Food Safety and Mesothelioma

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.

This page features: 11 cited research articles

To harness nutrition’s healing power to cope with a mesothelioma diagnosis, make sure you eat nutrient-rich foods with plenty of protein and calories.

It is vitally important to keep your food safe and free of bacteria and viruses that can make you sick, too.

You may receive mesothelioma treatments that make you more susceptible to food-borne illness. Many people refer to this as “food poisoning,” and that’s an accurate description. You can be so sick you feel as if you’ve been poisoned.

Fortunately, a few easy steps go a long way toward keeping your food safe. Anyone who is preparing food for someone with mesothelioma should learn about proper food-handling guidelines.

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. When their levels are abnormally low, this is referred to as neutropenia.

Neutrophils help your body fight off infections. When you don’t have enough of these cells, you have a higher than average risk of infections, particularly from bacteria.

For an adult, any number below 1,500 cells per microliter is considered neutropenia.

Some mesothelioma therapies cause neutropenia, and doctors track numbers of these cells with blood tests. Most health care providers do not consider neutrophil counts between 1,000 and 1,500 to be a cause for alarm.

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

Cancer experts used to recommend strict food safety guidelines called a neutropenic diet for any cancer patient experiencing low white blood cell counts.

Recent research does not support benefits of following a neutropenic diet, even for patients experiencing low white blood cell counts.

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

Anything that further restricts the types of food a person can have should be avoided, unless we know these restrictions provide a benefit.

Food Safety for Everyone

A 2015 Nutrition and Cancer study found the neutropenic diet was no more effective at protecting against infection and death in cancer patients than a regular diet prepared using safe food-handling techniques.

Medical papers published since this time support these results. This is great news. It allows more freedom and flexibility around eating for mesothelioma patients.

Pay attention to the news

An April 2018 E. colioutbreak linked with eating romaine lettuce demonstrates how serious food-borne illness can be.

The type of E. coli causing this outbreak, known as O157:H7, can cause severe illness, including kidney failure and death. To date, 172 people from 32 states have been reported as diagnosed with the infection.

Seventy-five people have been hospitalized, 20 have experienced kidney failure and one has died.

Health experts have identified the source of most of these infections to romaine lettuce grown in the area of Yuma, Arizona. However, some illness investigators believe there may be other sources of the bacteria.

Given how serious these infections can be, you’re better off avoiding romaine lettuce completely until food safety experts are certain they have found and addressed all sources of the infection.

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Follow Proper Food Handling Guidelines

According to, the following steps will reduce the risk you or your family suffer from a food borne illness. These guidelines are appropriate for mesothelioma patients in active treatment, too.

  1. 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.

  2. 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 one for produce. Separate these foods in the refrigerator in clean, sealable bags.

  3. 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.

  4. Chill

    Refrigerate perishable foods within one hour. Never thaw frozen food on the counter. 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.

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 (e.g. alfalfa and bean)

Foods You Can 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, be sure to wash fresh produce — frozen is prewashed prior to packaging and is safe to use — before blending.

Store any left-over smoothie in a sealed container in the refrigerator and discard after 24 hours.

Some types of produce, such as leaf lettuce, strawberries and raspberries, are difficult to clean well. You may want to avoid these items when you are immune compromised.

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

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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. Read More

Last Modified August 16, 2018
  1. Mayo Clinic. (2018, January 11). Symptoms. Neutropenia.
    Retrieved from:
  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. Food Safety for Cancer Patients. (n.d.).
    Retrieved from:
  8. Centers for Disease Control and Prevention. (2018, May 16). Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce.
    Retrieved from:
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