Food safety for people having chemotherapy (Systemic Anti-Cancer Treatment)

Food safety during chemotherapy

Cancer treatment may make you more likely to develop infections. This is partly because the neutrophils which normally fight infection may be low.  Also your gut lining, which normally acts as a barrier between the bacteria and the bloodstream, can be damaged.

It’s important to be careful with the foods you eat to reduce the risk of food poisoning.

Following the guidelines below will help you to reduce any risk.

When you’re shopping for food

You must:

• check use by dates and best before dates. Always use food within the recommended timescale
• avoid broken packaging
• avoid bruised or damaged fruits and vegetables
• avoid buying foods from salad bars or pick ‘n’ mix areas used by lots of people
• take chilled and frozen foods home quickly and put them away immediately. If possible, use a cool box to transport cold foods.

It’s safer to buy pre-packaged cheese and cold meats rather than from the delicatessen due to risk of cross contamination.

Storing food

You should:

• keep the coldest part of your fridge between 0 to 5°C and your freezer below -18°C. Use a fridge thermometer to check temperatures
• cool cooked food quickly and cover before storing in the fridge or freezer
• store raw and cooked food separately with raw food at the bottom
• never refreeze food once it has started to thaw. You can freeze raw food once it has been cooked.
• always cover food to be stored to stop contamination
• always store your eggs in the fridge.

Preparing food

You must:

• always wash your hands thoroughly before and after preparing food
• keep your kitchen clean; wash worktops using an antibacterial spray and make sure you wash all sponges, dishcloths and dishtowels frequently
• use different chopping boards for raw and cooked food to avoid contamination. Clean utensils between handling raw and cooked food
• wash fruit and vegetables thoroughly under running water
• keep pets away from food preparation areas as they may carry bacteria.

Cooking

You must:

• cooked food thoroughly. Make sure it’s piping hot throughout, especially meat, poultry and fish products.
• cook meat until the juices run clear
• always follow the instructions on packaged food
• serve hot foods as soon as possible after preparation.

Reheating foods

You must:

• cool leftover food quickly, ideally within one hour of cooking, then cover and store in the fridge or freezer
• eat any leftover food items within 24hours and make sure they’re heated until piping hot throughout when served
• do not reheat food more than once
• do not reheat cooked rice.

Takeaways and eating out

When eating out, check the food hygiene rating and only eat from restaurants and take aways with a 5 star food hygiene rating. A 5 star rating means that the hygiene standards are very good and follow legal requirements.

You can check the Food Standards Agency website for ratings of restaurants and takeaways in your local area.

You should also:

• only eat food cooked to order food and eat it immediately. Takeaway delivery times between cooking, transport and eating will vary.
• consider possible cross contamination from food left out for long periods of time and serving utensils shared by lots of people, for example, at buffets or salad bars
• avoid reheating takeaway food.

Foods to avoid during cancer treatment

Some foods are more likely to cause food poisoning and you should avoid them during treatment and for 14 days after completing your last treatment cycle.

These include:

All unpasteurised dairy products including mould ripened and blue veined cheeses

For example brie, camembert, goat’s cheese and stilton.

You can eat any cheese made with pasteurised milk.

Raw or undercooked eggs or any food made from uncooked eggs

For example, dressings or sauces such as mayonnaise.

Choose Lion marked eggs. They’re marked with a code showing the type of farming system, country of origin and farm production unit. The British Lion scheme has helped to drastically reduce the presence of salmonella in UK eggs.

Other foods to avoid

These include:

• rare or undercooked meat, fish and shellfish
• raw fish such as sushi or sashimi
• smoked salmon
• fresh pâté (meat, fish or vegetable)
• Any deli counter foods due to risk of cross contamination
• Foods labelled probiotic or bio, for example, Yakult/Actimel drinks or yoghurt with added bacteria.

If you want to include probiotic or bio foods in your diet, please talk to your consultant.

Eating well during chemotherapy

It’s important that you maintain a nutritious and well-balanced diet.

This will help you to:

• cope with any side-effects you may experience during treatment
• prevent unintentional weight loss
• reduce the risk of infections
• help with your recovery.

Eating well means having a varied and well-balanced diet that will give your body all the nutrients it needs to function well.

For more details see our guide about eating well during cancer treatment. Read our eating well with a small appetite guide if you’re struggling to maintain a healthy weight or have a poor appetite.

Common side effects of chemotherapy

Side effects are common during chemotherapy. These include:

• fatigue
• loss of appetite
• taste changes
• dry/sore mouth
• nausea and vomiting
• bowel changes (constipation or diarrhoea).

They can all impact on your nutritional intake. See our guide on common nutritional problems and cancer to help manage your side effects.

Weight loss during chemotherapy

You may have small weight changes as a result of chemotherapy that you don’t need to worry about.

Significant weight loss may affect your ability to tolerate treatment. It can also lead to muscle loss, decreased strength, weakness and fatigue.

If you’ve lost a lot of weight or are struggling with eating, talk to your nurse who may refer you to the Macmillan specialist dietitians.

Alternative diets

There’s lots of information online and in the media about complementary or alternative diets claim to cure or control cancer.

So far, there’s little scientific evidence to support claims about alternative diets.

These diets are potentially harmful because they’re often low in energy (calories) and protein and/or tend to be bulky, making them very filling. They can cause weight loss in people who already have problems eating due to their cancer treatment.

If you’re thinking of following a complementary or alternative diet, please talk to your nurse or consultant first.

Vitamin and mineral supplements

Most people, when they’re well can get all of their nutrients from a balanced and varied diet. The exception to this is Vitamin D.

The main source of Vitamin D is sunlight. Although you’ll find it in some foods it’s difficult to get enough Vitamin D just from your diet.

All adults should take a daily supplement of 10mcg of Vitamin D, especially during autumn and winter. Some at risk groups should consider taking the recommended daily supplement all year round.

If you want to take a vitamin and mineral supplement, choose a general multi-vitamin that gives you 100% of the reference nutrient intake (RNI). You can buy multi-vitamin tablets (A to Z) or in a chewable option from supermarkets, Boots or Superdrug.

High dose vitamin and mineral supplements

We don’t recommend them as they may interact with your cancer treatment. If you have any questions about other supplements or food additives, talk to your nurse or consultant.

Free prescriptions

All cancer patients undergoing treatment for cancer, the effects of cancer or the effects of cancer treatment can apply for an exemption certificate for a free prescription from their GP.

 

This patient advice is intended as general information only. We aim to make the information as up to date and accurate as possible, but please note that it is subject to change.

Always check specific advice on any concerns you may have with your doctor.