Traveling With Multiple Myeloma

If you have multiple myeloma, you might wonder whether travel is something you need to put on hold. But for many people, that’s not the case. "Most people with myeloma can still take the trips that are meaningful to them. It just requires the right precautions," says Joseph Mikhael, MD, a medical adviser at the International Myeloma Foundation.

"Once your treatment is stable and your blood counts are in a safe range, many patients can travel," says Shannon Collins, RN, a managing nurse at the transplant and cellular therapy program at OU Health Stephenson Cancer Center in Oklahoma City. "The key is a one-on-one conversation with your care team, so you can plan the timing around your treatment."

Get Medical Clearance Before You Go

Before you book your trip, talk to your care team first. Let them know where you're going, how long you'll be away, and what activities you're planning. This helps your doctor decide if it’s safe for you to travel and what precautions you should take.

Collins and Dr. Mikhael and Collins say that you may need to delay your travel if:

• You recently had a stem cell transplant
• You recently had CAR T-cell therapy
• Your blood counts are low
• Your immunoglobulin G (IgG) levels are low
• Your myeloma is not under control
• You have severe bone pain

If you receive infusions, your doctor can help plan your treatment around your travel plans. “More often than not, we work around it," says Mikhael. "If someone gets their treatment every four weeks, we might stretch it to five weeks, so they have time to travel."

Protect Yourself From Infection and Blood Clots

• Wash your hands often. Use soap and water frequently, especially before eating. When soap isn't available, use hand sanitizer.
• Wear a high-quality mask. In crowded areas, such as an airplane, use a N95 or KN95 mask to protect yourself from airborne illnesses like the flu or COVID-19.
• Avoid high-risk foods. Make sure that your food is cooked properly. This lowers your risk of getting a foodborne illness.

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Blood clots are another concern for people with myeloma, especially on long trips. "The more active the disease, the more risk of blood clotting — and certain drugs like lenalidomide (Revlimid) or pomalidomide (Pomalyst) increase that risk further," says Mikhael.

• Move your body. On long trips, stop every two to three hours to get out and move. If you have to stay in your seat, do calf raises by lifting your heels or roll your ankles in circles.
• Wear compression socks or stockings. These help prevent leg swelling and blood clots when you can’t move around.
• Stay well hydrated. Dehydration thickens the blood and raises your risk of clotting, so make hydration a priority. Mikhael says to start hydrating 24 hours before your flight, not just after you clear security.
• Take your blood thinner as prescribed. If you use a blood thinner, stay on your regular schedule and don’t skip doses while you travel.

Pack a Multiple Myeloma Travel Kit

• Medical Summary Carry a copy of your doctor's latest notes that explain your disease state and current treatments. In an emergency it can be helpful to have your most recent scans with you on a thumb drive.
• Medication Pack all your medications in your carry-on bag in their original labeled bottles. Never pack them in checked luggage, which can get lost or exposed to extreme temperatures. Bring extra doses in case your return home is delayed.
• Water Bottle Multiple myeloma can affect your kidneys, so staying hydrated is important. Aim for at least 8 to 10 cups of water a day, and drink even more in hot weather or at higher altitudes.
• Healthy Snacks Pack easy snack options like nuts, nut butter packets, whole-grain crackers, and protein bars for times when safe food isn't available nearby.
• Thermometer A digital thermometer can help you check for a fever, which is a red flag for infection.
• Sunscreen (SPF 30 or Higher) Some treatments can make your skin more sensitive to the sun, so use high-SPF sunscreen to protect your skin.
• Hand Sanitizer and Disinfectant Wipes These are easy to tuck into any bag and are useful whenever you visit crowded places.
• Face Masks Pack a few N95 or KN95 masks for airports, airplanes, and any crowded places you may visit.

Know What to Do in a Medical Emergency

If you have a medical issue while traveling, Collins advises contacting your care team before going to an emergency room. “Only your care team will know your medical history and can help you decide what to do based on your symptoms, lab values, and treatment,” she says. “However, if you are experiencing a life-threatening emergency, go to the nearest ER immediately. Then, have someone call your care team, so they can coordinate with the providers treating you.”

The Takeaway

• Traveling is safe for most people with multiple myeloma. Talk with your care team before you book a trip, so you can plan it around your treatment and overall health status.
• Multiple myeloma and its treatments can increase your risk of infection and blood clots. To prevent infections, wash your hands often, wear a mask in crowded places, and avoid risky foods. To lower your risk of blood clots, keep moving during long trips, stay hydrated, wear compression stockings, and take your blood thinner as prescribed.
• Pack a myeloma travel kit that includes your medications in your carry-on, a medical summary, a thermometer, a water bottle, healthy snacks, sunscreen, face masks, and hand sanitizer.
• If something goes wrong while traveling, call your care team first. For a life-threatening emergency, go to the nearest emergency room.