Medical Oncologist
Food and nutrition
A food allowed and avoid card
Three columns and one line at the bottom. What is allowed, what to avoid, what changes during the low-count days, and the hospital's phone number. One sheet on the fridge, written in the language the household actually reads, because food advice arrives from everywhere and nobody can hold it all.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
What goes on a one-page food card?
Three columns and one line at the bottom. What is allowed, what to avoid, what changes during the low-count days, and the hospital's phone number. One sheet on the fridge, written in the language the household actually reads.
It exists because food advice arrives from everywhere — the doctor, the nurse, four relatives and the internet — and a household cannot hold it all. A single sheet everyone can point at ends most of the arguments.
Write it yourself rather than printing a generic one
Your card carries your team's answers about curd, your low-count days, your own restrictions if you have diabetes or reduced kidney function, and your hospital's number. That is what makes it useful rather than decorative.
Give it authority
Ask the nurse or dietitian to check and sign it. A sheet with the hospital's mark on it settles a family disagreement in a way that your own handwriting does not, and that is half its value.
Ask for it in Telugu as well if that is what the household reads. This is a routine request.The card
Allowed, and avoid
Allowed
Avoid
Freshly cooked home food, served hot
Street food, chaat, pani puri
Boiled or filtered water, one covered container
Unboiled water, ice from outside
Well-cooked chicken, fish, egg, mutton
Raw, rare or undercooked meat, fish or egg
Boiled or packaged milk, fresh curd, paneer cooked
Loose unboiled milk, loose paneer, soft cheese
Fruit washed and peeled, cut at home
Cut fruit or juice from a stall or buffet
Dal, rice, curd rice, khichdi, cooked vegetables
Food left standing, or reheated twice
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The blanks only your team can fill
- Which days are the low-count days
- The single most useful line on the card, because the rules tighten for those days. Ask your team and write the dates for each cycle rather than a general description.
- Curd and live-culture foods
- Some teams restrict these during the lowest-count days and others do not. Ask yours specifically and write the answer, because this is the question families argue about most.
- Any restriction from another condition
- Diabetes, reduced kidney function, heart failure needing less salt or fluid. These override the general advice and belong on the card in your own words.
- Anything to avoid with your tablets
- If you take cancer medicine at home, ask the pharmacist about grapefruit, pomegranate and any timing rules, and write those on the card.
- Supplements: what continues and what pauses
- Ask once and write it down, so relatives cannot reopen it. This line prevents a great deal of quiet re-introduction of things that were meant to stop.
- The two phone numbers
- Day-time and out-of-hours. A food card without a number is only half useful, because the whole point of it is the night somebody is unwell.
!
Copy this line onto the bottom of the card
Go to the nearest emergency department the same day, saying clearly that the person is on chemotherapy, for: a fever or shivering uncontrollably · severe or bloody loose motions · vomiting with nothing staying down · no urine since the morning · severe stomach pain or a hard swollen stomach · confusion or being very hard to rouse. Do not give paracetamol to bring a temperature down before being seen, and do not treat severe loose motions at home with leftover medicines.
Making it work
How to actually use the card
Put it where the food is prepared, not in a folder. The card has to be visible to whoever is cooking, including household help and the relative who arrives to help for a week and has their own ideas.
Brief the cook out loud
Do not assume a sheet on the wall has been read. Walk whoever cooks through the water rule, the separate board and serving food fresh and hot. Instructions that live only on paper get followed inconsistently.
Use it to close arguments, not to start them
When a relative insists on a new restriction, point at the card and offer to ask the team at the next visit. That is easier than debating, and it keeps the decision with the doctor.
Put the date on it and update it
Answers change: a low haemoglobin may bring iron advice, reduced kidney function may bring a protein limit, and restrictions loosen after treatment. An out-of-date card is worse than none because people follow it confidently.
Keep the allowed column longer than the avoid column
A card that is mostly prohibitions reads as a list of losses and makes a household anxious about every meal. Write the allowed side first and make it generous, because the real risk across a course is a patient eating too little rather than eating the wrong thing.
Photograph it
Onto two phones, along with the emergency line and the numbers. The person who needs it at a shop, at a function or at midnight is often not the person standing in the kitchen, and a photograph travels in a way a sheet taped to a fridge does not. Send it to whoever does the shopping and to any relative who cooks when they visit.
Keep a copy in the treatment bag as well. Questions about food come up in the day-care unit constantly.Leave a number, we will call you
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Commonly believed
Four things that go wrong with food lists
"The longer the avoid list, the safer the patient."
The opposite. Long lists lead to patients eating too little, and poor nutrition causes more difficulty across a course than any individual food. Keep the real rules and leave the invented ones off the card.
"A printed list from the internet will do."
The useful parts are the blanks only your team can fill: your low-count days, your curd answer, your other conditions, your tablets and your phone numbers. A generic sheet has none of those.
"Everyone in the house knows the rules by now."
They know parts of them, differently, and the relative who arrives to help for a week knows none. A visible card and a spoken briefing for whoever cooks is what makes the rules actually followed.
"Once written, the card stays valid for the whole course."
Answers change as counts, kidney function and medicines change, and the rules loosen after treatment ends. Put a date on each version and rewrite it, because a stale card is followed with misplaced confidence.
Questions we are asked
Common questions about the food card
Is there a ready-made card to download?
The version that works is the one you write, because the useful parts are your low-count days, your team's answer on curd, your other conditions and your phone numbers. Copy the columns and ask your nurse to fill the blanks.
Where should it go?
Where the food is prepared, so whoever cooks can see it, plus a copy in the treatment bag and a photograph on two phones. A card in a folder helps nobody.
What is the most important line on it?
Which days are the low-count days, because the rules tighten for those. After that, the water rule and the two hospital phone numbers.
Can the hospital sign it?
Ask the nurse or dietitian to check and sign it. A sheet carrying the hospital's mark settles family disagreements far better than your own handwriting, and that is a large part of its value.
How often should it be updated?
Whenever medicines, counts or advice change, and at the end of treatment when restrictions loosen. Put the date on each version, since an out-of-date card is followed confidently.
We cannot read English. What do we do?
Ask for the card and the emergency line in Telugu or whichever language the household uses. This is a routine request, and never leave a translation gap between a family and a food or emergency decision.
Relatives keep adding items to the avoid column.
Keep the card as the team wrote it, and offer to ask about any new rule at the next visit. Most added restrictions are not medical advice and they reliably reduce how much the patient eats.
Should the card cover supplements too?
Yes, one line on what continues and what pauses. Written down, it prevents the quiet reintroduction of things that were meant to stop, which is otherwise very common.
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Dr. C. Raghavendra Reddy
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Vinay Mamidala
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Sources
- Cancer Research UK — Diet problems and cancer
- Macmillan Cancer Support — Eating problems and cancer
- National Cancer Institute — Eating Hints for Cancer Patients
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