From the Guidelines
Cancer patients undergoing chemotherapy should avoid eating raw or undercooked sushi due to their compromised immune system, and instead opt for fully cooked sushi options or consult with their oncologist when their blood counts are normal. Chemotherapy reduces white blood cell counts, making patients more vulnerable to foodborne illnesses that could be present in raw fish 1. The American Society of Clinical Oncology (ASCO) guidelines suggest that there is no evidence to support specific dietary modifications or foods as a part of cancer treatment, including neutropenic diets, which aim to reduce bacterial exposure by limiting raw fruits and vegetables 1.
However, the primary concern is that bacteria, parasites, or other pathogens in raw fish could cause infections that might be difficult for a chemotherapy patient to fight off, potentially leading to serious complications that could interrupt cancer treatment. The safest approach is to choose sushi from reputable restaurants with strict food safety practices and to avoid consuming sushi during periods of neutropenia (low white blood cell count), typically occurring 7-12 days after chemotherapy. Some key points to consider include:
- Avoiding raw or undercooked fish during chemotherapy treatment
- Opting for fully cooked sushi options, such as California rolls with cooked crab or shrimp tempura rolls
- Consulting with an oncologist before consuming traditional sushi, especially when blood counts are normal
- Choosing sushi from reputable restaurants with strict food safety practices
- Avoiding sushi consumption during periods of neutropenia, typically 7-12 days after chemotherapy, as suggested by guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN) 1.
Additionally, guidelines from the Ca-A Cancer Journal for Clinicians suggest that nutrition intervention, including counseling, supplements, or tube feeding, can improve nutrition status during radiotherapy and chemotherapy, and may improve patient-centered outcomes 1. However, these guidelines do not specifically address the consumption of raw or undercooked sushi during chemotherapy treatment.
From the Research
Chemotherapy and Sushi Consumption
- There is no direct evidence in the provided studies to suggest that chemotherapy patients can or cannot eat sushi.
- The studies primarily focus on the risks associated with fluoroquinolones, a type of antibiotic, and their potential interactions with other medications or conditions 2, 3, 4, 5.
- One study discusses the use of oral fluoroquinolones for cancer patients with gram-negative bacteremia, but does not mention dietary restrictions or recommendations 3.
- Another study reviews the risks of azole antifungals and new targeted therapies for hematological malignancy, but does not address dietary concerns 6.
- Overall, there is a lack of research directly addressing the question of whether chemotherapy patients can eat sushi, and therefore, no conclusive answer can be provided based on the available evidence.