New treatment options and scientific advances are helping patients with acute myeloid leukemia (AML) live longer and with better outcomes. However, the journey from diagnosis to treatment and beyond is difficult and navigating the large amount of information about cancer is a daunting task for anyone. Learning about what to expect from your diagnosis and treatment may help ease your anxiety and teach you about ways to cope with disease and treatment-related side effects. This section is designed to provide information and resources to help you manage life before, during, and after treatment.

Dietary Considerations

Food safety is an important concern for patients with acute myeloid leukemia (AML). Chemotherapy, and leukemia itself, can weaken the immune system and make you more susceptible to foodborne illness. This is particularly true for patients with stem cell transplants or neutropenia. Neutropenia is a condition in which you have a low number of neutrophils, a white blood cell that helps fight infections. Ask your doctor about any special food restrictions or instructions.

Some general guidelines on safe preparation and handling of food include:

• Avoiding rare or raw meat, poultry, seafood or eggs. Cook meat until it’s well done.
• Avoiding foods with raw eggs such as uncooked cookie dough or homemade mayonnaise. Thoroughly cook eggs so that the yolk isn’t runny.
• Avoiding unpasteurized beverages and dairy products, such as fruit juices, milk, cheese, and yogurt.
• Avoiding soft mold-ripened and blue-veined cheeses such as Brie, Camembert, Roquefort, Stilton, Gorgonzola, and Bleu, or other soft, unpasteurized cheeses.
• Avoiding salad bars and buffets.
• Refrigerating all meats, eggs, seafood, and deli meats.
• Avoiding raw sprouts, such as alfalfa sprouts.
• Washing fresh fruits and vegetables before peeling.
• Avoiding well water unless it has been filtered and boiled for 1 minute before drinking. Tap water and bottled water is ok to drink.
• Keeping your hands, counters, cutting boards, and utensils clean.
• Using separate dishes, cutting boards, and utensils for preparing meat, poultry or seafood.
• Not rinsing raw meat or poultry before cooking because water may splatter and spread bacteria to the sink or counter.
• Thawing frozen items in the refrigerator or microwave, not on the counter.
• Reading the expiration dates and looking for signs of food spoilage. If in doubt, throw it out.

Nutrition and Cancer

Healthy eating habits can improve your overall health, boost your mood, and help you cope with some of the side effects of cancer and its treatment. Consider the following tips on maintaining a healthy lifestyle:

• Eat a healthy diet rich in fruits, vegetables and whole grains.
• Limit your intake of red, grilled or processed meats.
• Increase your fiber intake.
• Exercise regularly. Aim for 150 minutes of exercise per week with at least two sessions of strength training exercises per week.
• Maintain a healthy weight.
• Limit alcohol to fewer than 1 drink a day for women and fewer than 2 drinks a day for men.
• Do not smoke.

Cancer treatment often causes side effects, such as nausea, diarrhea, mouth sores, and taste changes. These side effects may make it difficult to eat or drink enough each day. Keep the following tips in mind to help you get the nutrition you need:

• Speak with your healthcare team about adding a multivitamin or liquid nutritional supplements and snacks to your diet.
• If you have bothersome mouth sores, use a blender or food processor to make food smooth. Juices and smoothies may help keep your mouth moist.
• Eat 6 smaller meals instead of 3 large meals. Make sure you meet your calorie goals each day.
• If water tastes unpleasant, take in liquids through other foods and drinks, such as sports drinks, soups, teas, milk, or adding cut fruit to your water.
• If your mouth is sore, avoid acidic and spicy foods until you heal.
• If food tastes bland, season it well with flavorful spices.
• If certain foods are not appealing anymore, try substituting them with foods with similar nutrients. If meat makes you feel sick, try getting protein from fish, eggs, cheese, beans, nuts, tofu, or protein shakes.
• If you have a metallic taste in your mouth, use mints, gums, or citrus fruits. Cook food in non-metal pots and pans and use plastic utensils. Try brushing your teeth before eating.

Quitting Smoking

It is never too late to quit smoking. Smoking increases your risk of cancer and heart disease. Life expectancy for smokers is at least 10 years shorter than that of non-smokers. Quitting smoking before the age of 40 reduces your risk of dying from smoking-related causes by 90%.

• 1 year after quitting, your risk of heart disease is half that of a smoker.
• 5 years after quitting, your risk of mouth, throat, esophagus and bladder cancer is half that of a smoker. Your risk of cervical cancer and stroke are similar to a non-smoker’s risk.
• 10 years after quitting, your risk of lung cancer is half that of a smoker.
• 15 years after quitting, your risk of heart disease is the same as a non-smoker.
• Other benefits of quitting smoking include: saving money, food tastes better, your breath, clothes and hair smell better, less premature wrinkling, less gum disease and tooth loss, ability to do more activities without losing your breath (such as climbing stairs).

Quitting smoking is not easy, but there are strategies that will help you achieve your goal to become smoke-free. Some strategies include:

• Set a date for your Quit Day and prepare to quit. Stay busy. Avoid situations where you have a strong urge to smoke. Avoid alcohol.
• Talk to your doctor about using nicotine replacement therapy, such as a patch, gum, nasal spray, inhalers, or lozenges. Some prescription drugs may also help you quit, such as varenicline or buproprion.
• Look for support. Tell friends and family about your Quit Day. Set up a support system of people who have quit and are willing to help. Ask friends and family that smoke to not smoke around you or leave cigarettes out.
• Fight the urge to smoke by delaying for 10 minutes, breathing deeply, drinking water slowly, and doing something else to distract you.

Leukemia and Lymphoma Society. Diet Guidelines for Immunosuppressed Patients. https://www.lls.org/managing-your-cancer/diet-guidelines-for-immunosuppressed-patients. Accessed March 20, 2019.

Cancer.net. Nutrition Recommendations During and After Treatment. https://www.cancer.net/survivorship/healthy-living/nutrition-recommendations-during-and-after-treatment. Accessed March 20, 2019.

American Cancer Society. How to Quit Smoking or Smokeless Tobacco. https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking.html. Accessed March 20, 2019.