How cancer might affect your travel

When you have cancer, you may be at risk of certain problems. This can include blood clots, infection, lymphoedema (swelling) or sun sensitivity. You might need to take extra care when you are travelling. 

Blood clots

Some people with cancer are more at risk of developing blood clots. These are also called deep vein thrombosis (DVT) or pulmonary embolism (PE). 

You might also be more at risk if:

• your type of cancer has a higher DVT risk than others
• you are taking certain hormone therapies, such as tamoxifen
• you have had certain types of cancer drugs
• you’ve had surgery within the last few months
• you are not very mobile or active
• you smoke
• you take the contraceptive pill

Taking care while travelling

Sitting for long periods also increases your risk of developing a blood clot. So you need to take care if you’re travelling by car, plane, train or coach. The risk increases on journeys that are over 4 hours.

Tips to prevent blood clots

• Take short walks as often as possible.
• Do simple leg exercises every hour if you can't move around much, such as bending and straightening your legs, feet and toes.
• Wear compression stockings (these should be measured to fit you).
• Have plenty of non alcoholic drinks.
• Wear loose clothing.

It’s possible to walk around in most forms of travel, except by car. And even then you can stop for regular breaks.

On plane trips, walk up and down the aisle every hour or so if the seatbelt signs are off. Many airlines also give advice about exercises you can do in your seat. You can often find this in their in-flight magazine or on the entertainment system.

You can buy compression socks or stockings in chemists and at airports. It’s important that they’re the correct size. You usually need to measure the widest part of your calf. That's better than going by shoe size alone. 

Infection

Some cancer drugs will increase your risk of infection for a while after your last treatment.

Most people will be fine after a few weeks. But if you've had intensive treatment, such as a bone marrow or stem cell transplant, you’ll be more at risk of infection for a few months. Your doctor might advise you against going abroad for the first 6 to 12 months after intensive treatment. 

Think carefully when choosing your destination and the type of holiday. Talk to your specialist if you’re in any doubt.

The Travel Health Pro has some general health information about the country you might be visiting. You can search the country through their a to z list. Their website also has other information such as preparing for healthy travel. 

Tips for avoiding an infection

One of the most obvious is hand hygiene. Wash your hands before and after meals, as well as after using the toilet. It’s also worth carrying hand gel or wet wipes as a back up when handwashing facilities are not available. 

Other tips include:

• drinking bottled water - make sure the seal hasn’t been broken and the bottle refilled
• using boiled water and served steaming hot to make drinks such as tea and coffee
• avoiding ice cubes as you don’t know where the water came from to make them
• being careful to only eat food that has been freshly cooked and is still hot
• avoiding raw fruit and vegetables that you haven't peeled or prepared yourself
• being careful with ice cream as it may use unpasteurised milk which can contain harmful bacteria
• using an insect repellent at all times to avoid mosquito bites, as well as nets at bedtime to prevent the insects from getting to you
• taking a first aid kit so you can treat cuts and grazes straight away, especially in hot and humid climates

Talk to your doctor about whether you need to take some antibiotics with you, for stomach bugs or cuts and grazes. And remember to ask your doctor about which vaccinations you might need. Ideally, book an appointment to get travel health advice before booking your trip. 

It’s also a good idea to be aware of where the local hospital or doctor is.

Swelling (lymphoedema)

Lymphoedema is a build up of lymph fluid, causing swelling of a part of the body. It can develop if there are problems with the lymphatic system. For example, if you have had surgery to remove your lymph nodes. The swelling might become worse for some time when you’re travelling. This is most likely to be because you don't move a lot during the journey.

Some tips for coping with lymphoedema while travelling

• Wear loose fitting clothing and a well fitting elastic (compression) sleeve or stocking.
• Keep the affected arm or leg raised and keep moving around at least every hour.
• Break your journey up so you can walk around and exercise your arms and legs.
• Avoid sunburn.
• Keep your skin clean and moisturised.
• Use an insect repellent to avoid mosquito bites.
• Clean cuts and grazes with antiseptic and cover them.
• Drink plenty of water.
• Don’t overdo things. Do the same amount of exercise as usual.
• If possible, keep yourself cool as heat can worsen any swelling.

You might want to wear a medical alert bracelet to show that you have lymphoedema or are at risk of developing it. The bracelet alerts health professionals that they shouldn’t use your affected arm or leg to take blood pressure, blood tests or to give injections.

Taking care in the sun

Everyone should protect their skin from the sun. Exposure to strong sun isn’t good for anyone.

But after some cancer treatments, your skin may be more sensitive to the sun. Your skin may also be drier and more sensitive to chemicals, such as chlorine in swimming pools.

Talk to your doctor about whether your treatment will make your skin more sensitive.

Treatments that can make your skin more sensitive

Certain cancer drugs can make your skin more sensitive to the sun. Some of these include:

• doxorubicin
• dacarbazine
• fluorouracil
• idarubicin
• methotrexate

Radiotherapy can also make the skin where you had treatment sensitive to the sun for many years. Keep the skin covered for the first year after treatment. And keep protecting it for many years after that.

Tips to protect yourself from the sun

• Wear close weave cotton clothing or clothing with built in UV ray protection.
• Wear long sleeves and trousers.
• Wear a hat with a wide brim that shades your face and neck.
• Spend time in the shade when the sun is at it's strongest. In the UK this is between 11am and 3pm.
• Use sunscreen with a protection level of at least SPF15 and 4 or 5 stars. Apply the sunscreen carefully, reapply every few hours even if it says it's water resistance and especially after towel drying.

Travellers' diarrhoea

Travellers' diarrhoea is a common problem for all people going abroad, even within Europe. But you are more at risk of developing complications from travellers' diarrhoea if you have a weakened immune system.

Travellers' diarrhoea is caused by having food or water that’s contaminated with bacteria, viruses and in some cases parasites.

Symptoms can include:

• passing watery poo (stools), 3 or more times a day
• stomach cramps
• feeling or being sick
• urgency to have a poo
• high temperature (fever)

Symptoms are usually mild and often get better without treatment within 3 to 5 days. See a doctor if you have:

• blood or mucus in your poo
• high temperature
• severe stomach pain
• rash
• changes to your mental state such as confusion, memory loss, not very alert
• yellowing of the skin and whites of the eyes (jaundice)

See a doctor if symptoms do not improve within 3 days. 

You’re at risk of getting dehydrated so it’s important to drink plenty. Make sure the water you are drinking is safe, so for example boiled, treated or sealed bottled water.

It’s sensible to take a few basic items with you in case you get travellers' diarrhoea, such as packets of oral rehydration solution. It’s also handy to carry hand gel and wipes.