Lymphoma and some lymphoma treatments can affect your immune system. This makes it harder for you to fight infections. It’s therefore necessary to take extra care to help lower your risk of infection. This is especially important when visiting parts of the world where you could come into contact with new infections.
It’s important to note that:
- Your immune system might be lowered even if you are in remission (disappearance or significant shrinkage of lymphoma).
- If you have had your spleen removed (splenectomy), you have a higher risk of developing infections – this is the case even if you are on long-term antibiotics.
- If you are on long term treatment or maintenance therapy, your medical team might advise that you do not travel.
If you are travelling to a hot, sunny country, speak to your medical team for guidance about managing photosensitivity and how to protect your skin from sunlight. The NHS website also has general information about sunscreen and sun safety.
Give some thought to your trip before you go, to help make your travel plans as safe as possible.
Before you go
Ask a member of your medical team if it is safe for you to travel. Check with them:
- the safety of your travel plans, including how you will travel and where you’ll stay
- if there are any places or activities you should avoid while you’re away
- if they are able to tell you about the medical services that are available where you’re going and how to access them if you need them – if you’re using a travel company, you could ask them for this information
- whether there are any travel vaccinations you need
- whether you need to take precautions to protect against malaria.
It could also be helpful to find out about the medical services that are available where you’re going and how to access them if you need them – if you’re using a travel company, you could ask them for this information.
Take with you
When you travel, take:
- details of your travel insurance policy – some people take a photo of this information, to have an electronic copy on their phone or tablet
- extras of any medication you’re taking – you could split it between your baggage, in case any is lost
- your most recent clinic letter
- any warning cards you have been given by your doctors, for example, irradiated blood products card in case of the need for a blood transfusion.
You might need to take a letter from your medical team to say why you need the medication, especially if you take it by injection. The NHS website has more information about taking medicine abroad.
Some people set up a medical information page on their mobile phone to store medical contact details. In the event of an emergency, this is accessible on the home screen without unlocking your phone.
Cleanliness while you’re away
Make sure that you choose somewhere to stay that has high cleanliness standard and where food is freshly cooked. You could check for recent reviews from other people who have stayed in the accommodation.
- Keep good personal hygiene to reduce your risk of infection – wash your hands thoroughly before meals, after using the toilet and after using public facilities.
- Have some sanitising gel with you in case soap and water isn’t available to wash your hands.
- Make sure that any water you use to cook with, drink or wash with is clean and safe to use.
Travel vaccinations can help to protect you from serious infections that are not found in the UK.
Ask your GP for advice about whether you need any and, if so, which are suitable for you. Depending on where you are travelling to, you might also need to think about protecting yourself against malaria.
Seek medical advice at least 8 weeks before your trip. Some travel vaccinations need to be given well before you travel, otherwise they might not be effective. You might also need to allow time for them to be ordered in for you.
If it’s unsafe for you to have a vaccination, think carefully about the possible risks and benefits of making the trip. You can talk this through with a member of your medical team or your GP.
Your medical team can give you advice specific to your situation. However, the Department of Health Guidelines say that you should not have live vaccines for at least:
- 3 months after finishing a course of high-dose steroids
- 6 months after finishing treatment with chemotherapy or radiotherapy
- 12 months after finishing treatment to dampen your immune system after a stem cell transplant
- 24 months after you have had graft-versus-host disease (GvHD), a complication that can happen after an allogeneic stem cell transplant.
If you have lowered immunity, you might need other vaccines, including those against influenza (flu), meningococcal meningitis and pneumococcal infections.
Safety of travel vaccinations for people with lymphoma
Check with your medical team which vaccines you should have and if there are any you should avoid.
In general, vaccines made using killed bacteria or viruses (inactivated vaccines) are safe for people with lymphoma.
Vaccines made using weakened but living bacteria or viruses (live vaccines) might not be suitable people who have lymphoma because they could cause an infection.
The World Health Organization (WHO) has more information about the different types of vaccine.
Where can I get travel vaccinations?
Some vaccinations are available on the NHS at GP surgeries. These usually include vaccines against hepatitis A, typhoid and cholera and polio. The polio vaccine is usually given as a combined diphtheria/tetanus/polio vaccine.
Some vaccinations are not available on the NHS (for example yellow fever, Japanese encephalitis and rabies vaccines). Yellow fever vaccine is a live vaccine, so it might be unsuitable for people who have lymphoma. You need to pay for vaccines that are not available on the NHS. You will need to arrange to have these either at a pharmacy that offers travel health services or at a specialist licensed centre. One website that has an online search tool to help you find a travel clinic is Masta.
Take general precautions and follow advice from your medical team to prevent infection. Keep in mind that there is generally a higher risk of infection if you are going on a cruise and you might need to arrange for cruise travel insurance.
Depending on where you are travelling to, this might include:
- Protecting yourself from mosquito bites, which can cause diseases such as malaria.
- Sterilising water you drink or wash yourself with – you can do this by boiling it. Carbonated (sparking) bottled water should also be safe however, still bottled water can contain bacteria that could be harmful if you have a lowered immune system.
- Avoiding eating unpackaged foods like salads or unpeeled fruit, unless you’re certain they’ve been washed well in sterilised water.
Malaria is a serious tropical disease. It is carried by some types of mosquito, and they spread it when they bite. The bite wound itself can also lead to infection.
If you have lymphoma, you should be particularly cautious about travelling to areas where malaria is widespread. If you have had your spleen removed (splenectomy), you are more at risk of becoming very unwell if you develop malaria.
The risk of developing malaria is higher in tropical and subtropical parts of the world, including Africa, parts of Asia and South America. The Travel Health Pro website has information about travel safety when visiting different countries, including about malaria.
The UK government states that prevention of mosquito bites is the best way to protect yourself against malaria. Different species of mosquito bite at different times of the day, so it is best to take precautions at all times.
To help protect yourself from mosquito bites:
- Wear clothes that cover as much of your skin as possible. Mosquitoes are not able to bite through material.
- Use an insect repellent. Those that are 50% DEET-based are generally considered to be most effective. Some studies have found that DEET products can reduce the effectiveness of sunscreens.
- Sleep under a mosquito net. Bed nets that have been treated with long-lasting insecticide (LLIN) bought from a reputable travel company are considered to be most effective.
- Use air conditioning if it’s available. This helps to cool the room without opening windows, which lessens the chance of letting mosquitoes in. Mosquitoes are generally less active in lower temperatures too. A fan might also help to keep mosquitoes away if you sleep directly under the air movement. If you do open doors or windows, use a well-fitted fine mesh netting to prevent mosquito bites.
Your medical team might advise that you take anti-malaria tablets. These can significantly lower your risk of getting malaria.
Your GP can advise you on if and when you need anti-malaria tablets and which type is most suitable for you. They consider factors such as your age, medical history, whether you’re currently having treatment for your lymphoma and where you are travelling to. Some tablets need to be taken for a few weeks before you travel, so make sure you seek medical advice in plenty of time.
Anti-malaria tablets are not available on the NHS. Your GP can prescribe them but you will still need to pay for them in full.
The Fit for Travel website has more information about malaria and risk prevention.