Food safety tips during your cancer journey

Food safety is always a matter of importance. However, it’s especially important for immunocompromised cancer patients to decrease their risk for infections.

---

Cancer and the treatment thereof can substantially weaken your immune system. One of the side effects of cancer treatments, such as chemotherapy, radiation and bone marrow cell transplants, is that it weakens your immune system by temporarily decreasing your white blood cells, which are responsible to fight off infections. Thus will increase the risk for infections and food-born illnesses, known as food poisoning. ^1,2,3

SIX TIPS TO IMPROVE FOOD SAFETY

1. Food handling, cleaning and storage^2,3,4,5,6

• Always wash your hands thoroughly for 20 seconds with soap before eating or preparing food. The Centers for Disease Control and Prevention recommends singing the Happy Birthday song from beginning to end twice.
• Use antibacterial products with bleach or ammonia to clean surfaces, before preparing food.
• Rinse fruits and vegetables under running water before using them. 
• Clean the lids of canned goods before opening them.
• Refrigerate your food at or below  4°C, or freeze them below -18°C.
• Allow enough time to thaw meat, fish and poultry in the fridge, or  place them in a microwave or in  cold water. However, never leave them at room temperature.
• Don’t refreeze already defrosted foods.
• Eat leftovers within one day and refrigerate them within two hours and reheat them to at least 74°C before eating. Never keep leftovers for more than two days. 
• Refrigerate or freeze fresh meat, poultry, egg, seafood within two hours of buying them to inhibit bacterial growth.

2. Avoid cross-contamination^2,3,4,5

• Always try to separate raw meat from other foods. Use separate cutting boards for fresh produce and raw meat, poultry and seafood.
• Never put cooked food on a plate  hat had raw meat, poultry, seafood or egg on it. 
• Don’t reuse marinades that had raw meats, poultry or seafood in.
• Be careful to not reuse utensils and cutting boards when cutting raw meats or mixing raw eggs. Wash all dishes and countertops thoroughly after contact with raw meats, poultry and eggs. 

3. Food should be well-cooked^2,3,4,5

• The diet must primarily consist of cooked meat and vegetables. Meat, poultry, seafood and egg products must be heated to safe minimum internal temperature to kill harmful bacteria. See Table 1.
• Egg should be cooked until the yolk and white are firm.
• Bring sauces, soups or gravy to boiling point when reheating.

Table 1: Minimum internal temperatures⁵

Beef, pork, veal, and lamb (steaks, roasts, and chops)	63°C
Beef, pork, veal, and lamb (ground)	71°C
Poultry (including chicken, turkey, and duck)	74°C
Egg dishes and sauces	71°C
Fish and shellfish	63°C
Leftovers and casseroles	74°C

4. Grocery shopping tips^2,3,4,5

• Buy unblemished fruits and vegetables.
• Don’t buy cracked eggs.
• Avoid buying products that are out of their sell-by or use-buy dates.
• Don’t buy swollen, rusted or dented cans.

5. Dining out precautions^2,3,4,5

• Be careful when eating out, to not buy food that was left outside and not kept at the appropriate temperatures. 
• Be aware that takeaways can be a health risk because the temperature was not optimal during transit.
• Only order cooked meals and avoid foods with raw, unpasteurised eggs (Caesar salad dressing, fresh mayonnaise or Hollandaise sauce, mousse or lemon meringue).
• Cooked or canned fruits can also be eaten. 
• Avoid buffets, salad bars and deli counters.
• Try not to use condiments which are touched by many users.

6. Foods to avoid^2,3,4,5

• Avoid food products that may contain unsafe levels of bacteria, such as raw meats, spoiled or mouldy foods, as well as unpasteurised beverages. 
• Soft mould-ripened and blue-veined cheeses such as Brie, Camembert, Roquefort, Stilton, Gorgonzola and Bleu should also be avoided.
• Buy vacuum-packed meats instead of freshly sliced meats. 
• Drink pasteurised milk and eat pasteurised yoghurt, cheese and other dairy products. 
• Don’t use raw or unheated honey and sprouts.
• Avoid eating sushi. 
• Drink tested or bottled water, or cook and cool water before drinking.

---

References

1. Food and Drug Administration (FDA). Food Safety for Older Adults and People with Cancer, Diabetes, HIV/AIDS, Organ Transplants, and Autoimmune Diseases.
2. American Cancer Society. Food Safety During Cancer Treatment.
3. American Society of Clinical Oncology (ASCO). Food Safety During and After Cancer Treatment.
4. FDA. Are You Storing Food Safely? https://www.fda.gov/consumers/consumer-updates/are-you-storing-food-safely
5. Memorial Sloan Kettering Cancer Centre: Food Safety During Cancer Treatment
6. Centers for Disease Control and Prevention. CDC. When and How to Wash Your Hands. 

Header image by Adocbe Stock