Information for people affected by cancer who are planning to travel

Transcription

Information for people affected by
cancer who are planning to travel
Contents 1
Contents
About this booklet
2
How cancer can affect travel
5
Healthcare
17
Planning your trip
29
While you’re away
59
Further information
67
2 Travel and cancer
About this booklet
This booklet aims to help if you, or someone
close to you, has cancer and would like to
travel. It also covers issues that may affect you if you’ve had cancer treatment in the past.
There are many different reasons why you might want to travel.
You may want to go away to relax, see new places, meet friends or family, or perhaps to work.
Travelling can be a positive and fulfilling experience. But when
you have cancer, there are a few more things you will have to
think about when planning a trip. It’s important that you (and any
health professionals looking after you) think about any possible
health problems and check thoroughly whether you are fit to
travel. With careful planning, you’ll be able to look forward to
and enjoy your trip.
In this booklet, we’ve included comments from people affected by cancer, which you might find useful. Some names have been changed. Some are from the Macmillan online community
(visit macmillan.org.uk/community) and the website
healthtalkonline.org Others are from a video we have on
our website about travel and cancer. You can watch it at
macmillan.org.uk/travel
About this booklet 3
This booklet is divided into four sections:
•• how cancer can affect travel
•• healthcare – in the UK and abroad
•• planning your trip
•• information for while you’re away.
It aims to help you avoid or overcome any problems, so you can
enjoy your travels and have a stress-free break.
At the end of this booklet there are some useful addresses and
websites (see pages 72–83). There’s also a page to fill in with any notes or questions (see page 84).
If you’d like to discuss this information, call the Macmillan Support Line free on 0808 808 00 00, Monday–Friday,
9am–8pm. If you’re hard of hearing you can use textphone 0808 808 0121, or Text Relay. For non-English speakers,
interpreters are available. Alternatively, visit macmillan.org.uk
If you find this booklet helpful, you could pass it on to your family and friends. They may also want information to help them support you.
‘When they tell you you have
cancer, your mind goes off
because you are trying to put all of your affairs in order. I thought, wow, I want to get out there and see places I
haven’t been to. I want to travel.’
Alan
HOW CAncER
CaN AFFeCT
trAVEL
Cancer treatment
6
Travelling during treatment
8
Cancer and air travel
9
Medical conditions
10
6 Travel and cancer
Cancer is not a single disease with a single cause and a single
type of treatment. If you, or someone close to you, has only
recently been diagnosed with cancer, you may still be learning
more about the condition.
Cancer and its treatments can have physical effects that may limit your ability to travel. For example:
•• Lung cancer can cause a cough or breathlessness.
•• A cancer that’s spread into the lymph glands may cause parts of the body to swell up. This happens because the flow of lymph fluid is blocked (this is known as lymphoedema).
•• Cancer in a bone may make the bone weak. It can increase the chance of the bone breaking (a fracture).
It’s important to speak to your doctor before you make any plans
to travel. They can tell you whether your cancer or its treatment
could make travelling unsafe. They will tell you how you need to
prepare if you do travel.
We can send you information about your type of cancer. Call our
cancer support specialists on 0808 808 00 00.
Cancer treatment
Common treatments for cancer include surgery, radiotherapy,
chemotherapy, biological therapy and hormonal therapy. The aim of treatment will either be to cure a cancer, to prevent
cancer coming back, or to control its symptoms for as long as
possible and to improve quality of life.
How cancer can affect travel 7
Cancer treatments may cause short-term physical problems, such as sickness or diarrhoea. Some treatments can make your skin more sensitive to the sun. Occasionally, treatments can
cause long-term physical problems, such as lymphoedema.
Some treatments, such as chemotherapy and radiotherapy, can make you very tired (fatigued) both during and after
treatment. Tiredness may limit the travelling you can do or the amount of activity you can manage while you’re away.
You may find our booklet Coping with fatigue
useful. It has helpful tips on how to plan activities
and save energy.
How surgery can affect travel
Some types of surgery for cancer may cause permanent changes
to the body. For example:
•• Treatment for colon cancer can include removing part of the
bowel and creating an ileostomy or colostomy. This won’t stop you from travelling, but you will have to think carefully
about your trip. Most hospitals have specially trained nurses,
called stoma care nurses, who can help you after your
treatment. They can give you advice about travel insurance (see pages 37–41) and travel certificates (see page 52), supplies and any dietary issues you may have while you’re
away. See pages 50–52 for more information on travelling
when you have a stoma.
8 Travel and cancer
•• Breast cancer treatment may involve removing a breast
(mastectomy). You should still be able to travel, but we can
help you find organisations that supply bras, swimsuits
and holiday clothes for women who’ve had a mastectomy.
Contact our cancer support specialists on 0808 808 00 00
or use our online organisation search at macmillan.org.uk/
organisationsearch
If you’ve had any type of surgery or have any physical condition that could affect your ability to travel, there are many organisations that can help and support you. See pages 72–77 for some of these.
Travelling during treatment
You may be able to have a holiday while you’re still in the middle
of treatment – for example, between courses of chemotherapy
treatment. In this situation, it’s very important to discuss your
treatment with your cancer specialist beforehand. They can help
you plan the best time for your holiday to make sure it doesn’t
interrupt your treatment. You can talk through any possible
problems and how you may be able to deal with them. We can send you more information about cancer
treatments and their side effects.
You may only want to travel within the UK during your treatment
and for some time after treatment, because it may be difficult to
get insurance for a holiday abroad. See pages 37–41 for more
information on getting travel insurance.
‘I had two week-long holidays in
between chemo sessions, but only in
the UK. My oncologist was quite happy
for me to do this, but made sure I had
details of the nearest A&E hospital and
a local GP, and to continue taking my
temperature and being vigilant with
avoiding infections.’
Jacqui
Cancer and air travel
Some people with cancer may, under particular circumstances, be advised not to travel by air. This is because oxygen levels and
air pressure change at high altitudes. You may be advised not to
fly if you:
•• are breathless
•• are anaemic (have a low number of red blood cells)
•• are at risk of developing increased pressure or swelling in the brain (cerebral oedema) due to a brain tumour
•• have recently had surgery to your chest
•• have recently had brain surgery
•• have problems with your ears or sinuses – pressure changes
may make your symptoms worse
10 Travel and cancer
•• have recently had surgery or a medical procedure. This is
because flying can introduce gas into the body that may expand to cause pain and stretch your wound. Speak to your
cancer specialist about how long you should avoid air travel for after surgery.
See pages 30–33 for more information about air travel.
Medical conditions
Low immunity
If leukaemia, lymphoma or recent cancer treatment have given
you a weak immune system, you may need to take a supply of
antibiotics with you. Your GP can give you a prescription but they
may want to speak to your cancer specialist before they do this.
Blood clots
Travelling, especially flying, can increase the risk of developing
a blood clot. Some people with cancer have a higher risk of
developing a blood clot (deep vein thrombosis or DVT). There are
a number of possible reasons for this.
People with cancer often have slightly higher numbers of cells in
their blood that help it clot (platelets). People with cancer may
also have slightly higher amounts of clotting factors. Clotting
factors are proteins that are produced naturally in the body and
work with the platelets to form blood clots and prevent bleeding.
The risk of developing a blood clot is higher in people with
particular types of cancer. Some types of lung, stomach or bowel cancers produce a substance called mucin, which can raise the risk of clots. People with acute myeloid leukaemia (AML)
or pancreatic, ovarian or womb cancers have a slightly raised risk too.
Some cancer treatments can increase the risk of blood clots. This includes some types of hormonal therapy, such as tamoxifen
for breast cancer and stilboestrol for prostate cancer. It also
includes some types of biological therapy, including thalidomide
or lenalidomide for multiple myeloma.
If you’re worried you may be at risk of developing a blood clot
when you travel, talk to your cancer specialist. They can advise
you on whether you need to have treatment to help prevent blood clots.
Tips to prevent blood clots
•• Ask your cancer specialist whether you should wear special
compression socks when travelling.
•• Wear loose-fitting, comfortable clothing.
•• Drink plenty of water during flights. Don’t drink too many
caffeinated or alcoholic drinks, as they can make you
dehydrated.
•• On any type of journey, it’s helpful to walk around or do regular leg exercises.
Lymphoedema
People with lymphoedema (swelling of a part of the body) may
find that travelling on long flights (more than around four hours)
temporarily makes it worse. This is due to low cabin pressure,
poorer air quality and keeping still for long periods during the
journey. The tips on the following pages may help prevent any
problems. You can get a leaflet with more detailed information
about travel and lymphoedema from the Lymphoedema Support
Network (see page 74).
We have a booklet called Understanding
lymphoedema, which we can send you.
You can also get more information about lymphoedema
from the Macmillan Lymphoedema Academy at macmillanlymphoedema-academy.org.uk
Tips for before you travel
•• Don’t have vaccinations in a limb that’s affected with
lymphoedema. If you have had surgery or radiotherapy to your armpit, it may be best to avoid vaccinations in that arm even if you have no signs of lymphoedema.
•• Talk to your doctor about taking antibiotics with you in case you get an infection.
•• Wear a compression sleeve if the flight is over four hours, even if you haven’t worn one before.
Tips for during your journey
•• If you have to or plan to wear a compression sleeve or stocking,
have it checked to make sure it fits properly. Wear it throughout
your journey and for a few hours after landing.
•• If you have lymphoedema in a leg, wear well-fitting, supportive
shoes. Don’t take them off during the journey as this can
increase swelling.
•• Wear loose clothing that doesn’t restrict the affected limb.
•• Don’t wear tight belts.
•• Gently exercise the limb and move around as much as possible
while you’re travelling. Ask for an aisle seat so you can exercise
the arm more easily.
•• If you do lymphatic drainage massage, try to do this frequently
during the journey.
•• Drink plenty of water to prevent dehydration.
•• If your luggage is heavy, use a luggage trolley or ask a porter
for help. This will avoid strain on your body, including your back
and affected arm.
Tips for once you have arrived
•• Avoid strenuous exercise that you’re not used to. Gentle, repetitive exercise of the affected limb (such as swimming or cycling) can be helpful.
•• Avoid sunburn. Don’t forget you can still burn through
compression garments, particularly synthetic ones. Your lymphoedema nurse or specialist can advise you which garments offer the most sun protection.
•• If you have lymphoedema of the leg, never go barefoot. Always wear some sort of footwear – even in the sea.
•• Protect against insect bites during the day and at night by using insect repellent spray or cream that contains a high level of DEET (diethyl-m-toluamide).
•• Keep your skin clean and check it reguarly for any sign of infection.
•• Treat any cuts, scratches and bites quickly with an antiseptic
such as Savlon® or TCP®.
‘If I was travelling somewhere abroad away
from major cities or resorts in a country whose
language I did not speak, I would take with
me a brief summary of my condition and
current treatment in the language of that
country, just in case of emergency.’
Janet
HE ALTHCaRe
Healthcare in the UK
18
Healthcare abroad
19
Going abroad for treatment funded by the 25 NHS or Health and Social Care Board
Healthcare in the UK
If you’re a UK citizen and you need treatment while travelling in
the UK, you can be treated free of charge by the nearest NHS
or Health Service hospital. It can help to have a letter from
your cancer specialist with you. The letter should describe your
condition, including details of any medicines you’re taking and
information on how to deal with any potential medical problems.
It may be helpful to wear a medical alert badge or pendant
with emergency contact numbers attached, especially if you’re
travelling on your own. You can get these from some high street jewellers and chemists. They may also be available at your GP surgery.
If you’re taking prescription medicines and run out of supplies
while on holiday in the UK, you may be able to get emergency
supplies of non-chemotherapy drugs without a prescription. A community or supermarket pharmacy may be able to help, but will charge for this service. If you run out of chemotherapy
drugs, you will need to contact the place where you were
prescribed the drugs for advice.
If pharmacies can’t help you and you live in England, you may
be able to go to an NHS walk-in centre. They may be able to
organise a consultation with a GP. You could also contact a GP practice directly.
•• To find where your nearest NHS services are in England,
you can use the online ‘service search’ at nhs.uk/
servicedirectories/Pages/ServiceSearch.aspx
•• To find local health services in Scotland, visit nhs24.com/
findlocal
Healthcare 19
•• For information about local health services in Wales, visit
nhsdirect.wales.nhs.uk/localservices/searchlocalservices
•• To find where your nearest health and social care providers are in Northern Ireland, visit servicefinder.hscni.net
Healthcare abroad
Travelling in the European Economic Area (EEA) or Switzerland
The European Health Insurance Card (EHIC) entitles UK residents
to free or reduced-cost emergency treatment when temporarily
visiting the European Union (EU) and certain other European
countries (see pages 21–22 for a list of the countries where the
EHIC is valid). The EHIC has replaced the E111 form, which can
no longer be used.
The EHIC:
•• allows you to be treated in the same way as a resident of the country you’re visiting – this may not be the same as the
care you’d expect to get from the NHS or Health Service
•• can be used if you need to have ongoing treatment while you’re abroad, such as regular injections
•• covers treatments that are needed during your trip for chronic or pre-existing conditions.
The EHIC should allow you to receive emergency medical
treatment and, in some cases, the types of ongoing treatment
mentioned above. The EHIC can’t be used instead of travel
insurance. It will not cover any private medical costs, travelling to a country for health treatment, medical evacuation or help
getting back to the UK.
You should also buy travel insurance (see pages 37–41 for more
information on getting travel insurance).
Some countries expect you to pay your bill when you’re treated
and then claim a refund with your EHIC. You should try to apply
for a refund before you return to the UK. Each person travelling
needs to carry an EHIC, including children. To get cards for
children, you should list them as dependents when you apply for your own card. Each country’s healthcare system is different,
so your EHIC may not cover everything that would be free on the NHS or Health Service.
Applying for an EHIC
The EHIC is free and renewals are also free. You should avoid
any websites that charge to apply for or renew an EHIC for you.
You can apply for the EHIC if you are legally living in, and
settled in, the UK. If you usually live in the UK but are not a
national of the UK, another EEA country or Switzerland, you
will need to apply by post. You will need to include proof that
you are ordinarily resident in the UK (see nhs.uk/nhsengland/
healthcareabroad/ehic for more information).
You can apply for an EHIC:
•• online at nhs.uk/ehic
•• by post, using an application form you’ve downloaded from the website
•• by phoning 0845 606 2030.
Healthcare 21
For each person who needs a card, you will need to give their:
•• name
•• date of birth
•• national insurance or NHS number (England and Wales), CHI number (Scotland) or Health and Care Number (Northern Ireland).
Your card will normally arrive within seven days. When it arrives,
store it somewhere safe and secure. Keep it with your passport
while you’re travelling.
The EHIC is valid in the following countries:
•• Austria
•• France
•• Belgium
•• Germany
•• Bulgaria
•• Greece
•• Croatia
•• Hungary
•• Cyprus
•• Iceland
•• Czech Republic
•• Ireland
•• Denmark
•• Italy
•• Estonia
•• Latvia
•• Finland
•• Liechtenstein
•• Lithuania
•• Romania
•• Luxembourg
•• Slovakia
•• Malta
•• Slovenia
•• The Netherlands
•• Spain
•• Norway
•• Sweden
•• Poland
•• Switzerland.
•• Portugal
Your EHIC is only valid for five years before it needs to be
renewed. It’s a good idea to make sure yours hasn’t expired
before you travel.
More information about the EHIC and health advice for travellers can be found on the NHS Choices website at nhs.uk/healthcareabroad or on the NI Direct website if
you live in Northern Ireland at nidirect.gov.uk/travel-healthand-the-european-health-insurance-card-ehic
Countries with mutual healthcare agreements with the UK
Some countries outside the EU have mutual healthcare
agreements with the UK. These countries will provide free or
reduced-cost emergency medical treatment to people from the UK. You’ll be treated in the same way as a resident of that country. This may differ from what you’d expect from the NHS or Health Service. Because the agreements do not cover every situation, you will still need to get travel insurance. For more information visit nhs.uk/healthcareabroad
Healthcare 23
The following countries have mutual healthcare agreements with the UK:
•• Anguilla
•• Kyrgyzstan
•• Armenia
•• Macedonia
•• Australia
•• Moldova
•• Azerbaijan
•• Montserrat
•• Barbados
•• New Zealand
•• Belarus
•• Russia
•• Bosnia and Herzegovina
•• St Helena
•• British Virgin Islands
•• Serbia and Montenegro
•• Falkland Islands
•• Tajikistan
•• Georgia
•• Turkmenistan
•• Gibraltar
•• Turks and Caicos Islands
•• Isle of Man
•• Ukraine
•• Jersey (not Guernsey)
•• Uzbekistan.
•• Kazakhstan
To claim free or reduced-cost treatment in these countries
you‘ll need to prove you are a UK resident. Usually this involves
showing a UK passport (see nhs.uk/healthcareabroad for
more information).
Countries with no healthcare agreements with the UK
In countries that aren’t covered by the EHIC and where there is
no mutual agreement with the UK (including Guernsey, the USA,
South America, Africa, most of Asia and Turkey), you’ll have to
pay the full cost of any healthcare. Taking out comprehensive
travel insurance is particularly important if you’re travelling to
these countries.
The high commission, consulate or embassy of the country you’re
visiting should be able to give you information on the healthcare
services available. The Foreign and Commonwealth Office
website at fco.gov.uk has details of where you can find these
and British embassies when you’re abroad.
Getting a refund on your treatment
You may need to pay for treatment while you’re abroad and then
claim this money back. The process for getting a refund will vary
depending on your situation. You’re likely to need the original
invoices and documents from your treatment to make a claim.
If you’re covered by travel insurance (see pages 37–41), your
insurance provider will guide you through this process. If you
have planned treatment abroad in advance (see pages 25–27),
you may need to get reimbursement from your local health
commissioner when you return to the UK.
If you have an EHIC and are travelling in a country where it’s
valid, you should try to claim any refunds before you return home.
There’s information about how to do this in different countries at
nhs.uk/healthcareabroad
This website also has information about reclaiming costs in all countries that have mutual health agreements with the UK. To make a claim on your EHIC once you return to the UK, contact the Overseas Healthcare Team on 0191 218 1999.
Healthcare 25
Repatriation
The EHIC and some travel insurance policies won’t pay to
transport you back home in an emergency (repatriation).
A company called Swiss Assist offers a service where it will fly you
home in an ambulance jet, if required, for a fortnightly, monthly
or annual membership fee. They cover Europe and some other
countries. More information can be found on the website at
swissassist.ch
Going abroad for treatment funded by the NHS or Health and Social Care Board
If you’re thinking about going abroad to have medical treatment
funded by the NHS or Health and Social Care Board, you’ll need
to discuss your plans with your doctor first.
Your doctor will refer you to your local health commissioner, who will discuss the options available to you. In England, this will be your local clinical commissioning group (CCG) or NHS England. In Wales, this will be your local health board
or Health Commission Wales. In Scotland, it will be your NHS
Board. And in Northern Ireland, it will be your Health and Social
Service Board.
If you’re going to a European Economic Area country or to
Switzerland, you can apply for NHS funding in one of two ways. You can either apply by using an S2 form or under Article
56 of the Treaty on the Functioning of the European Union. There are important differences between the two ways of
applying. Your health commissioner will advise you about which is the most suitable for you. If you’re paying for treatment
privately, you won’t need to apply for funding.
S2 form
The S2 form entitles you to the same state-funded care as a
person living in the country you’re visiting. You may need to
contribute towards the cost. You may get this money back while
you’re abroad, or you may get it back when you return to the UK.
The S2 is only available in cases where there’s a need for specific
treatment. You can’t get one just in case you might need it. The S2 does not cover private treatment.
To get an S2, you need to apply to your local health
commissioner. They will need to be sure that:
•• an NHS or Health Service consultant has recommended that
you are treated abroad
•• the treatment is available under the other country’s state health scheme
•• the costs of sending you abroad are justified
•• you are entitled to NHS or Health Service care.
If the health commissioner agrees to fund your treatment, they will give you an S2. It can take a few weeks, sometimes
months, until this happens. If your local health commissioner
refuses to support your application for an S2, you can appeal. If you choose to appeal, you should seek legal advice first.
Healthcare 27
Article 56
Article 56 allows you to apply to get money back for the cost of
planned treatment that you’ve already had in a European country.
The treatment must be available through the NHS or Health and Social Care Board. The amount you will receive back will only be up to as much as the treatment would have cost on the
NHS or Health Service. Unlike the S2, Article 56 claims can be
used to get money back for state or private sector treatment.
However, you need to pay for the treatment first and claim
the cost back after the treatment is finished. Your local health
commissioner will need to help you apply. There’s no guarantee
that the local health commissioner will refund your treatment.
PLANnING
YOUR TRIp
Travel and transport services
30
Travelling by air
30
Travelling by sea
33
Travelling by car
33
Travel insurance
37
Vaccinations
41
Taking medicines abroad
45
If you have a stoma
50
Bowel or bladder problems
53
Checklist – things to consider before your travel
56
Travel and transport services
Most travel companies (including airlines, ferry companies and
coach tour operators) have a medical officer. This person can
help you decide whether or not it’s safe and practical for you to travel. The medical officer can be contacted before you leave
and can help you plan your journey. They can also be contacted
during the trip.
You can get information from your travel company about:
•• arranging early boarding
•• preparing special foods (if you have specific dietary needs)
•• booking a wheelchair.
Travelling by air
Help at the airport
Disabled facilities vary between different airports and airlines. Find out from your airport or airline if they have the facilities you need, such as a toilet with disabled access. If you have
problems with your mobility, you have certain rights when using transport at European airports. These include:
•• help at arrival points, such as at terminal entrances, transport interchanges and in car parks
•• help getting to the check-in desk
•• help with registration at the check-in desk
•• help with moving through the airport, including to toilets if needed.
Planning your trip 31
You can travel with up to two items of mobility equipment free of charge. This won’t count as part of your baggage allowance.
You need to tell your airline at least 48 hours before your flight if you will have specific needs during travel.
Airport security
Security searches are carried out on all passengers and baggage
before they’re allowed to board the aircraft. This includes
searches of disabled people and mobility aids. Some people,
including people who have an external breast prosthesis or
stoma, may be concerned about how body searches and
scanners will affect their privacy and dignity when travelling.
If you have an external prosthesis or a stoma, you may want to
tell the security staff as you enter the security area of the airport.
This may mean you are less likely to be searched than if you
hadn’t told them. It may be helpful to carry a letter from your GP or cancer specialist that explains your situation.
Your stoma care nurse or your equipment supplier should be able to provide you with a travel certificate that explains your
situation in different languages. This is also available from ostomy support groups (see pages 72–75).
In some cases, people will be randomly chosen to have a body
search. If you are asked to have a body search, you can request a security officer of the same sex to do this. Any body search
is carried out in a private, lockable room and you won’t be left
alone with just one security officer. A friend or family member
may come with you.
Body scanning
Full body scanners are used at some airports, including some
airports in the UK. Travellers are selected at random to have a body scan with security scanning equipment. You will not be
able to fly if you refuse to have a body scan during an airport
security check.
The purpose of a body scanner is to show whether you have
hidden weapons or banned items. But your image will also show
if you have a stoma, implant or external prosthesis. Security staff
have been trained to handle sensitive issues around surgery and
treat passengers respectfully.
You should expect that:
•• You’ll be picked out at random for a scan or if you’ve activated
a metal detector.
•• You can ask for a security officer of the same sex to be the one
who checks your scan on the screen.
•• You’ll have the scan in the security area, with a member of
airport staff present. It will take just a few seconds.
•• After the scan, only you and a security officer will see a
mannequin-style diagram on a small screen. No bodily features
or skin will be seen. They won’t be able to identify you from the
scanned image and you won’t meet the security officer.
•• Your scan will be permanently deleted after it’s been assessed
by a security officer.
The policy on body scanning may vary at airports in different
countries outside of the UK.
If you are travelling to a country where you don’t speak the
language, you may want to contact the embassy for the country you’re visiting to find out their policy on body scanning.
You may also want to carry a card with a brief description of your condition, including information about your prosthesis or
stoma if you have one.
Travelling by sea
Disabled people or people with reduced mobility who need help
when in a port or onboard a ship have the right to free help. This includes help when you’re getting on and off the ship. You should tell the carrier, travel agent or tour operator when you
book, or at least 48 hours before you travel, if you need this help.
Travelling by car
The following information applies to car travel in the UK. To find out more about driving and travelling by car abroad, visit gov.uk/driving-abroad
Motability Scheme
Under this scheme, people who receive the higher rate of the
mobility component of Disability Living Allowance, the enhanced
rate of the mobility component of Personal Independence
Payment, or the War Pensioners’ Mobility Supplement can get help to buy or hire a car, scooter or powered wheelchair.
Contact the Motability Scheme to apply (see pages 74–75).
Our booklet Help with the cost of cancer has more
information about welfare benefits.
Road tax exemption (free tax disc)
You may be entitled to a free tax disc if you’re disabled. This is
available to people who receive the higher rate of the mobility
component of Disability Living Allowance, the enhanced rate
of the mobility component of Personal Independence Payment,
the War Pensioners Mobility Supplement or Armed Forces
Independence Payment. If you receive the standard rate of the
mobility component of Personal Independence Payment, you may
qualify for a 50% discount on the cost of your tax disc.
For more information, call 0300 123 4321, textphone 0300 790
6201 or visit gov.uk/vehicle-exempt-from-car-tax
If you live in Northern Ireland, visit nidirect.gov.uk/taxing-yourvehicle-in-the-disabled-tax-class
You can also get renewal forms from your local Post Office®.
Blue Badge scheme
If you have a severe mobility problem and can’t use public
transport, you may qualify for a permit under the Blue Badge
scheme. This lets you park without a time limit or charge in on-street restricted-parking zones, disabled public parking bays or areas restricted by yellow lines.
The permit is free to individuals (but not organisations) in Wales. It generally costs £2 in Northern Ireland, £10 in England and up
to £20 in Scotland.
The scheme doesn’t cover private car parks, although they may
provide their own disabled parking spaces. You don’t have to be
the driver to qualify for a Blue Badge.
Visit gov.uk/blue-badge-scheme-information-council
to search for information about the scheme from your local
authority. You can apply through your local council or by visiting
gov.uk/apply-blue-badge
In Northern Ireland, visit nidirect.gov.uk/the-blue-badgeparking-scheme
Tunnels, bridges and toll roads
Blue Badge holders and other disabled people pay a reduced
rate or no fee at some river crossings, bridges and tunnels. In most cases, you have to apply in advance to get a concession.
Toll concessions can change, so check before you travel. Contact
your local authority for advice.
London congestion charge
There’s a charge to travel within the congestion charging zone in central London at certain times. If you have a Blue Badge, you can register so you don’t have to pay the charge. However,
you will have to make a one-off payment of £10 for this discount.
Seat belts
If you can’t wear a seat belt for medical reasons, you can get a
medical exemption certificate from your doctor. There are also
aids and adaptations available that make it easier for people with
disabilities to wear a seat belt. For more information, speak to
your doctor.
Bus, coach and train fares
There are special rates for bus, coach and train travel for older
people and some people with disabilities. People of state pension
age in England, people aged over 60 in Scotland and Wales, and
eligible disabled people, can apply for a bus pass. This gives you
reduced price or often free travel on local buses. Contact your
local council or authority for details.
You may be able to save up to a third on rail fares with a
Disabled Person’s Railcard or a Senior Railcard (for people
over 60). Check at your local train station for details, or visit
nationalrail.co.uk
If you live in Northern Ireland and are over 60 or disabled, you may be entitled to concessionary travel on buses and trains.
Ask at your local bus or train station or visit nidirect.gov.uk
Transport services
The British Red Cross can provide personal transport services
across the UK. These services include providing a companion for a journey on public transport or a private car with a driver. A contribution towards costs is usually asked for, but no one will be refused a service because they can’t pay. See page 72 for contact details for the British Red Cross.
In Wales, St John Wales can provide transport for people who
have difficulty using public transport or their own vehicles. See page 75 for contact details for St John Wales.
In Scotland, a ‘Safe Journey Card’ can be downloaded from
firstgroup.com/safejourney. This card can be used to let bus
drivers know you have mobility problems.
In Northern Ireland, anyone receiving the mobility component
of Disability Living Allowance can travel at half the usual cost
through the Concessionary Fares Scheme organised by Translink
(see page 75 for contact details).
Costs for extra services may vary from one service provider to
another, so it’s best to get several quotations. When you book
your trip, it’s important to give clear, detailed information about
your health to the travel companies. This way, your condition can
be taken into account from an early stage and any necessary
adjustments can be made in advance. It’s a good idea to carry
a full summary of your medical condition with you. Ideally you
should also carry a copy that’s translated into the language of the country you’re travelling to.
If you have mobility problems, there are many services available
to help you. The Disabled Living Foundation can give you
practical advice about equipment for independent living (see page 72 for contact details).
Additional costs
Travel can be very expensive to arrange if you have mobility
problems. Potential costs can include:
•• transport to and from the airport or other arrival point
•• expenses for a travel companion or helper
•• payment for extra seats if a stretcher is needed (or a reclining
first class seat if this is cheaper or recommended)
•• transporting any equipment that you may need.
You may want to contact the travel company in advance so you
can plan for any extra costs.
Travel insurance
Although your doctor may think you’re well enough to travel, you may find it difficult to get travel insurance. This is because
some insurance companies think that people with cancer are
more likely to need medical treatment abroad. This is not always
the case and, ideally, companies should base their decisions on
your individual situation. One of the most common problems
people affected by cancer have is being charged a higher
premium (the amount charged for the insurance policy).
Different insurance companies use different factors to decide
whether they will give insurance to people with cancer. You may
need to phone a few different companies before you find one that will give insurance cover for your particular situation.
If you’re affected by cancer, you may wish to get travel insurance
from a company that specialises in travel insurance for people
with medical problems.
Some companies say you must pay a set amount towards the cost of any treatment you need. This is known as an excess. The excess may range from £50 to a few thousand pounds, so it’s worth shopping around. The chances of you getting travel
insurance may depend on the type of cancer you have or have
had and how it’s likely to affect you in the future. You should be
ready to answer questions from the insurance company about
your cancer. They may ask about the stage and grade of your
cancer, when you were diagnosed and for information about
any treatment you’ve received. If you’re unsure about any of this
information, your cancer specialist will be able to help you.
People who have advanced cancer or are currently having
treatment are less likely to get travel insurance. People who’ve
had a blood transfusion in the last six months may also have
problems getting travel insurance. Companies are often less likely to insure patients for travel to countries where healthcare is expensive, such as the USA and Canada.
‘We opted for a policy that covered everything except
the cancer or anything related to it. We had already
discussed the holiday with the oncologist and she
was ok with the trip and thought the risk was small.’
Debbie
If you become ill, there may be other costs that travel
insurance policies may or may not cover. These may include
accommodation, living expenses or the cost of bringing people
you’ve travelled with back to the UK. Some companies will insist
that family and friends who travel with you are insured under the same policy.
Our booklet Getting travel insurance when you have been
affected by cancer has more information and contains a list of
companies that consider offering travel insurance to people with
cancer. You can also view this list online at macmillan.org.uk/
travelinsurancecompanies
We can’t promise you will be able to get travel insurance from
one of the companies we list. People affected by cancer have
recommended these companies because they were able to
get insurance from them. But where one person has a good
experience with a company, another person may have a bad one.
We do not endorse insurance companies and brokers or their
products, or search for them.
We have a travel insurance blog on Macmillan’s
online community, which gives updates and tips
about getting travel insurance. Visit tinyurl.com/
travelinsuranceblog
If you have a stoma
People who have an ileostomy or an ileo-anal pouch can get
special insurance by contacting IA (The Ileostomy and Internal
Pouch Support Group – see page 74 for contact details). People with an ileo-anal pouch can also contact the Red Lion Group for advice on insurance – call 0844 576 3029
quoting reference RL1.
Those with a colostomy can contact the Colostomy Association,
and those with a urostomy can contact The Urostomy Association.
See pages 50–52 for more information about travelling when you
have a stoma, including information about travel certificates.
Vaccinations
Vaccinations can reduce your chance of getting certain infections.
If you’ve had a particular type of cancer or cancer treatment, you may not be able to have some of the vaccinations you need
to travel to some parts of the world. This may affect your choice
of holiday location.
Live vaccines
Live vaccines use tiny amounts of the live virus or bacteria.
The virus or bacteria used in these types of vaccines have
been changed so they don’t cause the infection. The vaccines
encourage the immune system to develop white blood cells
(antibodies) to protect against the infection. If you have a weak
immune system, you should not have live vaccines. Your immune
system may be weakened if you:
•• are currently having or have recently had chemotherapy or radiotherapy
•• have had a solid organ transplant or bone marrow transplant
•• are having immunosuppressive treatment.
Your immune system can also be weakened by high doses of
steroids or immunosuppressive drugs that are used to treat
certain autoimmune diseases. Live vaccines can be given after
completing immunosuppressive treatments, but you will need to speak to your cancer specialist first. You may need to have a letter from your specialist to confirm that you are able to have live vaccinations.
Vaccinations given as live vaccines include:
•• BCG (tuberculosis)
•• MMR (measles, mumps and rubella)
•• oral polio (not currently given in the UK)
•• oral typhoid
•• yellow fever.
Some people may need to avoid live vaccines for the rest of their lives. This includes people who have had lymphoma or leukaemia, or if their cancer is related to the HIV infection.
Inactivated vaccines
Inactivated vaccines aren’t dangerous and are safe after cancer
treatment. But they may be less effective in people who have low
immunity. If you are having chemotherapy, you should discuss
with your cancer specialist when would be the best time to have
the vaccination. Inactivated vaccines include:
•• cholera
•• diphtheria, tetanus and polio
•• haemophilus influenza B (Hib)
•• hepatitis A
•• hepatitis B
•• influenza
•• Japanese encephalitis
•• meningococcal meningitis
•• pertussis (whooping cough)
•• pneumococcal
•• typhoid injection
•• tick-borne encephalitis
•• rabies.
Re-vaccination
If you’ve had high-dose chemotherapy and a stem cell transplant,
you may not be immune to diseases you were previously
vaccinated against. You may need to be re-vaccinated after your treatment has ended.
The vaccinations you may need for your holiday will depend on
where you’re going. If you have lymphoedema in an arm, or are
at risk of developing it in an arm due to breast cancer surgery or
radiotherapy to an armpit, it’s important to make sure you have
vaccinations in the other arm.
Splenectomy
If you have cancer that affects your spleen, you may have had
your spleen removed (this is called a splenectomy). You may
be more likely to get some types of infection. Pneumonia and
meningitis vaccinations are recommended. Before travelling, your doctor should give you a supply of antibiotics and tell you
when to take them. Malaria can be especially severe if you have had your spleen removed. In this case, where possible,
you should avoid travelling to areas where malaria is common.
Malaria is a risk in many tropical and sub-tropical parts of the
world. This includes parts of Sub-Saharan Africa, South America,
South Asia and the Pacific region.
If travel is essential, you should make every effort to avoid
infection, using the ABCD of malaria prevention:
•• Awareness of risk
•• Bite prevention
•• Chemoprophylaxis (anti-malarial tablets)
•• prompt Diagnosis and treatment.
It is important to use insect repellent (DEET – diethyl-m-toluamide
based repellents are recommended), wear suitable clothing and, if appropriate, use mosquito nets to reduce the risk. No anti-malarial tablets provide 100% protection.
You can get more information about vaccinations at nhs.uk/
planners/vaccinations or by contacting MASTA (see page 74).
Taking medicines abroad
If you’re taking regular medicines, make sure you have enough to
last for your whole trip. You should make sure you have enough
in case your return is delayed by a couple of days. If you’re going
for a long time, check whether you can get the medicines you
need in the country you’re going to, as your doctor can normally
only prescribe a limited amount.
If a course of medication you’re taking is due to end when you’ll
be abroad, speak to your GP before you travel. They may be
able to increase your prescription, if necessary. If you’re already
abroad and run out of supplies, you may be able to register with
a local doctor, or buy medicines from a pharmacist. The British
embassy or high commission in the country you’re visiting will be
able to advise you.
Medicines tend to have at least two names: the name of the drug
(its ‘generic’ name) and the name of the brand. For example,
the generic drug anastrozole is sold under the brand Arimidex®.
Brand names can vary between countries, so it’s a good idea to
keep a record of generic names.
‘Because I carry drugs and I worry
someone might steal them, I tend to
take a batch in my suitcase or rucksack
and some in my hand luggage because
I’m frightened I’m going to lose my
luggage and that’s going to mess up
my holiday.’
Alan
Taking your medicines at the right time
If you’re travelling across international time zones, this is likely to
affect the time you take your regular medicines. If there is only
a couple of hours’ difference in time, you may want to continue
taking the medicines at the same times you have been (UK time).
If there are several hours’ difference from UK time, you may end
up taking your medicines at inconvenient times of the day or
night. It may be easier to gradually change the times you take
your regular medicines to fit in with the local time. Your doctor or
pharmacist can help you plan how to change the times you take
your medicines.
Restrictions on some drugs
Some countries limit the amount of particular drugs that can be
taken into the country. It’s important to check with the country’s
high commission or embassy about any restrictions they may
have on taking certain medicines in or out. If you need to take
some types of medicine (such as painkillers like morphine) in
or out of the UK, you’ll need a letter from your doctor. This will
also be helpful if you have to take syringes, needles or portable
medicine pumps with you. The letter should include:
•• your name and address
•• your date of birth
•• your dates of travel in and out of the country
•• the country you’re visiting
•• the medicines you’re taking, the doses and total amounts you’re taking with you.
If you’re travelling for more than three months, you may need a
medicines licence from the Home Office so you can take certain
drugs out of the country. If you’re not sure whether you need this
for your medicines, check with your doctor.
Getting a personal medicines licence
To get a personal medicines licence, your doctor has to complete
a form and send it to the Home Office Drugs Licensing and
Compliance Unit. You can download a form at homeoffice.gov.
uk/drugs/licensing or ask for one to be sent to you by phoning
020 7035 6330. The Home Office will usually need at least
two weeks to process your application. You can get information
about the maximum amounts of controlled drugs that can be
taken out of the UK from the Home Office Drugs Licensing and
Compliance Unit (see page 74).
Travelling with medicines
You should carry all medicines, covering letters and licences for controlled drugs in your hand luggage, as customs officers will usually need to see them. Make sure you keep medicines in
their original packaging. With medicines that are not controlled
drugs, it may help to carry one set in your hand luggage and
another in your suitcase, so that if one set goes missing you still
have the other.
It can also help to keep a list of the medicines you’re taking,
along with information about the doses. This will help you get
replacements if you lose them. Always use the generic name of
the medicine, as brand names can vary from country to country
(see page 45).
Check medication rules in your destination country
Some countries don’t allow certain medication to be brought in. Check any restrictions with the country’s embassy or high commission.
Liquid medicines in hand luggage
Most non-medicinal liquids in your hand luggage are restricted to
a maximum of 100ml. However, liquid medicines and liquid diets
that are needed during the flight can be taken on a plane without
restriction. You can bring more than 100ml of a liquid medicine,
but you’ll need to check this with your airline and departure
airport before you travel. You will also need to bring a supporting
document from your doctor or another relevant medical
professional. This could be a letter or a signed prescription.
There’s more information about carrying liquids in your hand
luggage at gov.uk/hand-luggage-restrictions
Keeping medicines cool
The shelf life of some medicines can be reduced if they are
not kept at the correct temperature, so ask your pharmacist
for advice. If you’re travelling with medicines that need to be
kept cool, you can get small cool bags from your chemist for
the journey. It will help to check with your hotel whether or not
there will be a fridge in your room. If not, ask them if there’s
somewhere secure where your medicines can be stored and kept cool.
Oxygen
Oxygen for travel in the UK is provided by the NHS or Health
Service. You just need to let your usual oxygen provider (if you
live in England or Wales) or your GP (if you live in Scotland or
Northern Ireland) know the details of your holiday. You will need
to tell them the dates you are going and returning and where you will be staying, and they will arrange everything for you.
If you think you’ll need oxygen during a flight, you’ll need to
contact the airline well before your journey to check their policy
on taking oxygen while you’re on the plane. There may be a cost for this.
If you need oxygen for use throughout your holiday, you will need
to make arrangements for the oxygen to be provided before you
travel. Oxygen suppliers in the UK will only provide oxygen for
travel and stays within the UK, although they may have details of
overseas oxygen providers that you can contact.
If you are travelling in Europe, oxygen can be arranged through
the European Health Insurance Card scheme (see pages 19–22).
You will need to have a valid EHIC and you will have to use the
authorised oxygen company for the country you are travelling to.
If you are travelling outside Europe, you will need to contact an oxygen company that supplies the country you will be visiting.
To find an oxygen provider, you could contact the British consulate
in the country you are travelling to or search the internet.
For more information, visit the Travel section of the British Lung
Foundation website at blf.org.uk/travel
Hospice and support services abroad
The Hospice Information Service (Help the Hospices – see page
73) can give you information about hospice and palliative care
services abroad.
If you have a stoma
If you have a urostomy, a colostomy, an ileostomy or a
tracheostomy, there may be certain things you need to think about before you travel.
Getting information
Your stoma nurse can give you advice about issues such as:
•• your diet while you’re abroad
•• activities such as swimming
•• the effect of high temperatures on the adhesive used to secure the stoma bags.
If you have a urostomy, colostomy, ileostomy or tracheostomy,
there are specialist organisations that can give you information
specific to your condition. See our list of useful organisations on
pages 72–77 and our list of helpful leaflets, booklets, fact sheets
and websites on pages 78–83.
Stoma supplies
Having a stoma shouldn’t stop you from travelling, but you may
need to plan your trip more carefully. It’s important to make sure
you have stoma supplies. You should divide your stoma supplies
between your bags, in case one gets lost.
Make sure you take enough stoma supplies with you. It helps to
take more than you think you’ll need, in case you need to change
your bag more often than usual or in case you’re away for
longer than planned. This is especially important if you’re going
somewhere with a hot climate. Some suppliers will deliver abroad.
It’s helpful to check whether your supplier offers this service. You should store stoma bags in a cool place out of direct sunlight.
Colostomy and ileostomy
If you have a colostomy or ileostomy, it’s important to be careful about what you eat the day before you travel. Avoid spicy foods, fizzy drinks, alcohol and foods that cause wind. If you’re flying, the changes in air pressure may cause
problems with increased wind in the stoma bag. It may help to add an extra flatus filter, which helps wind to escape, on to the bag. Your GP or stoma nurse can advise you on anti-diarrhoea tablets (such as loperamide) and rehydration
powders (such as Dioralyte®) you can take in case you
have diarrhoea.
These tablets and powders can be bought in a chemist or
prescribed by your GP. If the diarrhoea is severe or continues for more than 48 hours, it’s important to see a doctor.
Insurance and travel certificates
A travel certificate includes details of your condition so you do
not have to explain it to travel officials, including airport security
staff. The certificate will include your name, address and passport
number and will be signed by your doctor.
People with ileostomies can get a travel certificate by contacting
IA (The Ileostomy and Internal Pouch Support Group). IA’s travel
certificate has translations in a variety of languages. See page 74
for contact details. The Colostomy Association (see page 72) and
The Urostomy Association (see page 75) can also provide travel
certificates in a number of different languages. Alternatively, your
stoma care nurse should be able to provide a travel certificate.
Travel Certificates should be signed by your GP.
All three stoma patient support groups can give you advice on travel insurance to make sure you are properly covered for
your condition. You can read more about travel insurance on
pages 37–41.
Bowel or bladder problems
Many people affected by cancer have problems with their bladder
or bowels. These may be either temporary or long term and can
be due to treatment or the cancer itself. If you have changes in
your bowel or bladder that mean you need to pass urine or bowel
motions urgently or often, you will need to be close to a toilet
and this can affect your travel plans. You may feel worried about
going out, especially to somewhere new, if you have problems
with bowel or bladder control. Planning ahead so that you are
prepared can help you feel more confident.
Access to toilets
If you’re going somewhere you’re not familiar with, it’s a good idea to find out more about toilet facilities in your
accomodation and in the area or country you are travelling to. It may be that they are very different to what you’d expect in the UK. This shouldn’t prevent you from travelling, but will help you plan ahead.
If travelling in the UK, many towns and counties keep information
about the public toilets in their area as lists or maps. Often these are on local authority websites. There are too many of these
websites to list here, but you’ll be able to find them online. Try putting the term ‘public toilets’ and the name of the place you plan to visit in a search engine to find out what’s available.
Carrying a Just Can’t Wait toilet card may help you get access to
a toilet more quickly when you’re out. The card can be used in
places such as shops and pubs, and states that the card-holder
has a medical condition that requires urgent access to a toilet.
You can get a Just Can’t Wait toilet card from the Bladder and
Bowel Foundation or Disability Rights UK.
You can use disabled toilets too. These often offer more privacy,
have a wash basin and more space if you need to change.
National Key Scheme for Toilets This scheme offers people with a disability access to around
9,000 locked public toilets across the UK. You can buy a Radar
NKS key for £4.50 (including postage and packaging) from
Disability Rights UK. Visit the online shop at disabilityrightsuk.
org or call 020 7250 3222.
In Northern Ireland, these keys can be purchased at any local
council office.
Take supplies with you
Pack a bag of the things you may need when travelling. This will
help you feel more confident.
You may want to include:
•• wet wipes or baby wipes
•• barrier cream such as Cavilon® or Sudocrem®
•• pads and pants
•• a change of clothing
•• a sealable bag.
If you have bladder problems, you might find it helpful to take a portable urinal with you.
Talk to your cancer nurse or specialist for advice on travelling and ask whether any medications, for example, treatment for
diarrhoea, may be helpful for you.
Checklist – things to consider before you travel
For all travellers:
•• Are you fit to travel safely?
•• Will you need a travel companion or helper to accompany you?
•• Will you need any special equipment?
•• Have you let the travel company and your accommodation
know about any particular needs?
•• Do you need any particular vaccinations for the destination?
Remember to take any relevant certificates with you.
•• Have you got enough medicines/medical supplies for the whole
time you will be away? Remember to take extra supplies in case
your return is delayed.
•• Do you have your passport and another form of proof of UK
residence, such as a driver’s licence? •• Do you have your travel insurance policy and certificate?
•• Have you packed all your medical supplies or equipment in
your hand luggage?
If you’re travelling to a European Economic Area country or to Switzerland:
•• Do you have your European Health Insurance Card (see pages 19–22)?
If you’re travelling with medicines for more than three months:
•• Do you need/have a personal medicines licence?
If you’re going abroad for planned treatment:
•• Do you have an S2 form (unless you will be claiming under
Article 56)? See page 26.
If you have severe mobility problems:
•• Do you have your Blue Badge, if you think you’ll need it?
If you have a stoma:
Does your hotel or accommodation have en suite facilities,
including facilities to dispose of appliances, if you think this will be necessary?
WHILE YOU’Re
AWay
If you become ill
60
Avoiding health problems while travelling 60
Taking care in the sun 62
Enjoying your trip
64
If you become ill
If you become ill while staying in a hotel, ask the receptionist to
call a doctor. If you need urgent attention, contact the emergency
services or visit the emergency department of the nearest
hospital. If you have time, try to seek help and advice from a doctor or nurse who speaks the same language as you – the Foreign and Commonwealth Office may be able to help (visit fco.gov.uk).
Contacting relatives
Keep the names and addresses of friends and relatives with your
passport so that British Consular officials can contact them if their
help is needed. It is important to keep these details up to date for
each time you travel.
If you need to return to the UK quickly, you should also contact
British Consular officials (see fco.gov.uk for details). They can
usually arrange this for you, but you may need to pay the costs.
Avoiding health problems while travelling
Eating and drinking
Wherever you are in the world, be careful about what you eat
and drink.
Many infectious diseases are spread by contaminated food and
water. This includes water in swimming pools, lakes, rivers and
the sea, so try not to swallow water when you’re swimming.
Tips for avoiding stomach upsets
•• If you’re not sure that the drinking water is clean, you should
sterilise it. You can do this by boiling it for one minute, or by
using a filtering system or sterilisation tablets. At high altitudes,
you may need to boil water for longer than usual to sterilise it properly.
While you’re away 61
•• Use bottled water if you are not sure that the water is clean.
•• Make sure that seals on bottles of water are not broken before opening.
•• Avoid ice unless you’re sure it is made from safe water.
•• Only eat freshly cooked food that has been cooked thoroughly
and is still hot.
•• Avoid uncooked food, unless you can peel or shell it yourself.
•• Avoid food that may have been exposed to flies, such as food
from street traders.
•• Avoid ice cream from unreliable sources, such as kiosks.
•• Avoid or boil unpasteurised milk.
•• Be careful when eating shellfish – they may contain harmful
bacteria. Make sure shellfish is cooked thoroughly, or avoid
eating it.
Insects
In some countries, diseases can be spread by insects and ticks.
Always use insect repellent (preferably containing DEET), and
cover your arms and legs with appropriate clothing (especially if
you’re walking in grassy or wooded areas).
Animals
Animal bites can lead to dangerous infections. It’s important to be careful, even with animals that seem tame. Animals in many regions, including most of Europe and North America, can carry rabies. If you are bitten, clean the wound carefully with soap and water, apply an antiseptic if you can and see a doctor immediately.
Taking care in the sun
During and after treatment, it‘s very important to protect your skin from the sun. Some cancer treatments can make your skin
more sensitive to damage from the sun. This can be temporary or permanent. How sensitive your skin is to the sun will also
depend on the type and dose of your treatment.
If you’ve had chemotherapy
Some chemotherapy drugs can make your skin more sensitive.
This can sometimes last for several years after treatment. If you’ve
had chemotherapy, you can ask your doctor whether you need to
take special care to protect your skin.
Some people also find that their skin is sensitive to chemicals such
as chlorine, and may need to avoid swimming in pools that have
been treated with chlorine.
If you’ve had radiotherapy
The skin in the area that was treated by radiotherapy will stay
sensitive for many years and you are at at a higher risk of long-term sun damage, including skin cancers. You should take extra care to protect it from the sun.
You don’t need to avoid the sun completely, but it’s good to start with going out into the sun only for very short periods and to use sun cream with a high sun protection factor (SPF). If this
causes no problems, you can gradually increase the time you
spend in the sun.
If you’ve had biological therapies
Some cancer treatments, including some biological therapies, can make your skin very sensitive to the sun and your skin may
burn more easily than normal. You can still go out in the sun, but you should wear a sun cream with a high SPF, and cover up
with clothing and a hat.
While you’re away 63
Tips for protecting yourself in the sun
Following the advice below will help ensure that your skin doesn’t burn:
•• Protect your face and neck with a wide-brimmed hat.
•• Always wear sunglasses (with a guaranteed ultraviolet light filter)
in strong sunlight.
•• Use a suncream with a high sun protection factor (at least
SPF 30). Follow the instructions on the bottle and reapply as
recommended, particularly after swimming.
•• Wear clothing made of cotton or natural fibres, as these have a closer weave and offer more protection from the sun. As the SPF of different fabrics varies, it’s possible you may need to use some of the other types of protection as well as
covering up with clothing.
•• Stay out of the sun during the hottest part of the day, usually
between 11am and 3pm. Try to sit in the shade, even at other
times of the day.
•• If you have had radiotherapy, keep the treated area completely covered.
•• Use fake tanning lotions or sprays to give yourself a tan, instead of sunbathing or using a sun-bed.
•• If you have to apply bite/mosquito repellent cream, apply the
sunscream first, followed by the repellent cream.
Enjoying your trip
Hopefully, once everything is planned you’ll be able to look
forward to enjoying your time away. For many people affected
by cancer, taking some time to travel can help them feel better.
It may help to put the treatment behind them and give them a
chance to reflect on all they’ve been through. For other people, it can be a special time with family or friends, to see a place
they’ve always wanted to see or visit people they’ve not seen in a while. Whatever the reason for your travels, with careful
planning you’ll be able to look forward to and enjoy your trip.
We have a video of someone talking about their travel
experiences after being diagnosed with cancer on our website. You can watch this at macmillan.org.uk/travel
‘We had ten blissful days away from
reality and that in itself was worth it.’
Samira
fURTHER
INForMATiOn
How we can help you
68
Other useful organisations
72
Further resources
78
Your notes and questions
84
How we can help you
Cancer is the toughest fight most of us will ever
face. But you don’t have to go through it alone.
The Macmillan team is with you every step of
the way.
Get in touch
Macmillan Cancer Support
89 Albert Embankment, London SE1 7UQ Questions about cancer?
Call free on 0808 808 00 00
(Mon–Fri, 9am–8pm) www.macmillan.org.uk Hard of hearing?
Use textphone 0808 808 0121 or Text Relay. Non-English speaker?
Interpreters are available.
Clear, reliable information
about cancer
We can help you by phone, email, via our website and
publications or in person. And our information is free to
everyone affected by cancer.
Macmillan Support Line
Our free, confidential phone line is open Monday–Friday,
9am–8pm. Our cancer
support specialists provide
clinical, financial, emotional
and practical information and
support to anyone affected by
cancer. Call us on 0808 808
00 00 or email us via our
website, macmillan.org.uk/
talktous
Information centres
Our information and support
centres are based in hospitals,
libraries and mobile centres, and offer you the opportunity
to speak with someone face
to face. Find your nearest
one at macmillan.org.uk/
informationcentres
How we can help you 69
Publications
We provide expert, up-to-date
information about different
types of cancer, tests and
treatments, and information
about living with and after
cancer. We can send you free booklets, leaflets, and fact sheets.
Review our information
Help us make our resources even better for people affected by cancer. Being one of our
reviewers gives you the chance
to comment on a variety of
information including booklets,
fact sheets, leaflets, videos,
illustrations and website text.
Other formats
We have a small range of
information in other languages
and formats. Our translations
are for people who don’t speak English and our Easy Read
booklets are useful for anyone
who can’t read our information.
We also produce a range of audiobooks. Find out more
at macmillan.org.uk/
otherformats
If you’d like to hear more about
becoming a reviewer, email
[email protected]
Please email us at
cancerinformationteam@
macmillan.org.uk if you’d like
us to produce our information
for you in Braille or large print.
You can find all of our
information, along with several
videos, online at macmillan.
org.uk/cancerinformation
Need out-of-hours support?
You can find a lot of
information on our website,
macmillan.org.uk
For medical attention out of
hours, please contact your GP
for their out-of-hours service.
Someone to talk to
Support for each other
When you or someone you
know has cancer, it can be
difficult to talk about how
you’re feeling. You can call our cancer support specialists
to talk about how you feel and what’s worrying you.
No one knows more about the
impact cancer has on a person’s
life than those who have been
affected by it themselves. That’s why we help to bring
people with cancer and carers
together in their communities and online.
We can also help you find
support in your local area, so you can speak face to face
with people who understand
what you’re going through.
Professional help
Our Macmillan nurses, doctors
and other health and social
care professionals offer expert
treatment and care. They help
individuals and families deal
with cancer from diagnosis
onwards, until they no longer
need this help.
You can ask your GP, hospital
consultant, district nurse or
hospital ward sister if there are any Macmillan professionals
available in your area, or call us.
Support groups
You can find out about support
groups in your area by calling
us or by visiting macmillan.
org.uk/selfhelpandsupport
Online community
You can also share your
experiences, ask questions, get and give support to others
in our online community
community
How we can help you 71
Financial and work-related support
Having cancer can bring extra
costs such as hospital parking,
travel fares and higher heating
bills. Some people may have to
stop working.
If you’ve been affected in this
way, we can help. Call the
Macmillan Support Line and
one of our cancer support
specialists will tell you about
the benefits and other financial
help you may be entitled to.
We can also give you
information about your rights at work as an employee and
help you find further support.
Macmillan Grants
Money worries are the last
thing you need when you have
cancer. A Macmillan Grant is
a one-off payment for people
with cancer, to cover a variety
of practical needs including
heating bills, extra clothing, or a much-needed break.
Find out more about the
financial and work-related
support we can offer
financialsupport
Learning about cancer
You may find it useful to learn
more about cancer and how to
manage the impact it can have on your life. You can do this online on our
Learn Zone – macmillan.org.
uk/learnzone – which offers
a variety of e-learning courses
and workshops. There’s also a
section dedicated to supporting
people with cancer – ideal for
people who want to learn more
about what their relative or
friend is going through.
Other useful organisations
British Red Cross
44 Moorfields, London EC2Y 9AL Tel 0844 871 1111
Email
[email protected] www.redcross.org.uk
Offers a number of services
to people with disabilities,
including a medical equipment
loan service and a transport
service. See the website for
details of local offices.
Colostomy Association Enterprise House, 95 London Street, Reading RG1 4QA Tel 0800 328 4257
www.colostomyassociation.
org.uk
Gives support to everyone
living with a colostomy. The organisation has a private Facebook group where members can read and post comments and
support, including tips on
travelling, from other people with stomas.
Disability Rights UK 12 City Forum, 250 City Road, London EC1V 8AF Tel 020 7250 3222
Email enquiries@
disabilityrightsuk.org www.disabilityrightsuk.org
Provides information on any aspect of disability.
Disabled Living Foundation
Ground Floor, Landmark House,
Hammersmith Bridge Road,
London W6 9EJ Tel 0300 999 0004
Email [email protected]
www.dlf.org.uk
A national charity that provides
free, impartial advice about
disability equipment and
mobility products through
its helpline, website and
demonstration centre.
Other useful organisations 73
Disabled Motoring UK
Ashwellthorpe, Norwich NR16 1EX Tel 01508 489 449
Email
[email protected] www.disabledmotoring.org
A UK charity that promotes
mobility for disabled people.
Publishes leaflets, fact sheets
and a monthly magazine to
help disabled drivers.
Family Holiday Association 3 Gainsford Street, London SE1 2NE Tel 020 3117 0650
Email info@familyholiday
association.org.uk www.fhaonline.org.uk Helps arrange holidays for
disadvantaged families with
school-aged children.
Foreign and Commonwealth Office
King Charles Street, London SW1A 2AH Tel 020 7008 1500
Email
traveladvicepublicenquiries@
fco.gov.uk www.fco.gov.uk
The government department
responsible for supporting
British citizens overseas.
Can provide details about
embassies, high commissions
and consulates and offer
support to travellers in an emergency.
Help the Hospices
Hospice House, 33–44 Britannia Street, London WC1X 9JG Tel 020 7520 8200
Email
[email protected] www.helpthehospices.org.uk Provides information relevant
to living with advanced illness.
Compiles a directory of
hospice services, as well as
practical booklets. These are all
available free on the website.
Home Office Drugs
Licensing and Compliance Unit 4th Floor Fry Building,
2 Marsham Street, London SW1P 4DF Tel 020 7035 6330
Email DLCUcommsofficer@
homeoffice.gsi.gov.uk www.gov.uk/controlleddrugs-licences-fees- and-returns
Provides personal export and import licences for people who are travelling with certain medicines for three months or more.
IA (The Ileostomy and Internal Pouch Support Group) Peverill House, 1–5 Mill Road, Ballyclare BT39 9DR Tel 0800 0184 724
www.iasupport.org
Provides information about
travelling for people who’ve
had stoma surgery, including
details of companies that offer travel insurance.
Lymphoedema Support Network St Luke’s Crypt, Sydney Street, London SW3 6NH Tel 020 7351 4480
Email adminlsn@
lymphoedema.freeserve.co.uk www.lymphoedema.org
Gives information and support
to people with lymphoedema
and produces a leaflet called
Holidays and travel.
MASTA Ltd City Exchange, Floor 7, 11 Albion Street, Leeds LS1 5ES Email [email protected]
www.masta-travel- health.com
Offers travel health
consultations, anti-malarial
tablets and vaccinations
through a network of private clinics.
Motability Scheme Motability, Warwick House, Roydon Road, Harlow CM19 5PX Tel 01279 635999
(Mon–Fri, 8.45am–5.30pm)
Minicom 01279 632213
www.motability.co.uk
The scheme enables disabled
people to exchange either their higher rate mobility
component of Disability
Living Allowance, their
enhanced rate of the mobility
component of Personal
Independence Payment, or
their War Pensioners’ Mobility
Supplement for a new car,
powered wheelchair or scooter.
St John Wales
Priory House, Beignon Close, Ocean Way, Cardiff CF24 5PB Tel 0845 644 2546
www.stjohnwales.co.uk
Provides a professional, non-emergency transport
service for people who would have difficulties using
other forms of transport.
Translink
Tel 028 9066 6630
Email
[email protected] www.translink.co.uk Manages the Concessionary
Fares Scheme in Northern Ireland.
Tourism For All
7A Pixel Mill, 44 Appleby Road, Kendal LA9 6ES Tel 0845 124 9971
Email
[email protected] www.tourismforall.org.uk
Provides information to
disabled people and their
carers about holidays in the UK and abroad, including how their access needs can be met. Has information about
transport, accommodation,
visitor attractions, activity
holidays and respite care
establishments.
The Urostomy Association
18 Foxglove Avenue, Uttoxeter ST14 8UN Tel 01889 563 191
www.urostomyassociation.
org.uk
Provides information and
support to people who have a urostomy.
General cancer support organisations
Cancer Black Care
79 Acton Lane, London NW10 8UT
Tel 020 8961 4151
Email
[email protected]
www.cancerblackcare. org.uk
Offers information and support
for people with cancer from
ethnic communities, their
friends, carers and families.
Cancer Focus Northern Ireland
40–44 Eglantine Avenue,
Belfast BT9 6DX
Tel 0800 783 3339
(Mon–Fri, 9am–1pm)
www.cancerfocusni.org
Offers a variety of services
to people affected by cancer,
including a free helpline,
counselling and links to local support groups.
Cancer Support Scotland Calman Cancer Support
Centre, 75 Shelley Road,
Glasgow G12 0ZE
Tel 0800 652 4531
Email info@
cancersupportscotland.org
www.cancersupport
scotland.org
Runs cancer support groups
throughout Scotland. Also offers
free complementary therapies and counselling.
Irish Cancer Society
43–45 Northumberland Road,
Dublin 4, Ireland
Tel 1800 200 700
(Mon–Thu, 9am–7pm, Fri, 9am–5pm)
www.cancer.ie
National cancer charity offering
information, support and care
to people affected by cancer.
Has a helpline staffed by
specialist cancer nurses.
Maggie’s Centres
1st Floor, One Waterloo Street,
Glasgow G2 6AY
Tel 0300 123 1801
Email enquiries@
maggiescentres.org
www.maggiescentres.org
Provide information about
cancer, benefits advice, and emotional or psychological support. Penny Brohn Cancer Care
Chapel Pill Lane, Pill, Bristol BS20 0HH
Helpline 0845 123 2310
(Mon–Fri, 9.30am–5pm)
Email
[email protected]
www.pennybrohn cancercare.org
Offers a unique combination
of physical, emotional and
spiritual support, using
complementary therapies and self-help techniques. Tenovus
Head Office, Gleider House, Ty Glas Road,
Cardiff CF14 5BD
Tel 0808 808 1010
(Mon–Sun, 8am–8pm)
www.tenovus.org.uk
Provides support such as mobile cancer support units, a free
helpline, an ‘Ask the nurse’
service on the website and benefits advice.
You can search for more organisations on our
website at macmillan.org.uk/organisations,
or call us on 0808 808 00 00.
Further
resources
To order any of our resources, visit be.macmillan.org.uk
or call 0808 808 00 00.
Related Macmillan
information
All of our information is also
available online at macmillan.
org.uk/cancerinformation
You may want to order some of our other booklets:
•• Coping with fatigue
•• Getting travel insurance
when you have been
affected by cancer
•• Life after cancer treatment
•• Understanding lymphoedema
We have information about
chemotherapy, surgery
and radiotherapy in these
languages: Bengali, Gujarati,
Hindi, Polish, Portuguese,
Punjabi, Russian, Traditional
Chinese and Urdu.
We also have a range of Easy Read booklets. Visit macmillan.org.uk/
otherformats to find out more.
Macmillan audiobooks
Our high-quality audiobooks,
based on our variety of
booklets, include information
about cancer types, different
treatments and about living
with cancer.
To order your free CD, visit
be.macmillan.org.uk or call
0808 808 00 00.
Macmillan videos
There’s a video of someone
talking about their travel
experiences after being
diagnosed with cancer on our
website. You can watch this at
macmillan.org.uk/travel
Further resources 79
Helpful publications
Air travel with a
lung condition
British Lung Foundation, 2012 A fact sheet that answers
questions that people with
lung conditions may have
about travelling by air.
Available online at blf.org.uk/
publications
A laryngectomee’s travel
guide to the British Isles
Cancer Laryngectomee Trust, 2013 A booklet that lists hospitals in
the UK that handle emergencies
that laryngectomees may
experience. Includes emergency
flash cards (in English, French,
Spanish, and German) to help
a voiceless laryngectomee
indicate what the problem is.
Available online at cancerlt.
org/assets/travelguide 2013.pdf
Breast cancer and
travel insurance
Breast Cancer Care, 2013 A web page with points to
bear in mind when looking
for travel insurance. Includes
a list of companies willing
to consider travel insurance
for people living with breast
cancer. Available online at
breastcancercare.org.uk/
breast-cancer-information/
impact-breast-cancer/
finances-practicalities/ travel-insurance
Going on holiday with
a lung condition
British Lung Foundation, 2012 A booklet aimed at helping
people with lung conditions
plan holidays in the UK and
abroad. It includes tips on
choosing accommodation,
travelling (by coach, train or
ferry), driving abroad, flying
with a lung condition and
getting oxygen away from
home. Available online at blf.org.uk/publications
Holiday advice for ostomists
Dansac, 2013 A booklet with general advice
for people with a colostomy,
ileostomy or urostomy who
would like to go on holiday. It covers health and insurance,
food and drink, practical issues,
clothing and swimwear, and
medical supplies. Order free
on 01480 484 300 or email
[email protected]
Holidays and travel
Lymphoedema Support
Network, 2012 A leaflet with advice on
travelling with lymphoedema.
Call 020 7351 4480 or email
adminlsn@lymphoedema.
freeserve.co.uk
Travel information
Urostomy Association, 2011 A leaflet about travelling with
a urostomy. Available online at
urostomyassociation.org.uk/
support/leaflets
Travel advice: having a
colostomy should not
prevent you from travelling
at home or abroad
Colostomy Association, 2012 A leaflet on travelling with a
colostomy. The Colostomy
Association also produces a Travel Insurance (2013) fact sheet. Both are available online at
colostomyassociation. org.uk
Travel and prostate cancer
Prostate Cancer UK, 2013 A fact sheet for men with
prostate cancer who are
planning a holiday or travel
abroad. It has tips to help
prepare for travel, including
guidance on arranging travel
insurance. Available online at
prostatecanceruk.org
Travel insurance
Lymphoma Association, 2013 A fact sheet with advice on
obtaining travel insurance.
Includes a list of companies
that consider providing cover
for people with lymphoma.
The Lymphoma Association
also produces a booklet called
Foreign travel precautions – a
guide for people with lymphoma
(2011), which gives advice
and guidance about vaccines
for people with lymphoma
who wish to travel abroad.
Both are available online at
lymphomas.org.uk
Travel insurance and
lung cancer
Roy Castle Lung Cancer
Foundation, 2013 A fact sheet listing insurance
companies that consider
providing insurance to people
with cancer. Available online at roycastle.org
Travel insurance
and myeloma
Myeloma UK, 2014 A list of companies that may
provide travel insurance for
people with myeloma, and tips
to facilitate obtaining insurance.
Myeloma UK also produces
a general fact sheet called
Travelling (2013), which covers
topics such as taking medicines
abroad, vaccinations,
insurance, flights, diet, sun
safety and treatment away
from home. Both are available
online at myeloma.org.uk
Travel tips
IA (the Ileostomy and Internal
Pouch Support Group) A leaflet with advice on
travelling when you have an ileostomy or an internal
pouch. Visit iasupport.
org/about/publications/
factsheets/travel-tips
Useful websites
A lot of information about
cancer is available on the
internet. Some websites
are excellent; others have
misleading or out-of-date
information. The sites listed
here are considered by nurses and doctors to contain
accurate information and are regularly updated.
www.macmillan.org.uk Find out more about living with
the practical, emotional and
financial effects of cancer. Our website contains expert
information about cancer and
its treatments, including:
•• all the information from our 150+ booklets and
360+ fact sheets
•• videos featuring real-life
stories from people affected
by cancer and information
from medical professionals
•• how Macmillan can help, the services we offer and
where to get support
•• how to contact our cancer
support specialists, including
an email form to send your questions
•• local support groups
search, links to other cancer
organisations and a directory
of information materials
•• a huge online community of
people affected by cancer
sharing their experiences,
advice and support.
British Foreign and
Commonwealth Office www.fco.gov.uk
Provides government advice,
including advice about travel
insurance and travel health.
Contains contact details of
British embassies and high
commissions around the world.
Cancer Research UK
www.cancerhelp.org.uk
Contains patient information on all types of cancer and has
a clinical trials database.
Citizens Advice
www.adviceguide.org.uk Online help from Citizens
Advice. Including information
about travel, passports, visas and travelling if you have a disability.
GOV.UK
www.gov.uk
Government website with
information about public
services. Has information about travel and transport.
Fit for Travel
www.fitfortravel.scot.nhs.uk
Website provided by NHS
Scotland, which has health
information for people
travelling abroad.
Health and Social Care in Northern Ireland
www.hscni.net
Information on travel health
and the EHIC for people who
live in Northern Ireland.
NHS Choices
www.nhs.uk The country’s biggest health
website that gives all the
information you need to make
decisions about your health.
National Cancer Institute –
National Institute of Health – USA
www.cancer.gov
Gives comprehensive
information on cancer and its treatments.
Patient UK www.patient.co.uk Provides people in the UK with
information about health and
disease. Includes evidencebased information leaflets on
a wide variety of medical and
health topics. Also reviews and links to many health- and illness-related websites.
Your notes
and questions
Disclaimer, thanks and sources 85
Disclaimer
We make every effort to ensure that the information we provide is accurate and up to date but it should not be relied upon as a substitute for specialist professional
advice tailored to your situation. So far as is permitted by law, Macmillan does not
accept liability in relation to the use of any information contained in this publication, or third-party information or websites included or referred to in it. Some photographs
are of models.
Thanks
This booklet has been written, revised and edited by Macmillan Cancer Support’s
Cancer Information Development team. It has been approved by Dr Tim Iveson,
Macmillan Consultant Medical Oncologist.
With thanks to: Dermot Ball, Area Cancer Team Pharmacist; Alison Crawshaw, Clinical Nurse Specialist Stoma Care and Bowel Function and Liaison with Stoma Care
Nursing for IA (The Ileostomy and Internal Pouch Support Group); Carole Cringle,
Macmillan Colorectal/Stoma Care Specialist Nurse; Julie Cunneen, Macmillan
Lymphoedema Clinical Lead; Dr Gerry Hanna, Consultant/Honorary Senior Lecturer
in Clinical Oncology; Mary Kane, Stoma Care/IBD Nurse Specialist; Margaret
Sneddon, Head of Nursing and Health Care, Macmillan Senior University Teacher/
Lymphoedema Specialist; Beverly Sykes, Special Nurse Travel Health (MASTA); Dr Alexandra Taylor, Consultant in Clinical Oncology; Chris Watson, Highly Specialist
Oncology Pharmacist; and the people affected by cancer who reviewed this edition.
Sources
We’ve listed a sample of the sources used in this publication below. If you’d like further information about the sources we use, please contact us at [email protected]
Breast cancer care. Body scanners in UK airports. www.breastcancercare.org.uk/
breast-cancer-information/impact-breast-cancer/breast-prostheses/body-scannersuk-airports (accessed February 2014).
British Lung Foundation. Travel. www.blf.org.uk/Page/Travel (accessed February 2014).
CancerHelp UK. Having oxygen on holiday. www.cancerresearchuk.org/cancer-help/
about-cancer/cancer-questions/having-oxygen-on-holiday (accessed February 2014).
Citizens Advice. Adviceguide – transport options for disabled people. www.adviceguide.
org.uk/index/your_world/travel/transport_options_for_disabled_people.htm (accessed
February 2014).
Colostomy Association. Living with a colostomy: travel home and abroad.
www.colostomyassociation.org.uk/index.php?p=144&pp=3&i=7&page=Travel
(accessed February 2014).
Fitfortravel. www.fitfortravel.nhs.uk (accessed February 2014).
GOV.UK. Foreign travel advice. www.gov.uk/foreign-travel-advice (accessed
February 2014).
The National Travel Health Network and Centre (NaTHNaC). www.nathnac.org
(accessed February 2014).
NHS Choices. www.nhs.uk (accessed February 2014).
NI Direct. Claim health treatment in Europe. www.nidirect.gov.uk/claimhealth-treatment-in-europe-european-health-insurance-card-formerly-e111 (accessed February 2014).
NI Direct. Travel information for people with reduced mobilities. www.nidirect.gov.uk/
index/information-and-services/travel-transport-and-roads/travel-information-forpeople-with-reduced-mobilities.htm (accessed February 2014).
Transport Scotland. Concessionary Travel. www.transportscotland.gov.uk/publictransport/concessionarytravel (accessed February 2014).
Welsh Government. Concessionary bus fares for the elderly and disabled.
www.wales.gov.uk/topics/transport/public/concessionary/fares/?lang=en (accessed February 2014).
Can you do something to help?
We hope this booklet has been useful to you. It’s just one of our
many publications that are available free to anyone affected by
cancer. They’re produced by our cancer information specialists
who, along with our nurses, benefits advisers, campaigners and
volunteers, are part of the Macmillan team. When people are
facing the toughest fight of their lives, we’re there to support
them every step of the way.
We want to make sure no one has to go through cancer alone,
so we need more people to help us. When the time is right for you,
here are some ways in which you can become a part of our team.
5 ways
you can someone
hElP with
cAncer
Share your cancer experience Support people living with cancer by telling your story, online, in the media or face to face.
Campaign for change We need your help to make sure everyone gets the right support.
Take an action, big or small, for better cancer care.
Help someone in your community A lift to an appointment. Help with the shopping. Or just a cup of tea and a chat. Could you lend a hand?
Raise money Whatever you like doing you can raise money to help. Take part in one of our events or create your own.
Give money Big or small, every penny helps. To make a one-off donation see over.
Call us to find out more 0300 1000 200
macmillan.org.uk/getinvolved
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More than one in three of us will get cancer.
For most of us it will be the toughest fight we
ever face. And the feelings of isolation and
loneliness that so many people experience
make it even harder. But you don’t have to
go through it alone. The Macmillan team
is with you every step of the way.
We are the nurses and therapists helping you
through treatment. The experts on the end of
the phone. The advisers telling you which benefits
you’re entitled to. The volunteers giving you a hand
with the everyday things. The campaigners improving
cancer care. The community there for you online,
any time. The supporters who make it all possible.
Together, we are all Macmillan Cancer Support.
For cancer support every step of the way,
call Macmillan on 0808 808 00 00
(Mon–Fri, 9am–8pm) or visit macmillan.org.uk
Hard of hearing? Use textphone
0808 808 0121, or Text Relay.
Non-English speaker? Interpreters available.
Braille and large print versions on request.
© Macmillan Cancer Support, February 2014. 5th edition. MAC11667.
Next planned review 2016. Macmillan Cancer Support, registered charity
in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604).
Printed using sustainable material. Please recycle.

Information for people affected by cancer who are planning to travel

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Student`s Worksheet 1 Zadania maturalne, Temat: Człowiek

Teacher`s Notes Zadania maturalne, Temat: Człowiek

this file - Ilfracombe Junior School

Manning Stainton team - Macmillan Cancer Support