September is Blood Cancer Awareness Month.
Stem cell transplantation (SCT), sometimes referred to as bone marrow transplant, is a procedure in which a patient receives healthy stem cells to replace damaged stem cells. After the stem cells are infused into the patient’s bloodstream, they travel to the bone marrow and begin the process of forming new, healthy blood cells including white blood cells, red blood cells and platelets.
Before SCT, the patient receives high doses of chemotherapy, and sometimes radiation therapy, to prepare the body for transplantation. This is called “conditioning treatment.” The conditioning treatment can lead to challenging side effects such as decreased appetite, taste changes, mouth sores and nausea that can make eating well difficult. However, staying well-nourished is important to promote recovery and quality of life.
Patients receiving SCT also have a weakened immune system, which increases their risk for illness caused by food. Following safety guidelines is extremely important for SCT patients to avoid foodborne illness.
If you are going to undergo a SCT, how can you ensure you’re getting proper nutrition and reduce the risk of foodborne illness? Are there things you can do in advance to prepare?
Use the following tips and suggestions.
Be informed. Ask your transplant center for printed list of nutrition guidelines and food restrictions. Each center often has specific food guidelines for you to follow, some of which should be followed for up to 3-4 months after the transplant. See the United States Department of Agriculture (USDA) Food Safety: A Need-to-Know Guide for Those at Risk. (Transplant recipient information begins on page 15.)
Wash fruits and vegetables. Contrary to popular belief, fresh fruits and vegetables are often safe to eat, but you must first wash them well under clean, running water. Fruits and vegetables that will be cooked and/or peeled should still be washed first. You may want to use a produce brush to help with washing.
Map out some menus. Using your nutrition guidelines, create some menus with meals and snacks that you like within the guidelines. Use our Meal Planning Worksheet to stay organized. Ask for help from your caregiver and friends to go shopping to fill your pantry and freezer. Remember ingredients for shakes, smoothies and healthy snacks. Don’t use dietary or herbal supplements unless prescribed by your transplant team.
Pump up with dietary protein before, during and after a transplant. Your dietary protein and calorie requirements after a transplant may be increased by 25 to 50%. Examples of safe, high-protein foods include:
- Well-cooked meat and poultry
- Pasteurized cheese and yogurts
- Homemade milkshakes
- Well-cooked eggs
- Canned meat or fish
- Roasted nuts
- Commercial nut butters
- Commercial supplement protein beverages.
Go small. Buy foods in small amounts or single serving packages so they will be fresh, and you won’t waste food. Single serving containers are also portable for snacks on the go. Eat iron-rich snacks like half of a meat sandwich, iron-fortified cereal and cereal snack mix.
Clock your nourishments. Eat every 2 to 4 hours. Don’t rely on appetite or hunger to remind you to eat. Cancer treatments and medication may decrease your appetite so make a plan to eat a mini meal or snack often.
Wash hands well before, during and after food preparation. It is important to wash your hands and any tools such as knives or cutting boards after touching meat. If you switch from working with meat to another food such as produce, wash your hands before touching the next food or tools. Ask others around you to wash their hands. Wash can tops before opening too.
Take temperatures seriously. Keep food in the safe zone. Keep cold foods less than 40 degrees Fahrenheit. Keep hot foods more than 140 degrees Fahrenheit. Use a food thermometer to check.
Be a food snob. Don’t eat bruised produce or foods that don’t smell right. Do not eat food that has expired. Prepare meals at home. Don’t share food or beverages with others. Only keep prepared foods refrigerated for up to 3 days and label leftovers with dates. Avoid buffets, food bars, food samples at grocery stores and pre-sliced vegetables, salads and fruits. You can’t be certain who has touched the food before you or how long the food has been sitting out.
Get smart supplies. The right utensils and supplies can help you follow food safety guidelines and reduce your risk of foodborne illness. These items include:
- Meat thermometer to check the internal temperature of foods
- Several cutting boards to keep meat and produce separate
- Bleach, dish soap and other cleaning supplies
- Hand soap and hand sanitizer
- Produce brush to wash fruit and vegetables
- Freezer food storage bags
- Glass food storage containers
- Rotating base for the microwave
- Labels and pens to add eat-by dates to leftovers.
Mange side effects. Address your side effects like bloating, digestive issues, taste changes, and poor appetite with your transplant team or a registered dietitian. Ask for a referral to a registered dietitian who sees transplant patients often.
For more on SCT, click here to view, download or order the free LLS booklet Blood and Marrow Stem Cell Transplantation Guide.
Dana-Farber Cancer Center: Food Guidelines 100 Days After Stem Cell Transplant
Memorial Sloan Kettering Cancer Center: The Science of Eating Well: MSK Research Focuses on Nutrition after a Stem Cell Transplant
Blood and Marrow Transplant Information Network: Nutrition after Transplant
From the Blood and Marrow Transplant Information Network