Are there any foods to avoid while I’m undergoing cancer treatment?

-Carla from Wisconsin

Unfortunately, some forms of cancer treatment alter your immune system, making you more susceptible to food borne illnesses. However, simply skipping meals is not a good option, no matter how nauseous you feel. During cancer treatment, it is very important to eat well and fuel your body. Food helps you sustain strength, maintain your weight, and assists your immune system.

Food borne illnesses become a real danger if you become neutropenic. Neutropenia is a blood disorder that can be caused by cancer treatment. If you are neutropenic, neutrophils, the white blood cells responsible for maintaining your immune system, are too low. As a result, your immune system is not strong enough to fight off bacteria.

How do you know if you are neutropenic? Your doctor can determine from routine blood work whether your neutrophils are falling. A normal Absolute Neutrophil Count (ANC) is between 2500 to 5000. If your immune system is compromised, your ANC may fall. If the ANC is lower than 1000, you are considered to be neutropenic or in a period of nadiring. During this time, you should follow a low microbial or neutropenic diet. A neutropenic diet consists of limiting foods that may cause food borne illness due to bacteria and fungus which are normally present in food.

Foods to avoid during cancer treatment

Fresh fruits and vegetables (peeled, thick-skinned varieties are okay)

• Dried fruit
• Raw or undercooked meats
• Sushi
• Runny yolks
• Soft cooked eggs
• Salad bars
• Fresh fruit bars
• Deli counters
• Unpasteurized items such as milk, yogurt, cheese, apple cider, or soft molded cheeses (e.g. Brie, Camembert, Roquefort, Gorgonzola, feta, Bleu)
• Well water (unless boiled prior to use)
• Eggnog
• Soft-serve ice cream
• Popcorn
• Filled donuts and pastries
• Uncooked or raw nuts
• Unpasteurized honey
• Fresh spices.

Other food safety considerations

Make sure both you and your caregivers frequently wash your hands.

• Maintain a clean kitchen; always wash hands, utensils, and countertops before cooking.

• Have two separate cutting boards, one for meats and the other for fruits and vegetables. Bleach the meat cutting board after each use to reduce bacterial contamination.
• Thaw meats in the refrigerator or in the microwave; cook them immediately to a safe temperature.
• When washing dishes, use a disposable cloth or launder after each use.
• Let dishes air-dry or place them in dishwasher.
• If you have leftovers, place them in containers and freeze or refrigerate them immediately.
• Throw away refrigerated leftovers within 48 hours.

Follow these precautions until your blood counts return to normal or your doctor gives you permission.

Dena McDowell, MS, RD Contributing Expert

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