Diving with Chemotherapy

I have been diagnosed with stage 3 breast cancer. The doctor put a port in my chest a few days ago, and the current treatment plan involves six months of chemotherapy followed by a double mastectomy. I assume I will be beached for the next year, but my doctors aren't trained in dive medicine, and I haven't found much reputable research on the internet. While I currently feel too lousy to dive, I'd love to do a shallow dive as soon as I'm feeling better just to keep my gills wet.
I have the following questions:
1.*Can I dive with a chemo port? Will the pressure be a risk?
2.*How about diving without a port during a chemotherapy cycle? Is there any correlation between chemo and DCS?
3.Would depth and pressure be variables that would affect my safety?

We are sorry to learn of your diagnosis but are happy to hear your treatment is already under way. Your primary-care physician and/or oncologist are your best resources, and DAN is always available to consult with them as needed.

The general response about returning to diving after any major health issue, including cancer, is that you should be released by your physician for full and unrestricted activity, with no limitations on mobility or lifting and with excellent exercise tolerance for extended swimming or exertion. If you have any residual pain, especially with certain motions, knowing your baseline will help you recognize differences between the norm and potential DCS symptoms. Note, however, that such symptoms could lead to diagnostic confusion, so we strongly recommend you dive conservatively.

There is no recognized correlation between chemotherapy and DCS, but some cancer treatments occasionally lead to pulmonary fibrosis, and radiation can injure adjacent lung tissue; both of these conditions would increase your risk of pulmonary injury. Prior to returning to diving, consider asking for a pulmonary workup that includes a high-resolution spiral CT scan of your lungs to determine lung health.

Because water acts as a whole-body pressure garment, there is a documented fluid shift from the periphery (arms and legs) to the core (torso and head) during diving, even at very shallow depths. Your doctor should therefore also perform a thorough cardiac evaluation, including a stress test, to determine whether your heart and lungs will be healthy enough and capable of handling this fluid shift.

Cancer treatments often affect your immune system, and the diving environment can be a potential source of infection. Travel also exposes you to a host of infectious organisms not found in the home setting, so your immune status is a major point to discuss with your physician.

The good news is that chemo ports, if healed and free from complications, typically pose no problems with implanted devices such as a Port-A-Cath®. These ports are fluid-filled and thus noncompressible at recreational diving depths.

After you are cleared to dive, consider taking all your dive gear to a pool or other shallow, confined environment. Practice swimming laps, including overhand strokes, and include the motions of climbing a boat ladder and handing up gear to a crew member. Test your strap configuration, arm movements and weighting. You might have to adjust your straps or shift from integrated weights to a weight belt. Because a double mastectomy will potentially affect the chest musculature, it may also affect your ability to swim. While a lot of recreational diving is easy and relaxing, DAN encourages all divers to prepare for the unexpected, including strong currents, surfacing far from your boat or buddy and self-rescue.

Your immediate focus should be on treatment and recovery. Once treatments are complete and you are physically fit, planning your return to diving is appropriate.
— Frances Smith, EMT-P, DMT
© Alert Diver — Q2 Spring 2018