My boyfriend who has stage IV Non-Hodgkins lymphoma and his doctors told him to avoid fesh vegetables (and cook them) because of the possible spread of germs. Do you think that sounds right? I am so worried about his diet.

Hi Angechick,

Your boyfriend's doctor is right and what he is recommending is sound, particularly if your boyfriend is undergoing high-dose chemo and a stem cell transplant/ bone marrow transplant. When treating lymphoma, the chemo will be affecting white cells. His counts will get quite low along with his body's ability to fight off microorganisms, including bacteria and mold, which are abundant in fresh fruit and vegetables. For now, and for the months following treatment when your boyfriend's body will be rebuilding white cells back to normal levels, your boyfriend should be avoiding all sources of infection, including avoiding eating leafy vegetables and vegetables and fruits with outer peels. With the number of recalls of produce for E. coli contamination in the past two years, surely you will understand the danger.

It may seem counter intuitive, but the dangers to a patient with a compromised immune system from bacteria and other microorganisms in things like honey, loose teas, and fresh vegetables & fruits far out weigh any benefits of their anti-oxidants.

Now let's get another important thing straight. The cookbook you are talking about and books like it are to help a normal, healthy person live a healthy lifestyle and hopefully reduce the chances of developing cancer. They are hopefully "preventative" (but the jury is still out on how helpful). However, they have nothing to say to a patient fighting active disease. The minute amounts of anti-oxidants in these foods do not have any significant cancer-fighting properties once someone has actual cancer. The anti-oxidants hopefully prevent DNA damage, but once mutations have occurred and cancer has developed, they cannot repair it. And do not fall for detox regimens! Total scams.

Of course, you want to help your boyfriend get well and do everything you can. This is not only common sense but helps you both feel more empowered and encouraged. The best things you can do are 1) keep his exposure to infection down; 2) make sure he gets some gentle exercise on most days as this has been shown to fight fatigue, keep energy up, lift mood and improve overall quality of life; 3) help keep his nausea level down and appetite up through taking the medications prescribed, cool cloths to the head and back of neck, hot or very cold ginger tea & ginger ale and medical marijuana if your state permits it; 4) make sure he gets adequate calories and protein through as wide a variety of foods as he can get. It helps to experiment in cooking to find what will taste good now to your boyfriend and make food more interesting. Chemo alters one's sense of taste. Flavors are flat or off. One might need stronger flavors for food to be appealing.

If you still feel uneasy about the lack of fresh or uncooked foods and are thinking about nutritional supplements, be sure to check with your boyfriend's oncologist. Some supplements may actually interfere with chemo and reduce its effectiveness thus compromising your boyfriend's fight and making him more prone to relapse. Lymphoma is dysregulating to vitamin D levels and patients may have too much vitamin D in their systems. So you do not want to give your boyfriend additional vitamin D, OK?

Lastly, I would recommend joining other patient communities such as Webmagic forums and Facebook groups such as Non-Hodgkin's & Hodgkin's Fighters & Supporters and Patients-Against-Lymphoma. You may also want to get in touch with the Lymphoma Research Foundation for your boyfriend to be matched with a cancer survivor mentor, another survivor who has had his type of NHL with similar life circumstances (age, gender, etc.) to talk & share.

Good luck and lots of healthy, healing hugs!

Liz