Food Safety During Cancer Treatment

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 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 defend itself very well. This is because you might not have enough infection-fighting white blood cells for a while. You may be told to try to avoid exposure to possible infection-causing germs that might be found in some foods.

Germs like Staphylococcus (staph), E coli , and Salmonella can be found on :

• Foods left out too long without proper refrigeration
• Foods left on dirty surfaces
• Foods handled with dirty hands
• Uncooked or raw meats

Here are some tips for handling storing, preparing, and shopping for food when your immune system is recovering:

Food handling  

• Wash your hands with warm, soapy water for 20 seconds before and after preparing food and before eating.
• Clean counters and cutting boards with hot, soapy water.
• Use paper towels or disinfecting wipes to clean kitchen surfaces.
• Wash tops of canned foods with soap and water before opening. 
• Wash fruits and vegetables well under running water before peeling or cutting. Do not use soaps, detergents, chlorine bleach solutions, or commercial produce rinses.
• Use a clean vegetable scrubber to 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.
• Rinse packaged salads, slaw mixes, and other prepared produce again under running water, even when marked pre-washed. Using a colander or a salad spinner can make this easier.
• Rinse meats, poultry, and fish under cold running water, pat dry with paper towels. 

Food storage

• Refrigerate foods at or below 40° F.
• Keep hot foods warmer than 140° F and cold foods colder 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.
• In the refrigerator, store raw meat sealed and away from ready-to-eat food.
• 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.

Food shopping

• Check “sell-by” and “use-by” dates. Do not buy out-of-date products (including meats, poultry, or seafoods).  Pick only the freshest products.
• Do not use damaged, swollen, rusted, or deeply dented cans. Be sure that packaged and boxed foods are properly sealed. Also, check their expiration dates.
• Choose unblemished fruits and vegetables.
• Do not eat deli foods (sliced meats and cheese and salads).
• 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.
• 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.

Food preparation

• Use a clean knife to cut each food.
• Use different utensils to stir foods and taste them while cooking.
•  Do not taste the food (or let others taste it) with any utensil that will be put back into the food
• Keep foods separated on the countertops. Use a separate board to cut raw meats, poultry, or fish.
• When grilling, always use a clean plate for the cooked meat.
• 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.
• Whole meats should be cooked to 145° F, ground meats (veal, beef, lamb, pork, goat) should be cooked to 160°F, and poultry to 165° 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.
• In a microwave, use a lid or vented plastic wrap to heat leftovers thoroughly. Stir often during reheating.

Food tips when your white blood cell count is low

White blood cells help your body fight infections, so if your white blood cell count is low, it is easier for you to get an infection. Here are suggestions of things to do and things to avoid to help stay healthy.

Tips for dining out

• Eat early to avoid crowds.
• Ask that food be prepared fresh in fast-food restaurants.
• Ask that some foods (poultry, seafood, ground meats) be cooked well done.
• Ask for single-serving condiment packages, and avoid self-serve bulk condiment containers.
• Do not eat from high-risk food sources, such as salad bars, delicatessens (deli), buffets and smorgasbords, potlucks, and sidewalk vendors.
• Do not eat raw fruits and vegetables.
• Ask for pasteurized fruit juices. 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. Eat leftovers within 3 days to decrease the risk of getting sick from bacterial growth.