If you have a low immunity due to leukaemia, lymphoma, or because of recent cancer treatment (such as removal of your spleen), you may need to take a supply of antibiotics with you.

Some people with cancer may be advised not to travel by air under particular circumstances, as oxygen levels and air pressures change at high altitudes.

You may be advised not to fly if you:

• Are breathless.
• Are anaemic (have a low number of red blood cells).
• Are at risk of developing an increased pressure or swelling in the brain (cerebral oedema) due to a brain tumour.
• Have recently had surgery or a medical procedure – as this can introduce gas into the body that may expand to cause pain and stretch your wound. Air travel should be avoided for 10 days after any surgery.
• Have recently had surgery to your chest. Air travel should be avoided for 3–4 weeks after chest surgery.
• Have recently had surgery to your brain.
• Have problems with your ears or sinuses, where pressure changes may make symptoms worse.

Travelling, especially by air, can increase the risk of developing a blood clot. Some people with cancer have a higher risk of developing blood clots (deep vein thromboses or DVTs). There are a number of possible reasons for this. People with cancer often have slightly higher numbers of platelets – cells that help the blood to clot – in their blood. People with cancer may also have slightly higher amounts of clotting factors. Clotting factors are proteins that are produced naturally in the body and work with the platelets to form blood clots and prevent bleeding. People with cancer also sometimes have lower levels of natural blood thinning proteins (anticoagulants), especially if the cancer is affecting their liver.

The risk of developing a blood clot is higher in people with particular types of cancer. Some types of lung, stomach or bowel cancer produce a substance called mucin, which can raise the risk of clots. People with cancers of the pancreas, ovary, lining of the womb, and acute myeloid leukaemia (AML), have a slightly raised risk.

Sometimes, cancer treatments can increase the risk of blood clots. Some examples of this are certain types of hormonal therapy, such as tamoxifen for breast cancer, and stilboestrol for prostate cancer.

Helpful hints – preventing blood clots:

• If you are worried that you may be at risk of developing a blood clot when you travel, it's best to discuss this with your cancer specialist. They can advise you whether you need to have treatment that can help to prevent blood clots.
• Discuss with your doctors whether you should wear special compression socks during your travels.
• All air travellers should drink plenty of non-alcoholic fluids during flights.
• On any type of journey it is helpful to walk around or do leg exercises regularly.

People with lymphoedema (swelling of a part of the body) may find that travelling temporarily makes their lymphoedema worse. This is thought to be due to keeping still for long periods during your journey. The tips in the box on the following pages may help to prevent any problems.

You can get a leaflet with more detailed information about travel and lymphoedema from the Lymphoedema Support Network.

Helpful hints – lymphoedema:

• Do not have vaccinations in a limb that is affected by lymphoedema.
• If you usually wear a compression sleeve or stocking, have it checked to make sure that it fits properly, and wear this for your travels.
• Wear loose clothing that doesn't restrict the affected limb.
• Don't wear tight belts.
• It is important to gently exercise the limb and move around as much as possible while you travel.
• If you do lymphatic drainage massage, try to do this frequently during the journey.
• Drink lots of water to prevent dehydration.
• Don’t carry heavy luggage with an affected arm; use a luggage trolley, or ask a porter or travel agency staff for help.
• If you have lymphoedema in a leg, wear well-fitting, supportive shoes and do not take them off during the journey as the swelling can increase.
• Avoid strenuous exercise that you are not used to. Gentle, repetitive exercise of the affected limb (such as during tennis or cycling) can be helpful.
• Try to avoid extremes of temperature – stay cool if possible.
• Avoid sunburn – you can burn even through compression garments.
• If you have lymphoedema of the leg, never go barefoot. Always wear some sort of footwear as protection – even in the sea.
• Protect against insect bites by using insect repellent spray or cream, especially at dusk or at night.
• Keep your skin clean and check your skin regularly for any sign of infection.
• Treat any cuts, scratches and bites quickly with an antiseptic such as savlon or TCP.
• Talk to your doctor about taking antibiotics with you, just in case you develop an infection.