Foods to Avoid During Chemotherapy

What to know about the increased risk of food-borne illness

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When undergoing cancer treatment, you may stop eating certain foods because of taste changes, mouth sores, or nausea. If you are receiving chemotherapy, it's also important to pass on raw and undercooked foods because of an increased risk of food-borne illnesses.

For example, unwashed vegetables, unpasteurized dairy, raw sushi, and runny eggs are all foods that should be avoided while on chemotherapy.

A poached egg on bread
Jodie Louie / Moment / Getty Images

Chemotherapy suppresses your immune system, making you more susceptible to infections. And if you do get one, your symptoms may be worse than if you got sick and weren't undergoing treatment.

This article provides examples of foods to avoid while on chemo and other precautions you should take.

Why Some Foods Are Unsafe During Chemo

Chemotherapy suppresses your immune system, which may affect what you should and should not eat until your immune function is back to its full potential.

Many people experience neutropenia related to chemotherapy. Neutropenia refers to a reduced number of white blood cells called neutrophils. These are white blood cells that fight off bacteria that enter the body.

Ordinarily, when you eat foods containing harmful bacteria, these white blood cells fight them off, and you're unaware of their presence. Chemotherapy can change that.

Raw or undercooked foods can actually make you sick. If your immune system is already tied up fighting on other fronts, the sickness can become more serious than a case of diarrhea or a bellyache.

According to the United States Department of Agriculture, 48 million Americans suffer foodborne illnesses annually. If your immune system is weakened, the chance of severe illness, hospitalization, and even death increase with one of these illnesses.

Not only are ordinary infections worse than they otherwise would be, but you are more likely to develop infections that would never even begin if your immune system was in good order.

Foods to Avoid on Chemo

Foods to avoid during chemotherapy include:

  • Unpasteurized dairy and under-cooked eggs: If it's got a runny yolk, avoid it. If it comes straight from the udder, avoid it.
  • Raw seafood: Oysters, most types of sushi, and other kinds of raw or undercooked seafood should be off the menu for now.
  • Unwashed fresh fruits and vegetables: Even "ready-to-eat" salad mixes and veggies must be carefully washed and peeled again, if possible.
  • Raw honey and associated products: Raw honey products can carry the botulism toxin and make you ill.
  • Moldy cheeses: Think brie and blue cheese. Remember, the mold that gives these cheeses their taste and color is actually a fungus—a fungus that a healthy immune system can normally deal with, but that a compromised immune system may not.
  • Foods out of dented cans: The dents can actually compromise the integrity of the contents of canned foods and allow bacteria to form.
  • Raw nuts and fresh-made nut butter: These should also be avoided.

Hidden Ingredients

Some off-limits foods can be hidden in other products. Don't forget to exclude foods that are made with these products, such as raw eggs in:

  • Hollandaise sauce
  • Freshly prepared Caesar salad dressing (bottled is okay)
  • Homemade mayonnaise

When in doubt, ask your healthcare provider before eating the food in question.

Does My White Blood Cell Count Matter?

There will be times during chemo when your white blood cell count is higher or lower than others. (Most often, your white blood cell count will be lowest 10 days to two weeks following a chemotherapy infusion, but this can vary.) It's best to be safe and avoid certain foods, even if you've just had your blood checked and it's normal.

Precautions When Dining Out on Chemo 

If you are immunosuppressed (have bone marrow suppression from chemotherapy), eating out may have to take a hiatus for now. Think about how many hands restaurant-prepared food travels through:

  • The people in the warehouse
  • The people who transport it to the restaurant
  • The people who unpack it and store it in the facility
  • The people who set up and prep the food to be cooked
  • The chef
  • The wait staff

Although a buffet of germs may not actually be present in your food, it isn't worth the risk.

Speaking of buffets, you should avoid them during and shortly after chemotherapy, when your body has the least chance of fighting off common germs.

Similarly, avoid any delicatessen or self-serve salad bars.

Food-Prep Awareness

Perishable foods should not be left out for grazing. After any meal or snack is served, the food should be packaged safely and refrigerated within at least two hours of preparation.

  • Cold foods must be kept at or less than 40 degrees Fahrenheit
  • Hot foods must be kept at or hotter than 140 degrees Fahrenheit

It's OK—and actually encouraged—to use multiple spoons, cutting and preparation surfaces, and pans while cooking. You don't want to contaminate the bacon by stirring it with the same fork that was used to whip your raw eggs, for example.

Be sure to use a cutting surface that is not made of wood or another permeable surface while chopping or preparing raw meats. Wood can harbor bacteria despite how well you wash it.

Swap rare beef for some well-cooked poultry—at least until your chemotherapy is over. Use a meat thermometer to figure out whether your meat is thoroughly cooked, instead of "eyeballing it."

Safe Cooking Temperatures

  • Poultry: 165 degrees at the thickest part
  • Red meat: 160 degrees at the thickest part
  • Reheated casseroles and leftovers: 165 degrees

Be sure that your meat thermometer is not placed too shallow and it is not touching the bone if there is one, as both mistakes could cause a false reading.

The Importance of Hand Washing

One of the most important things that you can do—and not just before eating or preparing food—is to wash your hands.

It's been shown repeatedly that careful hand washing by yourself and others around you can do wonders in decreasing the risk of infections.

Remember: PICCY

This can be a lot to remember. To help you choose safer foods while you are undergoing chemo, remember the PICCY pneumonic:

  • P: Pasteurized. Make sure foods such as dairy products have been heated or say "pasteurized" on the packaging.
  • I: Inspect. Take a careful look at any foods before eating them. Check for mold, as well as for cuts or breaks in fruits and veggies.
  • C: Clean. Clean the foods that you eat, and use clean cutting boards and other surfaces. Always prepare food with clean hands and tools. 
  • C: Cook. Cook any meats, poultry, or seafood thoroughly.
  • Y: Yuck. Mark dates on leftovers and throw them out after a few days. Remember that refrigeration doesn't stop bacteria growth. (In fact, scientists bacteria samples on a dish and let them grow in a fridge.)

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. Food safety during cancer treatment.

  2. Office of Disease Prevention and Health Promotion: Food safety.

  3. American Society of Clinical Oncology: Foods to avoid during cancer treatment.

  4. Leukemia & Lymphoma Society. Diet guidelines for immunosuppressed patients.

  5. Centers for Disease Control and Prevention. Prevention & control - Immunocompromised persons.

Additional Reading

By Julie Wilkinson, BSN, RN
Julie Wilkinson is a registered nurse and book author who has worked in both palliative care and critical care.