Medical Oncologist
Living with Enhertu
Work, Travel and Daily Life on — Trastuzumab Deruxtecan
Being prescribed a new treatment raises a question most people are afraid to ask: can I still live my life? For most people on trastuzumab deruxtecan, the answer is yes — with some planning around each cycle.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- Most people keep working — Desk work and lighter roles are usually compatible with treatment, especially once you know your side-effect pattern.
- Travel is possible — Domestic and international travel can happen between infusion cycles with some forward coordination with your team.
- Fatigue is predictable — It tends to follow a pattern within each cycle, which makes it something you can plan around.
- One symptom is urgent — New breathlessness at any point in your cycle — report it the same day, not at your next appointment.
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Most people on trastuzumab deruxtecan continue working, travelling and living normally between infusion days. The treatment cycle runs every three weeks, meaning most of your time is spent away from the clinic. Planning around the days when fatigue or nausea is most likely makes day-to-day life significantly more manageable.
Can you keep working during treatment?
Many people on trastuzumab deruxtecan continue in their jobs throughout treatment, particularly those in desk-based or lighter roles.
Fatigue tends to be most noticeable in the two to three days after your infusion, then improves as the week progresses. If you know your pattern, you can plan heavier workdays and important meetings for the later part of each cycle.
If your work involves physical labour, prolonged standing, or exposure to large numbers of people, talk with your oncologist about any adjustments needed around each infusion. You do not need to stop working — but some temporary flexibility helps.
You are not required to tell your employer your diagnosis. You need to share only what is necessary to request adjustments — flexibility on the day after your infusion, for instance, or time off for clinic appointments.
Is travel safe during trastuzumab deruxtecan treatment?
Travel is possible for most people on this treatment, but it needs to be planned around your infusion schedule and blood count pattern.
The safest window is generally the week before your next infusion — by then your blood counts have usually recovered and your energy is closer to normal. Avoid planning trips that coincide with your infusion day or the two to three days that follow.
If you are travelling by air, carry a letter from your oncologist describing your treatment. Keep all prescribed medicines in your hand luggage. If your destination is abroad, check whether any of your medicines need documentation for customs.
Tell your oncologist before any trip that would take you more than a few hours from a hospital. They will tell you what to watch for and how to reach the team if anything changes while you are away.
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How to plan each treatment cycle
Infusion day
Trastuzumab deruxtecan is given as a day-care infusion — you come in, receive the treatment over several hours, and go home the same day. Arrange a lift; do not plan to drive yourself. Take your prescribed anti-nausea medicine before you leave home as your team instructs.
Days 1–3 after infusion
Nausea and fatigue are typically at their peak in this window. Keep your schedule lighter than usual, take anti-nausea medicines on time, and rest when you need to. This is not the window for travel or demanding commitments.
Week two
Blood counts are at their lowest during this period. Avoid large indoor crowds if your team advises it. If you develop a fever at any point, contact your oncology team the same day — do not wait for your next scheduled appointment.
Week three
For many people, energy and appetite return during this week. This is the best window for travel, social occasions, or work commitments that need your full concentration.
Before the next cycle
Attend your pre-infusion blood test. Your team needs those results before proceeding. Raise any new symptoms — especially any change in your breathing — at this point if not before.
Did you know?
Trastuzumab deruxtecan causes hair thinning rather than the complete hair loss that many people associate with chemotherapy — a distinction that matters to many people when they are first prescribed it.
If you are worried about visible changes during treatment, ask your oncologist specifically about what to expect rather than assuming your experience will match someone else's.
Source: DESTINY-Breast clinical programme, presented at ASCO and ESMO
Questions about specific parts of daily life
Is it safe to drive during treatment?
On your infusion day, arrange a lift rather than driving yourself — you will not know in advance how the treatment will feel, and some anti-nausea medicines cause drowsiness. In the days that follow, drive only when you feel alert and your nausea is well controlled. If you develop new breathlessness at any point during your cycle, do not drive until your team has assessed you. Breathlessness that reduces your concentration is not safe behind the wheel, and it may indicate a lung reaction that needs prompt review.
Can you drink alcohol at social occasions?
There is no absolute rule against alcohol on trastuzumab deruxtecan, but there are reasons to be cautious. Alcohol can worsen nausea, which is already a common side effect in the days after your infusion. It can also place additional demand on your liver, which the treatment monitors closely. Ask your oncologist what they advise for your situation. If you choose to drink, do so moderately and not in the few days immediately after your infusion when side effects are most active.
Can you exercise during treatment?
Gentle to moderate exercise is generally encouraged during cancer treatment, and most people on trastuzumab deruxtecan can continue walking, yoga, or swimming. Intense exercise may be harder to tolerate in the first week after your infusion when fatigue is highest. The most important signal to watch for is new breathlessness during activity — if exercise that previously felt easy now leaves you short of breath, stop and tell your team the same day. This is one of the early ways interstitial lung disease, a recognised risk with this treatment, can present.
How do you handle social events and crowded places?
Your immune system may be lower than usual during the second week of each cycle. Crowded, enclosed spaces carry a higher infection risk at this time. It is not about avoiding all social life — it is about choosing your moments. Outdoor settings and well-ventilated spaces are lower risk than packed indoor venues. If you develop a fever — whether after a social event or not — contact your oncology team the same day. Fever during treatment is not something to manage at home and wait out.
What do you need to tell your employer?
You are not legally required to disclose a cancer diagnosis to your employer in India, though individual workplace policies differ. What most people find practical is sharing enough to explain why they need specific accommodations — flexibility on certain days, time off for clinic appointments, or a temporarily lighter workload. A letter from your oncologist describing your treatment schedule in general terms, without specifying your diagnosis, is usually enough for HR purposes. Your oncologist can provide this letter on request.
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Common questions
Frequently asked questions
How long does each infusion appointment take?
The infusion itself takes several hours, and your total time at the centre will be longer because you are observed after the infusion before being discharged. Plan for most of the day and arrange transport home rather than driving yourself. Your clinical team will give you the exact timing for your centre and any pre-infusion steps — such as blood tests — that need to happen first.
What if you need to reschedule an infusion because of travel or work?
Speak to your oncologist as soon as you know there is a conflict. Missing or significantly delaying an infusion is not a decision to make alone — the timing of each cycle matters clinically, and your team will tell you what flexibility exists in your situation. Short adjustments are often manageable. Plan your commitments around your treatment schedule rather than the other way around wherever possible.
Are there foods to avoid during treatment?
There are no widely established food restrictions specific to trastuzumab deruxtecan. Eating small, frequent meals rather than large ones helps manage nausea, especially in the days after your infusion. If you are taking any herbal medicines, supplements, or products from an Ayurvedic or homeopathic practitioner, tell your oncology team before continuing them — some interact with cancer treatments in ways that are not obvious, and your team needs to know.
What new symptom is most important to report during treatment?
New breathlessness — particularly if it is worsening, or if activity that felt easy before now leaves you short of breath — is the symptom to report the same day, not at your next scheduled appointment. This can be an early sign of interstitial lung disease, a serious but recognised risk with trastuzumab deruxtecan that ESMO and ASCO guidance treats as needing prompt assessment. Fever, uncontrolled nausea, and any other symptom that feels new or worsening also warrant same-day contact with your team.
Is it normal to feel anxious when starting a treatment you have never heard of?
Yes, and it is worth saying plainly: being prescribed a drug you do not recognise and looking it up late at night is frightening. What many people find is that the uncertainty before starting is harder than the reality of treatment itself. Most people on trastuzumab deruxtecan maintain their daily routines between infusion cycles. Asking your oncologist what to expect in your specific situation — rather than reading population-level clinical trial data — gives you something more grounded to hold onto.