For people with weakened immune systems
Cancer and its treatment can weaken your body’s immune system by affecting the blood cells that protect us against disease and germs. As a result, your body can’t fight infection, foreign substances, and disease as well as a healthy person’s body can.
During your treatment for cancer, there will be times when your body won’t be able to protect itself very well. While your immune system is recovering, you may be told to try to avoid exposure to possible infection-causing germs. Here are some tips on how to do this:
- Wash your hands with warm, soapy water for 20 seconds before and after preparing food and before eating.
- Refrigerate foods at or below 40° F.
- Keep hot foods hot (warmer than 140° F) and cold foods cold (cooler than 40° F).
- Thaw meat, fish, or poultry in the microwave or refrigerator in a dish to catch drips. Do not thaw at room temperature.
- Use defrosted foods right away, and do not refreeze them.
- Put perishable foods in the refrigerator within 2 hours of buying or preparing them. Egg dishes and cream- and mayonnaise-based foods should not be left unrefrigerated for more than an hour.
- Wash fruits and vegetables well under running water before peeling or cutting. Do not use soaps, detergents, chlorine bleach solutions, or commercial produce rinses. Using a clean vegetable scrubber, scrub produce that has a thick, rough skin or rind (melons, potatoes, bananas, etc.) or any produce that has dirt on it.
- Rinse leaves of leafy vegetables one at a time under running water.
- Packaged salads, slaw mixes, and other prepared produce, even when marked pre-washed, should be rinsed again under running water. Using a colander can make this easier.
- Do not eat raw vegetable sprouts.
- Throw away fruits and vegetables that are slimy or moldy.
- Do not buy produce that has been cut at the grocery store (like melon or cabbage).
- Wash tops of canned foods with soap and water before opening.
- Use different utensils for stirring foods and tasting them while cooking. Do not taste the food (or allow others to taste it) with any utensil that will be put back into the food.
- Throw away eggs with cracked shells.
- Throw out foods that look or smell strange. Never taste them!
Do not cross-contaminate
- Use a clean knife to cut different foods.
- In the refrigerator, store raw meat sealed and away from ready-to-eat food.
- Keep foods separated on the countertops. Use a different cutting board for raw meats.
- Clean counters and cutting boards with hot, soapy water, or you can use a fresh solution made of 1 part bleach and 10 parts water. Moist disinfecting wipes may be used if they’re made for use around food.
- When grilling, always use a clean plate for the cooked meat.
Cook foods well
- Put a meat thermometer into the middle of the thickest part of the food to test for doneness. Test a thermometer’s accuracy by putting it into boiling water. It should read 212° F.
- Cook meat until it’s no longer pink and the juices run clear. The only way to know for sure that meat has been cooked to the right temperature is to use a food thermometer. Meats should be cooked to 160° F and poultry to 180° F.
- Rotate the dish a quarter turn once or twice during cooking if there’s no turntable in the microwave oven. This helps prevent cold spots in food where bacteria can survive.
- Use a lid or vented plastic wrap to thoroughly heat leftovers. Stir often during reheating.
- Check “sell-by” and “use-by” dates. Pick only the freshest products.
- Check the packaging date on fresh meats, poultry, and seafood. Do not buy products that are out of date.
- Do not use damaged, swollen, rusted, or deeply dented cans. Be sure that packaged and boxed foods are properly sealed.
- Choose unblemished fruits and vegetables.
- Do not eat deli foods. In the bakery, avoid unrefrigerated cream- and custard-containing desserts and pastries.
- Do not eat foods that are bought from self-serve or bulk containers.
- Do not eat yogurt and ice cream products from soft-serve machines.
- Do not eat free food samples.
- Do not use cracked or unrefrigerated eggs.
- Get your frozen and refrigerated foods just before you check out at the grocery store, especially during the summer months.
- Refrigerate groceries right away. Never leave food in a hot car.
- Eat early to avoid crowds.
- Ask that food be prepared fresh in fast-food restaurants.
- Ask for single-serving condiment packages, and avoid self-serve bulk condiment containers.
- Do not eat from high-risk food sources, including salad bars, delicatessens, buffets and smorgasbords, potlucks, and sidewalk vendors.
- Do not eat raw fruits and vegetables when eating out.
- Ask if fruit juices are pasteurized. Avoid “fresh-squeezed” juices in restaurants.
- Be sure that utensils are set on a napkin or clean tablecloth or placemat, rather than right on the table.
- If you want to keep your leftovers, ask for a container, and put the food in it yourself rather than having the server take your food to the kitchen to do this.
Tips for when your white blood cell count is low+
Avoid (do not eat)
Meat, poultry, fish, tofu, and nuts
Ensure all meats, poultry, and fish are cooked thoroughly.
Use a food thermometer to be sure that meat and poultry reach the proper temperature when cooked.
When using tofu from the refrigerated section (not shelf-stable), cut it into 1-inch cubes or smaller and boil 5 minutes in water or broth before eating or using in recipes. You don’t have to do this if using aseptically packaged, shelf-stable tofu.
Vacuum-sealed nuts and shelf-stable nut butters
Raw or lightly cooked fish, shellfish, lox, sushi, or sashimi
Raw nuts or fresh nut butters
Cook eggs until the yolks and whites are solid, not runny
Pasteurized eggs or egg custard
Raw or soft-cooked eggs. This includes over-easy, poached, soft-boiled, and sunny side up.
Foods that may contain raw eggs, such as Caesar salad dressing, homemade eggnog, smoothies, raw cookie dough, hollandaise sauce, and homemade mayonnaise
Milk and dairy products
Only pasteurized milk, yogurt, cheese, or other dairy products
Soft, mold-ripened or blue-veined cheeses, including Brie, Camembert, Roquefort, Stilton, Gorgonzola, and blue cheese
Mexican-style cheeses, such as queso blanco fresco, since they are often made with unpasteurized milk
Breads, cereal, rice, and pasta
Breads, bagels, muffins, rolls, cereals, crackers, noodles, pasta, potatoes, and rice are safe to eat as long as they are purchased as wrapped, pre-packaged items, not sold in self-service bins.
Bulk-bin sources of cereals, grains, and other foods
Fruits and vegetables
Raw vegetables and fruits and fresh herbs are safe to eat if washed under running water and lightly scrubbed with a vegetable brush.
Fresh salsas and salad dressings found in the refrigerated section of the grocery store. Choose shelf-stable salsa and dressings instead.
Any raw vegetable sprouts (including alfalfa, radish, broccoli, or mung bean sprouts)
Desserts and sweets
Fruit pies, cakes, and cookies, flavored gelatin; commercial ice cream, sherbet, sorbet, and popsicles
Commercially prepared and pasteurized jam, jelly, preserves, syrup, and molasses
Unrefrigerated, cream-filled pastry products
Raw honey or honeycomb. Select a commercial, grade A, heat-treated honey instead.
Water and beverages
Drink only water from city or municipal water services or commercially bottled water.
Pasteurized fruit and vegetable juices, soda, coffee, and tea
Water straight from lakes, rivers, streams, or springs
Well water unless you check with your cancer care team first
Unpasteurized fruit and vegetable juices
Sun tea (Make tea with boiling water, and use commercially prepared tea bags instead.)
Vitamin- or herbal-supplemented waters (These provide little, if any, health benefit.)
+ Adapted from Grant BL, Bloch AS, Hamilton KK, Thomson CA. American Cancer Society Complete Guide to Nutrition for Cancer Survivors, 2nd Edition. Atlanta, GA: American Cancer Society; 2010.
- Benefits of good nutrition during cancer treatment
- Cancer and cancer treatment affect nutrition
- Before treatment begins
- Once treatment starts
- Managing eating problems caused by surgery, radiation, and chemotherapy
- For people with weakened immune systems
- How to cope with common eating problems
- Appetite changes
- Mouth dryness or thick saliva
- Mouth or throat pain or sores
- Swallowing problems
- Taste and smell changes
- Weight gain
- Nutrition after treatment ends
- To learn more
- Recipes to try during cancer treatment