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Medical repatriation of lung cancer patients

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Medical repatriation of lung cancer patients

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Travelling can be stressful in the best of circumstances, but it can be especially anxiety-inducing for those who have been diagnosed with lung cancer or are undergoing lung cancer treatment. A lung cancer diagnosis, on the other hand, does not have to spell the end of travel, whether for business or pleasure. You might even have to travel for specialized treatment. While visiting a distant location may have little or no effect on your health – in fact, getting away can help improve your mental health by providing a break from daily stresses – the safety of your flight is dependent on your current condition and whether you require ongoing medical care. Proper planning and preparation can help reduce stress and ensure a pleasant, risk-free trip. If you have lung cancer and are planning to travel, read these tips before you fasten your seatbelt!

The key points to remember about flying long distances with lung cancer:

  • Most cancer patients, including those with lung cancer, can travel without difficulty. However, there are times when not travelling is preferable.
  • People suffering from lung cancer may be unable to fly because changes in oxygen levels and air pressure at high altitudes can cause problems.
  • Acute breathlessness, DVT, or heart failure are all possible mid-flight complications.

Is it safe to fly with lung cancer?

According to NHS Choices, lung cancer is by far one of the most common types of cancer in the UK, with over 47,000 people diagnosed each year.

While in some cases, patients with lung cancer can travel without any complications arising, there are times when it is preferable not to travel. This explains why commercial airlines routinely require medical clearance for anyone suffering from a terminal or life-threatening illness, such as lung cancer.

lung problems

Air travel risk assessment in lung cancer patients is a complex clinical assessment that requires the collaboration of multidisciplinary oncology specialists. They consider the patient's physical capabilities, the distances involved, and the country of destination when certifying fitness to fly.

We discuss the difficulties of traveling with cancer in this factsheet, with a particular emphasis on air travel, as well as a review of the scientific literature, which we used to critically evaluate the current data on this topic.

Lung cancer: when is flying commercially discouraged?

Cabin pressure is lower at altitudes above 30,000 feet than at ground level. This reduces the amount of oxygen in people's blood. Even if you are normally healthy, if you do not get enough oxygen into your blood, you may feel ill, have a headache, and become sick.

People with cancer, particularly those with lung cancer, may be unable to fly because the changes in oxygen levels and air pressure at high altitudes can be life-threatening. If they are severely anaemic or have low oxygen levels in their blood due to a lung tumour, for example, their doctor may advise them not to fly.

commercial plane

Air pressure changes during a flight can also cause lymphedema. In patients who have had some of their lymph nodes removed, this is characterised by swelling in the arms, legs, or other parts of the body (lymphadenectomy).

Finally, long flights are already a risk factor for developing a blood clot, also known as thrombosis, and people with cancer, especially those who have recently had surgery or are receiving chemotherapy, are at an even higher risk. Because blood clots are potentially fatal, you may be unable to travel if you must sit for an extended period of time.

Flying with lung cancer: an increased risk of breathlessness

While in the air, patients with lung cancer are more likely to develop hypoxemia, or low oxygen levels in the blood, because of the high altitude. Most people will not experience any side effects, but you may experience a headache and nausea if you do.

Shortness of breath and other symptoms of acute hypoxemia cause less-ventilated areas of the lung to contract and redirect blood to better-ventilated areas of the lungs. However, if the lungs are not adequately ventilated in a chronic state, such as lung cancer, this can lead to pulmonary hypertension, which can overload the heart and cause heart failure. This illustrates how difficult it can be if you already have low blood oxygen levels and are considering flying for your next vacation.

patient in ambulance jet

Advice: It is recommended that you consult your GP or treating consultant before planning your trip, depending on your specific condition. If you are cleared to fly but require some breathing assistance, airlines may be able to provide additional oxygen facilities. There may be a fee for using oxygen on your flight, so check with the airline ahead of time to find out how much it will cost. Moreover, it is important to note that there is a limit on the amount of oxygen that you are allowed to carry mid-air. Visit the British Lung Foundation website for more information on flying with a lung condition.

A hypoxic challenge test determines the need for in-flight oxygen by exposing the patient to hypoxia at an altitude of 8,000 feet while measuring hypoxemia and assessing symptoms. This is simulated using a 15% oxygen mixture that the patient breathes for 20 minutes. Inflight oxygen is required if the arterial oxygen pressure is less than 6.6 kPa (50 mmHg) or the blood oxygen saturation is less than 85 percent.

When is flying contraindicated for lung cancer patients?

According to the British Thoracic Society guidelines, patients with significant respiratory symptoms, comorbidities exacerbated by hypoxemia, recent pneumothorax, risk of or previous venous thromboembolism, and a pre-existing need for oxygen should be evaluated for fitness to fly, which may include referral to a respiratory physician and possibly a hypoxic challenge test. Likewise, patients who have recently had a pneumonectomy or lobectomy may have a reduced pulmonary reserve that becomes apparent only during a flight.

Patients whose usual oxygen requirement flow rate at sea level exceeds 4 l/min will experience respiratory decompensation in flight. As a result, air travel is prohibited. Those with an inflammation of the lymphatic vessels should only fly if absolutely necessary, especially if their arterial oxygen pressure and respiratory function are compromised, or if they have superior vena cava obstruction, and they should have in-flight oxygen available. Patients with severe haemoptysis (coughing of blood) are at risk of exacerbation and should avoid flying.

Additional information: Large pleural effusions should be drained at least 14 days before the flight, and post-thoracocentesis chest imaging should be performed to check for pleural fluid reaccumulation or pneumothorax. Patients with a current closed pneumothorax should not fly on a commercial aircraft, whereas those with a previous pneumothorax should have a chest x-ray to confirm resolution before flying.

Why should lung cancer patients opt for an air ambulance?

Because a cancer diagnosis is already stressful, assisting patients who want to travel to new horizons or who require regular treatment overseas or in remote areas helps alleviate the burden of long-distance travel. Flying with lung cancer presents a unique challenge, especially for those who need to travel for medical treatment and necessitate complex on-going medical care.

Sophisticated and personalized medical care

As a result, when a scheduled flight is out of the question for someone with recently diagnosed lung cancer or with advanced lung cancer, they can still be transported in an ambulance aircraft. Our air ambulance services provide in-flight health monitoring and medical care for safe and timely patient transportation. This type of ambulance aircraft is usually only available for one patient. An experienced flight doctor and their team are in charge of the flight's medical safety. The medical equipment on board the ambulance aircraft is comparable to that found in a modern intensive care unit, allowing the patient to receive the best possible care.

ambulance jet

Sea-level flights

Furthermore, the ability to adjust cabin pressure to suit the patient's condition is the deciding factor that allows an ambulance flight for lung cancer patients to take place. The cabin pressure in our medical jets can be regulated using a combination of technical measures and reduced flight altitude so that it is similar to the air pressure on the ground. Because these so-called sea-level flight conditions have no effect on the existing air trapped in the pleural space, the patient’s breathing difficulties do not worsen.

Quick international flights

Moreover, depending on the urgency of the situation, our medical aircraft are usually ready to deploy the same day or the next day, anywhere in the world. Being significantly smaller than scheduled airliners, they are not dependent on major passenger airports. As a result, they can land in regional airports close to the patient's location or the receiving facility, thereby reducing the length of stressful ground transportation.

Bed-to-bed services

We understand that many people affected by lung cancer find it difficult to travel to and from different locations. Our bed-to-bed services were created specifically to assist people in getting to their treatment. We can pick up the patient in a ground ambulance from their hotel, or local hospital and transport them to the airport for their flight. When the patient arrives in their home country, another ground ambulance will be waiting to transport them safely to the destination hospital. It goes without saying that all of our ground transportation is accompanied by qualified medical personnel.

Contact us for an air ambulance today!

If you require an air ambulance for a long-distance patient transportation from anywhere in the world to the UK, please contact our friendly and multilingual team at any time of day or night. We are here to help you and organise your medical flight. We only require an initial contact and will handle the rest. Get in touch by: 

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