Taking care while you are on holiday

Eating and drinking

Wherever you are in the world, be careful about what you eat and drink. Many infections are spread by food and water. This can include water in:

swimming pools
lakes
rivers
seas
oceans.

If you are at risk of infection because of cancer treatment, you need to be extra careful about what you eat and drink. Infections can be more serious and difficult to treat if your immune system is weak. Make sure you get advice from your cancer doctor or specialist nurse before your trip.

You can find information about the risks of contaminated food and water in specific countries at:

travelhealthpro.org.uk/countries if you live in England, Wales or Northern Ireland
fitfortravel.nhs.uk/destinations if you live in Scotland.

Tips for avoiding stomach problems

One of the best ways to reduce your risk is to wash your hands regularly. Always wash your hands with soap and clean water after going to the toilet, and before eating or preparing food or drink. If there is no clean water, use disposable wipes or alcohol hand gel.
Try not to swallow water when you are swimming. If you are not sure the water is clean, try not to swallow water when you are brushing your teeth, showering or having a bath.
Drink bottled water unless you know the water is clean. You can also use this to brush your teeth. Check that seals on bottled water are not broken before you open them.
If you are not sure the drinking water is clean, sterilise it. You can do this by boiling it for 1 minute, or by using a filtering system or sterilisation tablets.
Avoid ice in drinks, unless you are sure it is made from safe water.
Cooked food is safest. Try to choose freshly cooked food that is still steaming hot. Avoid pre-prepared foods that are not kept hot or have not been kept refrigerated – for example, avoid buffets. Also avoid reheating leftovers.
Avoid raw and undercooked food. This includes raw fruit and vegetables, unless you can peel them or remove the outer skin or shell yourself.
Fish and shellfish can be harmful even when cooked. If you are worried or have a weakened immune system, avoid eating these.
Only drink or eat pasteurised milk or dairy products. Avoid or boil unpasteurised milk.
Avoid ice cream from unreliable sources, such as street stalls. Only eat ice cream made from pasteurised milk.

Taking care in the sun

It is always important to protect your skin from the sun. You may need to be more careful during and after cancer treatment. Some cancer treatments make your skin more sensitive to the sun and you may burn more easily. You may also have a higher risk of overheating and becoming unwell.

If you have had chemotherapy

Some chemotherapy drugs can make your skin more sensitive. This can sometimes last for several years after treatment. Ask your cancer doctor or specialist nurse whether you need to take special care to protect your skin.

Some people also find chemotherapy makes their skin sensitive to chemicals, such as chlorine. You may need to avoid swimming in pools treated with chlorine. It is best to avoid hot tubs and saunas because bacteria and other germs grow faster in warm water.
If you have had radiotherapy

The skin in the area treated by radiotherapy stays sensitive for many years. You need to take extra care to protect it from the sun, especially for the first year. The skin in that area is at a higher risk of burning and long-term sun damage, including skin cancers.
If you have had targeted or immunotherapy drugs

Many targeted therapy and immunotherapy drugs can make your skin sensitive to the sun. Your skin may burn more easily than normal. Ask your doctor or nurse whether you need to take special care to protect your skin.

Tips for protecting yourself in the sun

It is important to protect your skin by using a suncream with both a:

high sun protection factor (SPF) of at least 30
4-star or 5-star ultraviolet A radiation (UVA) protection rating.

The SPF and UVA rating measure how well the suncream will protect you from the sun’s rays, which can cause skin cancer. Follow the instructions and reapply regularly as recommended, particularly after swimming or washing.

When you are in the sun, you can also protect yourself by wearing a wide-brimmed hat, suitable sunglasses and clothing to cover up. Sunglasses with the most protection for your eyes have wraparound lenses or wide arms, and they have either:

a CE mark
the British Standards Institution KitemarkTM

Following these tips will also help make sure your skin does not burn:

Cover up with long-sleeved tops and trousers or long skirts. If you have had radiotherapy, keep the treated area completely covered.
Wear light, loose and comfortable clothes made of cotton or natural fibres. These have a closer weave and give better protection from the sun.
If you have lost your hair or it is thinning, cover up with a hat or headscarf to protect your scalp. If you do not want to cover your head, use suncream that has an SPF of at least 30 on your scalp.
If you are using insect repellent, apply your suncream first and then spray the repellent on top.
Spend time in the shade during the hottest part of the day between 11am and 3pm, and when it is sunny.
If you want to look tanned, use fake-tanning lotions or sprays instead of sunbathing or using a sunbed.

If you are in a hot country, you may also need to do the following:

Try to keep cool and spend time in the shade, even at other times of the day. Heat can make cancer-related fatigue (tiredness) worse.
Drink plenty of fluids throughout the day, unless your doctor or nurse has given you advice about restricting how much you drink. Remember that alcohol or drinks with caffeine in them can make you dehydrated.

Insects

Insect bites and stings are often not serious. But they can become infected. And sometimes they can spread illnesses. If you are travelling abroad, the most common illness spread by mosquitos is malaria. Others include dengue fever and yellow fever. In the UK, Lyme disease can be spread by infected ticks.

If you are planning to travel abroad, you can find information about the risk of illness from insect bites in specific countries at:

travelhealthpro.org.uk/countries if you live in England, Wales or Northern Ireland
fitfortravel.nhs.uk/destinations if you live in Scotland.

The National Travel Health Network and Centre (NaTHNaC) also has a factsheet about preventing insect and tick bites.

Preventing insect bites

Wherever you travel, and especially if you have a risk of lymphoedema or serious infection, it is best to try to prevent insect bites. You can help prevent insect bites by:

covering up your skin as much as possible, especially if you go out at night – wear long sleeves, trousers and shoes when outdoors
using insect repellent, preferably containing up to 50% DEET (diethyl-m-toluamide) – this is the main ingredient that makes insect repellent work.

This helps reduce your risk, but you still need to check for bites. If you do get bitten, try not to scratch. If you have signs of an infection, get advice from a doctor straight away – this includes flu-like symptoms, a high temperature, redness, a rash or heat in the affected part of the body, and increased swelling.

Malaria

Malaria is a risk in many tropical parts of the world. It is a disease spread by mosquito bites. You are more at risk of being seriously ill with malaria if your immune system is affected by the type of cancer you have or by cancer treatment.

Think very carefully about your travel plans and get advice from your cancer doctor and a travel clinic before you book a trip to anywhere with a risk of malaria. If your spleen has been removed, we have more information to help you.

Visit the NHS website for more information about preventing malaria and possible symptoms.

Lyme disease

Lyme disease is more common in North America and other parts of Europe than in the UK. But it is important to know about if you are spending time outdoors in grassy or wooded areas where the risk of tick bites is highest.

Lyme disease is not always serious, but it can cause ongoing and severe symptoms. Some people develop more severe symptoms months or years later.

It can be treated with antibiotics. This is more effective the earlier you have the antibiotics. If you think you have been bitten and you have flu-like symptoms or a round or oval rash, tell your doctor as soon as possible.

Visit the NHS website for more information about preventing Lyme disease and possible symptoms.

Animals and rabies

Animal bites and scratches can cause dangerous infections. It is important to be careful and avoid contact with animals abroad, even if they seem harmless. Animals in many places, especially in Asia, Africa, and Central and South America, can carry rabies. This is a rare, but very serious, infection of the brain and nerves. It is not found in the UK, except in a small number of wild bats.

You can find information about the risk of rabies in specific countries at:

travelhealthpro.org.uk/countries if you live in England, Wales or Northern Ireland
fitfortravel.nhs.uk/destinations if you live in Scotland.

If you are travelling to an area where rabies is common, you can have a vaccine before you travel.

Rabies is usually caught from the bite or scratch of an infected animal, such as a dog. Any animal can carry rabies, including pets. An animal licking an open wound or spitting in your face can also put you at risk. It is important to treat any wound straight away and get urgent medical help.

If you have treatment for rabies before any symptoms appear, it is very effective. But once symptoms appear, rabies is usually fatal. If you are scratched or bitten, or if an animal spits in your face, it is important to follow these steps:

Clean the wound with soap and running water, or wash your face straight away for several minutes. If there is any rabies virus on the wound surface or in your eyes, nose or mouth, this can help wash some of it away and reduce the risk.
Use an antiseptic containing alcohol or iodine to disinfect the wound.
See a doctor straight away, even if you had the rabies vaccine before you travelled. You will need extra treatment urgently.

Visit the NHS website for further information on rabies.

If you become ill

If you become unwell and need urgent attention during your trip, it is important to know what to do and who to contact.

We have more information about getting emergency healthcare during travel.

About our information

References

Below is a sample of the sources used in our travel and cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

GOV.UK. Guidance: Disability and travel abroad. Updated June 2019. Available from www.gov.uk/government/publications/disabled-travellers/disability-and-travel-abroad [accessed January 2023].

GOV.UK. The Green Book: Immunisation against infectious disease. Updated November 2020. Available from www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book [accessed January 2023].

National Travel Health Network and Centre. Travel Health Pro. Available from travelhealthpro.org.uk [accessed January 2023].

Travel and International Health Team, Public Health Scotland. Fit for Travel. Available from fitfortravel.nhs.uk [accessed January 2023].

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been approved by members of Macmillan’s Centre of Clinical Expertise.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.