Planning a flight on a domestic or international airline? If you have active cancer, do your homework first.
Janet Freeman-Daily is a writer, speaker, science geek and epatient with metastatic lung cancer. She uses her systems engineering background to translate the experience and science of lung cancer treatment and research into language other patients can understand. She comoderates the Lung Cancer Social Media (#LSCM) Chat on Twitter and blogs at www.grayconnections.wordpress.com.
Many patients with active cancer can fly safely. If you have concerns about your fitness for flying, ask your doctor -- some cancer patients (such as those who have had lung-related problems, edema, or recent surgery) might be at risk for complications if they fly. Cancer Research UK’s brief list
addresses situations when you shouldn’t fly. The National Comprehensive Cancer Network’s online article
offers general tips about traveling with cancer.
However, even though you and your doctor think you can fly safely, sometimes the airline might prevent you from flying. Did you know airline employees have the right to deny boarding to anyone who, in their judgement, is too sick to fly or doesn’t meet their medical device regulations? It doesn’t happen often to cancer patients, but it does happen.
In April 2015, an Alaskan Airlines flight attendant took multiple myeloma patient Elizabeth Sedway off her flight
because she thought Ms. Sedway looked sick and did not have a doctor’s note saying she was cleared to fly. In November 2013, US Airways flight attendants kept lung cancer patient Penny Blume from boarding the second flight of her cross-country trip
because they said she did not have sufficient battery life remaining for her portable oxygen device. In May 2011, a Korean Air ticket agent refused a boarding pass to metastatic breast cancer patient Crystal Kim
even though she carried approval to fly from her doctor, because the agent insisted the airline’s medical team should determine her fitness to fly. Though these situations were frustrating for the travelers, and the situations could have been handled better, the airlines were within their rights to deny boarding.
Because airlines are held accountable for the safety of their passengers and crew, each airline determines which passengers can safely travel in their airplanes. Airline employees who interact with passengers are instructed to “passively” screen passengers for health risks
such as persistent coughing, recent surgery, or mention of terminal illness. Many airlines follow the recommendations in the International Air Transport Association’s Medical Manual
and Aerospace Medical Association’s Medical Guidelines for Airline Travel.
The IATA Medical Manual specifically states the following:
“Medical clearance is required by the airline’s medical department if the passenger…has a medical condition which may be adversely affected by the flight environment.”
Even if the passenger has a note from their doctor stating that passenger may safely fly, the IATA Medical Manual considers the doctor’s opinion to be only advisory because not all doctors are familiar with the medical effects of the flight environment. Each airline’s own medical department has the final say over which passengers are medically able to fly safely.
The IATA manual’s Passenger Care section lists the period of time a passenger must wait to fly after having experienced “acute and unstable” medical conditions like surgery or pneumonia. The manual specifically states that symptomatic cancer patients and those undergoing chemotherapy or radiotherapy must be assessed by a doctor with aviation medical experience -- which most oncologists do not have.
What can you as a cancer patient do?
If you have ANY cancer symptoms, or even just “look sick” (as you might during active treatment), be proactive! Self-advocacy isn’t limited to interacting with medical facilities and healthcare providers.
Ask your doctor if you can fly safely with your health condition. If they say yes, ask them to write a note specifically stating your medical condition and that you can fly safely. Allow your doctor adequate time before your departure to process the paperwork.
Research your airline’s policies. Check their website for specific requirements regarding health, mobility, oxygen, and medical devices. If they require specific signed forms, download and print the forms and get them signed by the proper authority. If you’ve recently had a procedure or health event, check the IATA Medical Manual to see how long you need to wait before you fly.
Attempt to get a Frequent Traveler’s Medical Card (FREMEC) from your airline. Airlines consider this card sufficient proof that you have medical clearance to fly. However, cancer patients who show symptoms or are in active cancer treatment might not be considered eligible.
Talk to your airline when planning your trip. Ask how to get approval from their medical team to fly with your condition. If you need oxygen during a flight, consult the airline ahead of time, even if you will bring an FAA-approved portable oxygen concentrator on board.
Consider trip insurance. Be sure to read the fine print. Some policies do not cover travel to obtain medical care (like clinical trials) or travelers with metastatic cancer. Fully disclose your cancer when you buy the policy, or you’ll risk losing coverage if you cancel for reasons related to your cancer.
Be prepared to show you’ve met the airline’s requirements. Not all airline employees are current on medical policy. If an airline employee is unsure what to do in your case, show them proper documents that prove you’ve done all that their airline requires.
If you develop a condition that does not allow you to fly after you have purchased non-refundable tickets: get a note from your doctor, review the IATA Medical Manual, then ask the airline for a refund.