The immune system is weakened during all types of cancer treatment. Unfortunately, chemotherapy medications are not able to tell the difference between healthy cells and cancer cells. For this reason, perfectly healthy red and white blood cells are damaged or killed during treatment and shortly thereafter. The result of this is that the body is not as good at fighting illness and infection. A common term used to refer to a very low neutrophil (white blood cell) count is neutropenia. Paying special attention to food safety during cancer treatment to reduce the risk of exposure to food borne illness may also be referred to a neutropenic diet. The following are some simple tips to reduce exposure and avoid unnecessary infection and/or illness during the time the immune system is compromised.

Keep EVERYTHING Clean

  • Wash hands often and thoroughly especially before handling any food as well as after. Be sure to wash hands with warm water and soap for at least 20 seconds. Pay special attention to finger nails and the backs of the hands.
  • Keep raw and cooked foods separate. Do not reuse any utensils, cutting boards, plates, dishes, etc. once they have been touched by raw meat or eggs. Utensils, cutting boards, plates, dishes, etc. that have been used for preparing raw meats or eggs should be washed in hot, soapy water. It is best to keep separate cutting boards for meat and fruits/vegetables. Have an extra clean cutting board available for additional preparation as well.
  • When shopping for and storing raw meats, keep them away from other foods and cover the packages with extra plastic wrap or use plastic bags. This will prevent any liquids from leaking onto other foods or surfaces. Store meats and eggs toward the bottom of the refrigerator to prevent any dripping on other foods below.

Cook Food Thoroughly

  • Avoid raw meat such as sushi, undercooked eggs and other meats that have not been cooked to a proper internal temperature.
  • Cook all eggs until both the white and the yolk are firm.
  • Use a meat thermometer to make sure that all meats are cooked to the proper internal temperature prior to eating. Here is a chart for reference:

For more on cooking food to a safe internal temperature, visit eatright.org or FoodSafety.gov.

Foods To Avoid

  • Raw or undercooked meats
  • Unpasteurized milk and juices
  • Soft cheeses made with unpasteurized milk such as feta, blue cheese, Roquefort, Stilton, brie, or Farmer’s cheese
  • Processed meats such as luncheon meats as well as anything else from a deli counter
  • Refrigerated meat spreads or paté
  • Smoked fish or precooked shrimp or crab meat
  • Sprouts such as bean sprouts, alfalfa sprouts, or broccoli sprouts
  • Pre-cut fresh fruit and vegetables. Buy them whole, wash, and cut them yourself using proper sanitary techniques as outlined above.
  • Unwashed fresh fruits and vegetables
  • Unroasted or raw nuts and seeds
  • Raw tofu or tempeh
  • Food from salad bars of buffets
  • “Fresh” salad dressings, salsas, sauces, etc. sold in the refrigerated section of the grocery store.
  • Raw apple cider
  • Raw honey
  • Unrefrigerated cream filled pastries

The guidelines above were created with those who have severely weakened immune systems in mind. Consult your physician or health care team for regular updates on your blood counts and the status of your immune system.

If you are currently undergoing cancer treatment, you may be experiencing side effects. For tips on managing your side effects, visit Nutrition Tips for Managing Side Effects.