ages at a working Montana ranch. Travel scholarships to cover plane tickets are also available. On-site staff can administer oral chemotherapy, IV antibiotics, blood transfusions, platelets and blood tests. To apply, click here.
Traveling in the outdoors does come with challenges, but facing these challenges (safely) can build much-needed confidence for a person coping with cancer. This travel company specializes in structuring outdoor programs for young adults (aged 18-39). Medical attention is ensured, and activities are structured to help travelers with cancer regain their confidence. First-time participants travel for free; after that, participants can join by committing to raise funds for future participants to travel free. Travel scholarships to cover plane tickets are also available. In 2013, participants can travel to Patagonia, kayak Idaho’s Salmon River, or go surfing in Bali. To apply and view programs, click here.
Travel can help people of all ages figure out what’s important to them. This is especially important for those recovering from cancer. True North Treks aims to help young adults (ages 18-39) recovering from cancer with “re-entry” by leading outdoor programs that focus on meditation and self-discovery. Participants must be finished with active treatment and cleared for travel by their physician. Those without the means to pay for a trek can participate for free by committing to raise funds for another young adult to join in the future. In 2013, True North Treks will take participants to the Olympic Peninsula of Washington and the Upper Missouri River in Montana. To apply, click here.