Patients & Caregivers

General oncology diet guidelines

These guidelines are for patients with decreased immune function, such as those with low white blood cell counts (absolute neutrophil count less than 1,000 mm3).

White blood cell A type of blood cell that is made in the bone marrow and found in the blood and lymph tissue. White blood cells are part of the body’s immune system and help the body fight infection and other diseases. A type of blood cell that is made in the bone marrow and found in the blood and lymph tissue. White blood cells are part of the body’s immune system. They help the body fight infection and other diseases. Types of white blood cells include granulocytes (neutrophils, eosinophils and basophils), monocytes and lymphocytes (T cells and B cells). Checking the number of white blood cells in the blood is usually part of a complete blood cell (CBC) test. It may be used to look for conditions such as infection, inflammation, allergies and leukemia. Also called leukocyte and WBC.

Individuals with decreased immune function are at increased risk of developing a food-related infection. You can decrease your risk of food-borne illness through proper preparation of food and drinks. Some food and drinks are more likely to contain harmful bacteria and germs.

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 preparation 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 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.

Grade In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. Grading systems are different for each type of cancer. They are used to help plan treatment and determine prognosis. Also called histologic grade and tumor grade.

Eggs

Cook eggs thoroughly 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

For meat and poultry, use a food thermometer to ensure a 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.
For hot dogs, “ready-to-eat” sliced lunch meats, cold cuts, and summer sausage, heat in the microwave or oven until steaming 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.
Avoid deli meats.

Fluorescence in situ hybridization A laboratory method used to look at genes or chromosomes in cells and tissues with the help of fluorescent dye. It is used to help diagnose diseases such as cancer and to help plan treatment. A laboratory method used to look at genes or chromosomes in cells and tissues. Pieces of DNA that contain a fluorescent dye are made in the laboratory and added to a cell or tissue sample. When these pieces of DNA bind to certain genes or areas on chromosomes in the sample, they light up when viewed under a microscope with a special light. FISH can be used to identify where a specific gene is located on a chromosome, how many copies of the gene are present and any chromosomal abnormalities. It is used to help diagnose diseases such as cancer and to help plan treatment.

Fruits and vegetables

Wash raw fruits and vegetables under cold, running water. Fruit and vegetable “cleaners” or “sprays” are not necessary.
- Do NOT use soap to wash produce since soap can cause diarrhea if not thoroughly rinsed off the food.
Choose shelf-stable salsas and salad dressings. 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

Enjoy commercially packaged sweets, such as cookies, cakes, pies and other shelf-stable items. Twinkies®, Chips Ahoy® and frozen treats are acceptable. Avoid unrefrigerated, cream-filled pastry products.
Do not consume raw honey or honeycomb. Select pasteurized commercial, grade-A, heat-treated honey.

Water

Do not drink water straight from lakes, rivers, streams or springs.
It is recommended to use distilled or bottled water if using a water service other than city water service.

Beverages

Homemade juices are acceptable if consumed within 2 hours of juicing. Do not drink unpasteurized fruit or vegetable juices.
Make tea with boiling water, using commercially packaged tea bags. Do not drink sun tea.

Dining out

Order cooked fruits, vegetables and entrees.
Avoid raw fruits and vegetables, such as salad, garnishes, and other raw produce items when dining out. Raw fruits and vegetables are encouraged at home.
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 fresh salsa and guacamole.
Ask for single-serving condiment packages. Do not use public self-serve condiment containers.
Avoid salad bars, delicatessens, buffets, smorgasbords, potlucks, sidewalk vendors and food trucks. These are high-risk food sources due to potential improper food storage or holding temperature.
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.