Charity
Home > Resources > Patients and visitors > Eating During Chemotherapy

Eating During Chemotherapy

Cancer and its treatment can have a number of effects on the body. Chemotherapy can affect your appetite and enjoyment of food and may lead to weight changes. It can also have an effect on your immune system, reducing the body’s natural defences against infection.

This booklet will outline food safety and dietary advice to follow during your chemotherapy treatment.  

Food safety advice

One of the most effective ways of avoiding infection is to maintain high levels of hygiene. The following points may help:

Purchasing food

Do

  • Always check use by and best before dates on packaging
  • Purchase chilled/frozen foods last and take the food home as quickly as possible, using a cool bag to carry food. Avoid salad bars.
  • Pack raw and cooked food in separate food bags. Buy prepacked deli items instead.

Do not

  • Buy foods where the packaging may be damaged and avoid buying from overloaded fridges or freezers as the food may not be cold enough.
  • Choose foods from large self-service containers where food is unwrapped, such as sweets
  • Buy meat where raw and cooked meats are stored in the same fridge or loose from a deli counter.

Storage

Do

  • Refrigerate foods between 0oC and 5oC and freeze below -18oC.
  • Store cooked food at the top of the fridge with raw or defrosting meats stored at the bottom of the fridge and in a sealed container.
  • Cool food before refrigerating, cool at room temperature and within an hour of cooking. Place into smaller containers to allow quicker cooling rather than cooling in a large container.
  • refrigerate eggs and store in their box.
  • Defrost meat and poultry in a fridge rather than at room temperature.
  • Ensure food is solid frozen when first taken out of the freezer and do not refreeze food.

Do not

  • Overload your fridge or freezer as this can stop it from working properly
  • Place hot food in the fridge or freezer.

Preparing food

Do

  • Wash hands thoroughly using hot soapy water before and after preparing foods as well as after visiting the toilet, sneezing, or touching pets etc.
  • Use a separate towel or tissue to dry hands rather than using a tea towel.
  • Drip dry pots or dry using kitchen towel rather than using a tea towel.
  • Wash can tops before opening
  • Regularly change cloths and sponges
  • Use separate utensils and chopping boards for raw and cooked foods to prevent cross contamination.
  • Regularly clean work surfaces with hot soapy water or an antibacterial spray.
  • Keep pets away from work surfaces, food storage and food.
  • Wear a waterproof plaster if you have any cuts or grazes.
  • Wash fruit and vegetables well before using.

Do not

  • Use a tea towel to dry pots.
  • Allow pets near work surfaces, food storage or cooking utensils.
  • Use the same chopping board for raw or cooked meat.
  • Drink directly from a container, bottle or can.

Cooking food

Do

  • Cook food thoroughly until the centre is hot.
  • Ensure juices run clear from cooked meat.
  • Use microwaves for defrosting as long as food is cooked right away.
  • Use microwaves to heat prepared foods according to manufacture’s instructions.
  • Pre-heat the oven to ensure food is cooked at the correct temperature and that the food is hot throughout.
  • Defrost food thoroughly in a fridge before reheating. Only reheat food once and ensure this is hot all the way through before eating it.
  • Eat rice as soon as it is cooked and avoid reheating.

Do not

  • Reheat cooked food more than once as this may allow bacteria to grow
  • Reheat cooked rice.
  • Shorten cooking times, always follow the manufacturer’s guidelines.

Eating out

Do

  • Choose a reputable establishment with good food hygiene practices – check their food safety rating on their door or via the food’s standards agency.
  • Make sure food is hot and thoroughly cooked before eating.
  • Buy individually wrapped ice creams/ice lollies from ice cream vans or shops.

Do not

  • Share foods from tabletops (e.g., buffets, nuts, and crisps in bars).
  • Avoid foods from salad bars, hot dog vans, market stalls and other street vendors, ice cream served in large containers from ice cream vans.
  • Avoid eating at hot buffets and avoid food which has been sitting under a lamp.

Eating during chemotherapy—Foods to Avoid

During chemotherapy to minimise infection risk you should avoid the following foods:

  • Raw/lightly cooked eggs including homemade mayonnaise, mousse, egg nog, meringue and sauces made with raw egg. Ensure that you choose eggs that have the Red Lion mark.
  • Soft un-ripened cheese such as brie, camembert or goats’ cheese, as well as blue veined cheese such as Danish blue and stilton.  Soft cheese made with unpasteurised milk e.g., feta or parmesan.
  • Pate—meat, fish, and vegetarian
  • Grapefruit and Seville oranges including juice and products containing these such as marmalade.
  • Probiotics or ‘bio’ foods drinks or supplements i.e., Yakult, Actimel or ProViva
  • Yoghurt which is described on the label as ‘bio’ or ‘probiotic’.
  • Yoghurts described as ‘live’ can be eaten safely as an alternative.
  • Raw or undercooked meat or raw fish
  • Cold meats that have been smoked but not cooked such as salami
  • Unwashed fruit, vegetables, and salad
  • Avoid commencing over the counter supplements i.e., vitamins or herbal remedies – speak with your oncology team first.

Your doctor or nursing staff will monitor your blood levels during treatment, and should your white blood cells (neutrophils) fall below a particular level (neutropenia) you will be given more detailed advice on any further dietary restrictions needed.

If you have a poor appetite or have lost weight

It is important to try and eat well during chemotherapy to provide the essential nutrients and energy that your body needs as well as to rebuild damaged tissue and fight infection. However, there may be times during your cancer treatment when you may find eating well more difficult. This may be due to the illness or due to treatment side effects.  Losing weight or eating less than usual can make it more difficult for you to cope with your chemotherapy treatment or to fight infections. 

At this time, it is important to relax any healthy eating restrictions and focus on eating well and enjoying your food as much as possible. Eating on a little and often basis may help. This may involve eating small meals or snacks every few hours. Nutritious fluids such as full fat milk should also be included regularly throughout the day.

Ideas for light meals and snacks:

  • Cake, malt loaf, jam tart
  • Biscuit – cream, chocolate, or plain varieties
  • Chocolate bar
  • Scoop of ice cream
  • Thick and creamy yoghurt, full fat mousse or dessert such as custard or rice pudding
  • Crisps
  • Fruit scone with butter and jam or cheese scone with butter
  • Sausage roll, pies, pastries, pizza – party type food
  • Cheese (hard, pasteurised type) and crackers
  • ‘Cream of’ type soups with bread and butter
  • Beans, scrambled egg, or cheese on toast
  • Baked potato with fillings such as cheese, beans, or tuna
  • Omelette
  • Small sandwich containing egg (well cooked), meat, fish, or cheese
  • Slice of toast and butter
  • Bowl of cereal with full fat milk

Fortifying your food

If you have a small appetite and cannot manage large portions, it is important to make the food you are eating more calorific and energy dense without increasing the size of the portion. Try some of the following:

  • Add extra butter/margarine, peanut butter or chocolate spread to foods
  • Add cream to soups and milky desserts
  • Use evaporated milk, condensed milk, or cream (pouring or whipped) to top desserts, cakes, and hot drinks.
  • Try grating cheese into foods
  • Add extra jam, honey, or syrup to sweet foods
  • Use plenty of sugar/honey on cereals and in hot drinks and puddings
  • Add sweet sauce to ice creams
  • Add four heaped tablespoons powdered milk to one-pint full cream milk and use on breakfast cereals, in sauces, with puddings, soups, jellies and other desserts
  • Add one scoop of ice cream to cold drinks
  • Whilst your appetite is poor buy full fat foods i.e., thick, and creamy yoghurts
  • Try to fry foods where possible if able to tolerate
  • Add mayonnaise or oil-based dressings to salads, sandwiches, and jacket potato fillings, or use as a dip for crisps or chips.

If you have diabetes or any other condition requiring a special diet, or if you have ongoing concerns regarding your appetite and weight, you may find it useful to speak with your health professional who can refer you to a registered dietitian for more individualised advice.

You will be given information by the chemotherapy day unit on coping with common chemotherapy side effects such as taste changes, nausea, diarrhoea, and constipation. Again, referral to a dietitian can allow individualised advice should this be needed.

If you have had no change to your appetite or weight

The World Cancer Research Fund has published guidelines for the general population on ways to reduce cancer risk and to eat well. These guidelines can be used by people who have and those who haven’t got cancer. These guidelines include:

  • Reduce or maintain your weight to within a healthy range
  • Limit intake of energy dense foods and sugary drinks
  • Limit fast foods
  • Eat mostly foods of plant origin – for example fruit and vegetables, whole grains, and pulses. Aim to eat at least five portions of fruit and vegetables per day.
  • Avoid processed meat and limit your intake of red meat to three portions per week which is equivalent to 350- 500g (12-18oz).  Replace with poultry, meat alternatives or fish.
  • Limit your alcohol
  • Limit salt and salty/processed foods
  • Aim to meet nutritional needs through diet alone, avoid the use of dietary supplements (tablets).
  • Be physically active

The Eatwell guide (2016) as a visual guide to show the proportions of foods that we should eat to have a healthy and well-balanced diet.

The Eatwell Guide includes: 

  • Eating plenty of fruit and vegetables
  • Eating plenty of bread, rice, potatoes, pasta, and other starchy foods – choose wholegrain varieties whenever you can and include these foods at each mealtime.
  • Include milk and dairy foods
  • Include some meat, fish, eggs, beans, and other non-dairy sources of protein (lean / reduced fat varieties)
  • Limit foods which are high in fat and sugar
  • Choose unsaturated oils and use in small amounts
  • Check the labels on packaged foods and choose foods low in fat salt and sugar
  • Include six to eight glasses of water per day

Following advice from the Eatwell Guide and guidelines from the World Cancer Research Fund will help you to achieve a healthy lifestyle. Your health professional can refer you to a Registered Dietitian should you wish to lose weight or require more individualised advice for example on a special diet or if you have diabetes.