Sachin Sarcoma Society
Diet During Chemotherapy

Diet During Chemotherapy

Neutropenia- Patients with cancer may have a low white blood cell count (WBC) for a variety of reasons, some of which include radiation therapy, chemotherapy, or the cancer itself. One type of white blood cell, neutrophils, is especially important in fighting infections. A shortage of neutrophils is called neutropenia.

Neutropenia makes the patient susceptible to bacterial or fungal infections, which may at times be life-threatening.

A neutropenic diet is a low-bacteria diet that would decrease the amount of bacteria that may be ingested in foods and beverages. This diet reduces the chances of infection developing in patients with weakened immune systems. Here are some suggestions to assist patients in preventing infections related to neutropenia.

  • Check the expiry dates on food and do not buy or use it if the product is out of date.
  • Thaw foods in the microwave- never thaw foods at room temperature.
  • Cook foods immediately after thawing.
  • Personal hygiene and environmental hygiene have to be maintained.
  • Keep hot foods hot and cold foods cold.
  • Cook all meat, poultry, and fish thoroughly using a pressure cooker.
  • Buy individually packaged foods, which are better than larger portions that result in leftovers.
  • Limit exposure to large groups of people and people who have infections.
  • Wash hands frequently to prevent the spread of bacteria.

AVOID

  • Avoid fresh uncooked foods, such as fruits, raw eggs, and raw vegetables.
  • Avoid old, moldy, or damaged fruits and vegetables.
  • Avoid tofu/ paneer in open bins or containers.
  • Avoid eating out and avoid eating raw vegetable salads and raw thin-skinned fruits.
  • Do not buy or use food in cans that are swollen, dented, or damaged.
  • Avoid raw fish.

FOODS ALLOWED AND EXCLUDED IN NEUTROPENIA

FOODS GROUPS  FOODS ALLOWEDFOODS EXCLUDED
BEVERAGES● Boiled and cooled water
● Freshly made ice from boiled cooled water
● Canned drinks only
● Water from taps and wells.
● Unboiled milk
● Ice made from tap water
● Open drinks left at room temperature for more than 1 hour
CEREALS● Freshly prepared rice, chappati/roti (hot and direct from stove), pasta, noodles
● Bread and wheat bread (preferably toasted)
● Homemade cakes
All eggs must be cooked well eg. hard-boiled egg
EGGSAny undercooked or soft-cooked eggsAny undercooked or soft-cooked eggs
NON-VEG (MEAT, FISH, POULTRY) 
● Pressure-cooked non-veg food only
● Deskinned chicken
● Fresh fish like Pomfret, Mackerel, Sardine  
● Meats that are not well cooked.
● Salted and dried fish.
● Fishes with shells like crabs
● Organ meats like liver and mutton
NUTS


● Roasted and cooked nuts
● Boiled groundnuts
● Almonds, Walnuts, Kaju
● Uncooked nuts
● Raw groundnuts
● Pista, Raisins
MILK AND MILK PRODUCTS● Boiled milk
● Pasteurized milk and pasteurized curds (Nesvita)
● Cheese made from pasteurized milk
● Prepackaged or freshly homemade pasteurized ice cream or sherbet
● Commercially made nutritional products, supplements, and baby formula
● Use prepacked curds as a culture to be used for setting curds every day at the patient’s bedside for every meal
● Raw milk
● Unpasteurized milk and unpasteurized curds.
● Cheeses which are made of molds ( blue cheese, Roquefort)
● Cheeses made from unpasteurized milk
● Soft serve ice creams, frozen curds, or sherbets from bulk machines.
FRUITS● Thick smooth skinned fresh fruits (eg. bananas, oranges, mosambi, watermelons, musk melons, pomegranate)
● Smooth skin fruits that are washed well 3-4 times and then peeled off and have no obvious bruising ( eg. apples, pears, chickoo,  papaya)
● Canned and cooked fruits
● Pasteurized juices
● Any fruit that is rough-skinned (eg sitaphal, strawberries, litchi, raspberries)
● Any fruit that can not be peeled after washing (eg. grapes, peach, apricot, cherries)
VEGETABLES● Vegetables have to be washed and peeled well and then boiled
● Rough surface vegetables that have been blanched for at least a minute in boiled water (eg cauliflower, broccoli)
● All canned and cooked vegetables
● Raw vegetables
● Vegetables which are not peeled or blanched