General Oncology Diet Guidelines
These guidelines are for people with decreased immune function, such as those with low white blood cell counts (absolute neutrophil count less than 1,000). If you have had a transplant, please refer to the transplant diet guidelines, Diet Guidelines for Transplant Patients.
People with decreased immune function are at increased risk of developing a food-related infection. You can protect yourself from many infections by preparing food and drinks properly and by avoiding specific foods that are more likely to contain infection-causing organisms.
Discuss the safety of these or other foods with a dietitian or your doctor, who can advise you about when you do or do not need to follow the diet guidelines described here. Also, read our Food Safety Guidelines to learn about safe food practices.
Milk and Dairy Products
- Eat or drink only pasteurized milk, yogurt, cheese, or other dairy products (pasteurized, grade-A milk and milk products).
- Avoid soft mold-ripened and blue-veined cheese, including Brie, Camembert, Roquefort, Stilton, Gorgonzola, and blue cheese.
- Avoid Mexican-style cheeses, such as queso blanco fresco, since they are frequently made from unpasteurized milk and are associated with a higher rate of foodborne illness.
- Cook eggs until the yolk and white are solid, not runny.
- Do not eat foods that may contain raw eggs, such as hollandaise sauce, raw cookie dough, homemade mayonnaise, and Caesar salad dressing. If you prepare these foods at home, use a pasteurized egg product instead of eggs in the shell. (You can find pasteurized eggs in the dairy case at your supermarket; Egg Beaters is one example.)
Meat, Poultry, Fish, and Tofu
- Use a food thermometer to be sure that meat and poultry reach the proper temperature when cooked.
- Red meat and ground beef: minimum internal temperature of 160° F.
- Ground poultry: internal temperature of 165° F.
- Whole poultry: internal temperature of 180° F.
- Casseroles: internal temperature of 165° F.
- Heat until steaming all hot dogs and “ready-to-eat” luncheon meats, colds cuts, and other deli-style meats before eating.
- Cut tofu into 1-inch cubes or smaller and boil for five minutes in water or broth before eating or using in recipes. (Note: This process is not necessary if using aseptically packaged, shelf-stable tofu, such as Mori-Nu silken tofu).
- Do not eat meat, poultry, or fish that is spoiled, raw, or undercooked.
- Do not eat raw or lightly cooked fish, shellfish, lox, sushi, or sashimi.
Fruits and Vegetables
- Raw fruits and vegetables and fresh herbs are safe to eat if you wash them carefully under cold running water. You don’t need to use special sprays.
- Do NOT use soap to wash produce since soap can cause diarrhea if not thoroughly rinsed off the food.
- Avoid fresh salsas and salad dressings found in the refrigerated section of the grocery store. Choose shelf-stable salsas and salad dressings instead. (Shelf-stable refers to unopened canned, bottled, or packaged food products that can be stored at room temperature before opening; the container may require refrigeration after opening.)
- Do not eat any raw vegetable sprouts, such as alfalfa, radish, broccoli, mung bean, or other sprouts.
Bread, Grain, and Cereal Products
- Avoid “bulk bin” sources of cereals, grains, or other foods.
Desserts and Sweets
- Avoid unrefrigerated, cream-filled pastry products. (Shelf-stable items, such as Twinkies or Ding Dongs, are allowed.)
- Do not consume raw honey or honeycomb. Select commercial, grade-A, heat-treated honey.
- See our Water Safety Guidelines.
- Do not drink water straight from lakes, rivers, streams, or springs.
- Do not consume well water unless it is tested at least yearly and contains no coliforms. It is recommended to use distilled or bottled water if using a water service other than city water service.
- Do not drink unpasteurized fruit or vegetable juices.
- Do not drink sun tea. Make tea with boiling water, using commercially packaged tea bags.
- Eat early to avoid crowds.
- Ask that food be prepared fresh in fast-food establishments. (It may help to order the product prepared slightly differently from standard, such as without pickles.)
- Ask if fruit juices are pasteurized.
- Avoid raw fruits and vegetables when dining out; save these items for home, where you can wash them thoroughly and prepare them safely.
- Do not eat salsa or other condiments that are unrefrigerated and are used by multiple people at a restaurant.
- Ask for single-serving condiment packages. Do not use public self-serve condiment containers.
- Avoid salad bars, delicatessens, buffets, smorgasbords, potlucks, and sidewalk vendors. These are high-risk food sources due to potential improper food storage or holding temperature and poor hygiene by food handlers.
- Check the general condition of the restaurant. Are the plates, glasses, and utensils clean? Are the restrooms clean and stocked with soap and paper towels? How clean the restaurant looks may indicate the level of care taken while preparing the food.