Hello!

Hi Rose 321 and welcome to this corner of the Community although always sorry to see folks joining us. I am Mike Thehighlander and I help out around our blood cancer groups.

Well done getting up your post, it’s takes a little time to understand how the community works be you are here now. If you need any further help, want to ask questions just put them up as someone will be around to help.

I don’t have follicular lymphoma but was diagnosed way back in 1999 with another type of low grade incurable but treatable type of skin (CTCL) Non Hodgkin’s Lymphoma Stage 4a and although my Lymphoma ‘type’ is different I have experienced most types of treatments used but not necessarily the exact same drug mix but understand this journey rather well unfortunately.

Always around to chat ((hugs))

Hi thanks for replying. I have previously had rituximab treatment but having to start combined rituximab and chemo in December. I'm not looking forward to it obviously, but accept it has to be done. What bothers me is the seemingly conflicting advice about diet both before and during treatment. My fact sheets from the hospital state no pro biotics, live yogurt etc., etc., but I looked on google (as you do!!) and found that many sites advocated using pro biotics to help the body fight the fallout from the chemo..... they can't both be right!  I want to give muself the best chance of a good result by eating as well as I'm able, hence my research beforehand, but so far it has just been confusing!

I was seen by a dietitian before, during and post my years of treatment (see my profile) 

Defiantly a no to no pro biotics, live yogurt etc., etc.

This is taken from an info sheet I get from my dietitian.

Part of the way chemotherapy works is it kills fast growing cells. This includes not only the cancer cells, but your white blood cells (neutrophils) that fight infections.

There is some debate about whether patients need to change their diet to prevent infections when having chemo.

Some doctors and dieticians believe it’s very important to follow strict dietary guidelines. Others give less strict advice. This is because we don’t have evidence behind this and we are using professional opinion.

This can be confusing but food safety and hygiene are very important…… and why take the chance of developing a food based infection.

Some tips for you:

Shop smart – Check foods are in date.

Make sure you get the chilled and frozen foods home quickly.

Prepare and clean up - Clean hands and the kitchen.

Use separate chopping boards for raw and ready to eat foods.

Prevent cross-contamination - Separate raw meats, chicken, seafood from ready to eat foods in the fridge.

Cook food properly, piping hot throughout.

Eat out in clean places and make sure your food is hot.

Don't have carry out food as you can not control it.

Eat

Meat, chicken and fish cooked through

Pasteurised milk

Cooked eggs with a firm yolk

Washed fresh or cooked fruit and vegetables

Hard cheese or soft cheese made from pasteurised milk

Vacuum-packs meat, ham.

Re-heat cold rice till it is steaming all the way through.

Some foods have a higher risk of becoming tainted with bacteria. Here are some foods you might want to avoid.

Avoid

Raw or undercooked meat, chicken, fish and no shellfish

Unpasteurised or raw milk

Raw or undercooked eggs

Unwashed fresh fruit and vegetables

Soft cheeses made from unpasteurised milk

Uncovered deli meats

Cold rice

To limit your risk of infection from food:

• Cooking food (eggs/meat/fish) thoroughly and having good hand hygiene.
• Avoid cross-contamination between cooked and raw foods
• Wash fruit and vegetables well
• Avoid unpasteurised cheeses and milk
• Choose pasteurised milk, yoghurts and cheese
• Ensure that food is in date
• If having cooked/cured meat, opt to vacuum packed and not from the deli counter.

When it comes to takeaways..... regardless of the type of takeaway I was told the main issue was when our immune system is anyway reduced by treatments a small food bug in ‘any’ food can be hard for us to fight compared to someone having a fully functioning immune system that would not have any effects.

Early on in my treatment I harassed my wife that I wanted a Chinese takeaway (even although my team had told me not to have them) the following morning I was very ill.... the rest of the family were fine... I had to go see my team and after a few tests I had developed Helicobacter Pylori, a bacteria that developed ulcers and stomach inflammation.

It turns out a high percentage of the population have HP but it’s basically dormant but a small infection can set it off

The 3 pack antibiotics I was given for the HP were horrendous..... never did have any more takeaway during and immediately after treatments until my counts were well up.... but even now - 5 years on we are very careful

Thanks I will certainly query the live yogurt issue when I next see my consultant. Treatment not starting till December so time to stock the cupboards with good stuff! I live in small rural area, takeaways not really an option which is just as well! 

Good morning Rose 321 yes do talk this through with your consultant.

Rituximab is a targeted therapy not a chemo as such so tends not to effect the digestive system as much as chemo does.

The digestive system can take a big hit during chemo so it’s ability to deal with live cultures and food borne bugs is greatly reduced resulting in problems with bad diarrhoea.

In the big picture, protecting yourself from problems like this during treatment is one thing less to deal with during treatment.

Again thank you for help and support. I was somewhat confused as to whether I should join this group or the Non Hodgkins Lymphoma one... I will certainly ask to speak to a dietician on my next appointment at the centre.

The Non Hodgkin’s Lymphoma group covers all types of NHL.

But we do have the 4 specific NHL groups covering the main types.

But with over 60 Lymphoma types and subtypes it’s impossible to have a group for each type so the general NHL group helps cover all the types.

A lot of folks post on their group type but also in the general NHL group.

That's interesting as no mention was made about diet when I was undergoing my RCHOP treatment, so I ate what I would normally including the odd takeaway.

Hi M.A.C., my two teams (Heamatology and Stem Cell Transplant) were very insistent on the diet thing.

But lots of hospitals don’t mention it but it will often be in all the information we get.

It’s like many things in life it’s not a big deal until something goes wrong