Food Safety for People with Cancer

Mesothelioma treatment can decrease immunity, making people very susceptible to the bacteria and viruses that cause food poisoning. Not following proper food-safety techniques can lead to severe illness, especially in people with a weakened immune system.

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This page features: 11 cited research articles

Mesothelioma treatments, including chemotherapy and radiation, may keep your cancer under control, but they also weaken your immune system.

The immune system helps the body fight dangerous bacteria and viruses that are all around you — even on the food you eat.

The Foodborne Diseases Active Surveillance Network received reports of 24,484 illnesses linked to contaminated food, according to preliminary 2017 data.

Those illnesses resulted in 5,677 hospitalizations and 122 deaths in the U.S.

People with mesothelioma are at a higher risk of developing symptoms of foodborne illnesses if they or their caregivers do not follow proper food-safety techniques.

Food Safety Principles: Clean, Separate, Cook and Chill

The U.S. Food and Drug Administration (FDA) recommends vigilance among cancer patients and their caregivers when handling, preparing and consuming foods.

Foodsafety.gov recommends following four basic steps to food safety to avoid contracting a foodborne illness from germs commonly found on meats, vegetables, fruit, other food items and kitchen counters.

These guidelines are appropriate for your family, too.

Clean

Wash hands for 20 seconds with plain soap and running water immediately after handling raw meat, poultry, seafood, eggs and unwashed produce. Wash surfaces, cutting boards and utensils with soap after each use.

Separate

Never use the same cutting board and knives for uncooked meat, poultry, seafood and produce (vegetables and fruit). Many people have one cutting board for raw meat, poultry and seafood and another for produce. Separate these foods in the refrigerator in clean, sealable bags.

Cook

Cook all foods to the proper temperature to kill illness-causing bacteria. Beef, pork, lamb and veal must be cooked to a minimum internal temperature of 145 F. Ground meats, such as hamburger and sausage, must be cooked to at least 160 F all the way through the meat. Poultry must be cooked to a minimum internal temperature of 165 F.

Chill

Refrigerate perishable foods within one hour. Never thaw frozen food on the counter. As it thaws at room temperature, bacteria that may have been present before freezing can start to multiply. Leave enough time to thaw in the refrigerator and place on a plate or pan to avoid any drips onto ready-to-eat items below.

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What Food Should Cancer Patients Avoid?

Along with these four important, safe food-handling practices, mesothelioma patients should avoid a few specific foods. These are difficult to clean or have a higher risk of being contaminated with disease-causing microbes.

Foods to Avoid

  • Raw or undercooked meat, poultry, seafood and eggs

  • Unpasteurized or raw milk

  • Unwashed fresh produce

  • Soft and raw-milk (unpasteurized) cheeses

  • Cold or undercooked hot dogs or deli meats

  • Raw sprouts (alfalfa and bean)

  • Leaf lettuce, strawberries and raspberries, which are difficult to clean

Foods to Enjoy

  • Meat, poultry and seafood cooked to a safe internal temperature

  • Pasteurized milk and pasteurized milk cheese

  • Cooked eggs with a firm yolk and no runny whites

  • Washed fresh or cooked produce

  • Hard cheeses and soft cheese made from pasteurized milk

  • Hot dogs and deli meats heated to 165 F or until steaming

  • Cooked sprouts

Additional Precautions

If you enjoy homemade smoothies, wash fresh produce before blending. Frozen is prewashed prior to packaging and safe to use straight from the package.

Store any leftover smoothie in a sealed container in the refrigerator and discard after 24 hours.

Why Is Food Safety So Important for Mesothelioma Patients?

Following proper food safety is important to mesothelioma patients because treatment weaken the immune system and makes them more susceptible to foodborne illnesses.

Many people refer to this as “food poisoning.” That’s an accurate description. You can be so sick you feel as if you’ve been poisoned.

Symptoms of foodborne illness can include:

  • Nausea

  • Vomiting

  • Upset stomach

  • Abdominal cramps

  • Diarrhea

  • Dehydration

  • Loss of appetite

  • Fever

  • Flu-like illness

  • Weakness

  • Muscle aches

  • Lethargy

  • Dizziness

Following proper safe food-handling precautions will minimize the risk of food poisoning for mesothelioma patients.

These precautions are important for optimizing your nutrition before, during and after mesothelioma treatment.

Immune Function Matters

When thinking about food safety for mesothelioma patients, doctors and dietitians pay attention to a type of white blood cell called a neutrophil.

Neutrophils are part of the immune system. They help your body fight off infections. When their levels are abnormally low, this is referred to as neutropenia.

When you don’t have enough of these cells, you have a high risk of bacterial infections from the food you eat, the counters you touch or any other item that may contain illness-causing bacteria.

Doctors track neutrophil numbers with blood tests during mesothelioma treatment. Although any number below 1,500 neutrophil cells per microliter is considered neutropenia in an adult, most health care providers do not consider neutrophil counts between 1,000 and 1,500 a cause for alarm.

However, when counts drop below 1,000, and especially when they drop below 500, infection risk increases. At these levels, even normal bacteria from your mouth and digestive tract can cause serious infections.

Learn More About Nutrition During Mesothelioma Treatment

Do You Need a Neutropenic Diet?

No. Recent research does not support the benefits of following very strict food safety precautions called a neutropenic diet.

The neutropenic diet is more restrictive than following well-accepted safe food handling practices. Some versions of the diet eliminate tap water and all fresh vegetables and fruit, allowing only foods cooked at high temperature.

Cancer experts used to recommend the neutropenic diet for all patients experiencing low white blood cell counts. However, this isn’t proven to reduce infection risk beyond simply following food safety guidelines.

Many people in cancer treatment have a poor appetite. They may be avoiding many foods already.

Anything that further restricts the foods a person can have isn’t helpful, especially because experts now believe these restrictions provide no benefit.

Pay Attention to Reports of Contaminated Food

Health officials — federal, state and local — frequently announce disease outbreaks linked to contaminated food.

For example, the CDC in March 2018 announced an E. coli outbreak linked with eating romaine lettuce. The type of E. coli causing this outbreak, known as O157:H7, caused severe illness, including kidney failure and death.

The outbreak infected 210 people, across 36 states. Five people died.

Although the contaminated lettuce is no longer available, and the threat has ended, the incidence shows how serious these infections can be.

A good tip to follow during food-related disease outbreaks: Avoid any contact or consumption of the suspected foods.

If you are unsure whether a particular food is safe for you, ask your doctor, nurse or dietitian for guidance.

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Last Modified November 13, 2018

Oncology Medical Writer

Suzanne Dixon is a registered dietitian, epidemiologist and experienced medical writer. She has volunteered with the National Cancer Policy Forum, Oncology Nutrition Dietetic Practice Group, American Institute for Cancer Research, American Society for Clinical Oncology, The National Academies of Sciences, Engineering, and Medicine. The New York Times and Time Magazine also have reviewed her cancer patient resources.

Walter Pacheco, Managing Editor at Asbestos.com
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8 Cited Article Sources

  1. Mayo Clinic. (2018, January 11). Symptoms. Neutropenia.
    Retrieved from: https://www.mayoclinic.org/symptoms/neutropenia/basics/definition/sym-20050854
  2. Sonbol, M.B. et al. (2015). The Effect of a Neutropenic Diet on Infection and Mortality Rates in Cancer Patients: A Meta-Analysis. Nutr Cancer, 67, 1230-8. DOI: 10.1080/01635581.2015.1082109
  3. Baumgartner, A. (2018). Optimization of nutrition during allogeneic hematologic stem cell transplantation. Curr Opin Clin Nutr Metab Care, 21, 152-158. DOI: 10.1097/MCO.0000000000000461
  4. Lassiter, M. and Schneider, S.M. (2015). A pilot study comparing the neutropenic diet to a non-neutropenic diet in the allogeneic hematopoietic stem cell transplantation population. Clin J Oncol Nurs, 19, 273-8. DOI: 10.1188/15.CJON.19-03AP
  5. Maia, J.E. et al. (2018). Microbiological profile and nutritional quality of a regular diet compared to a neutropenic diet in a pediatric oncology unit. Pediatr Blood Cancer, 65, DOI: 10.1002/pbc.26828
  6. Moody, K.M. et al (2018). A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients. Pediatr Blood Cancer, 65, DOI: 10.1002/pbc.26711
  7. FoodSafety.gov. Food Safety for Cancer Patients. (n.d.).
    Retrieved from: https://www.foodsafety.gov/risk/cancer/index.html
  8. Centers for Disease Control and Prevention. (2018, May 16). Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce.
    Retrieved from: https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
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