Holiday food safety tips for all (especially cancer patients)

November 25, 2014 | by Sara Lewis

food safety tipsFood preparation is a big responsibility. Thanksgiving food preparation is an even bigger responsibility, especially if one of your guests is a cancer patient.

Preparing a holiday meal is a huge responsibility, not just in terms of taste and presentation, but also in terms of food safety. Special care must be taken when handling, assembling and cooking the feast  – and this is never more true than when your guests will include immunosuppressed patients, such as cancer patients currently in treatment.

For them, illnesses can be longer and more debilitating, possibly resulting in hospitalization. Their bodies simply can't clear infection as easily as other people's bodies. Here are some Thanksgiving food safety tips from City of Hope dietitians to help you shop, and prepare, carefully.


Which kind of turkey to choose? Fresh, frozen, natural, organic? Here's an explanation of what the labels mean – and, in some cases, warnings about storage.

  • Fresh: Should be stored at a temperature no lower than 26° F. The USDA warns against buying fresh, pre-stuffed turkeys because any harmful bacteria in the stuffing can multiply quickly. Learn more.
  • Frozen: Should be stored at 0° F or below.
  • Organic: Has not been given antibiotics or growth hormones and is certified by the USDA as such.
  • Basted: Has been injected with a sodium-based solution such as flavor enhancers, fat, broth or stock to increase the juiciness of the bird. Per USDA, the labels on the package must include a statement listing the total quantity and common name of all the ingredients in the injected solution.
  • Natural: Turkeys that have no added artificial flavors, food coloring, chemical preservatives or other artificial ingredients.
  • Free-range: Turkeys that roam freely while being raised.
  • Kosher: Turkeys processed under the supervision of a rabbi, grain fed with no antibiotics, allowed to roam free and soaked in salt brine before being packaged.


If you choose to buy a frozen bird, you may do so at any time, but make sure you have adequate storage space in your freezer. If you buy a fresh turkey, purchase it only one to two days before cooking. Again, don't buy a pre-stuffed, fresh turkey.

Type of Turkey Pounds to Buy
Whole bird 1 pound per person
Boneless breast of turkey 1/2 pound per person
Breast of turkey 3/4 pound per person



Clean: Wash hands and surfaces often.Food prep - scrubbing raw vegetables

Bacteria can spread throughout the kitchen and get onto cutting boards, utensils, counter tops and food.

To ensure that your hands and surfaces are clean, be sure to:

  • Wash hands in warm soapy water for at least 20 seconds before and after handling food and using the bathroom, changing diapers or handling pets.
  • Wash cutting boards, dishes, utensils and counter tops with hot soapy water between the preparation of raw meat, poultry and seafood products, and preparation of any other food that will not be cooked. As an added precaution, sanitize cutting boards and counter tops by rinsing them in a solution made of one tablespoon unscented liquid chlorine bleach per gallon of water, or as an alternative, run the plastic board through the wash cycle in your automatic dishwasher.
  • Use paper towels to clean up kitchen surfaces. If using cloth towels, wash them often in the hot cycle of the washing machine.
  • Wash produce. Rinse fruits and vegetables, and rub firm-skin fruits and vegetables under running tap water, including those with skins and rinds that are not eaten.
  • With canned goods: Remember to clean lids before opening. Cross-contamination occurs when bacteria are spread from one food product to another.  This is especially common when handling raw meat, poultry, seafood and eggs. The key is to keep these foods – and their juices – away from ready-to-eat foods.
  • Daily microwave sponges or put through automatic dishwasher.


Separate: Don’t cross-contaminate.

To prevent cross-contamination, remember to:


  • Separate raw meat, poultry, seafood and eggs from other foods in your grocery shopping cart, grocery bags and in your refrigerator.
  • Never place cooked food on a plate that previously held raw meat, poultry, seafood or eggs without first washing the plate with hot soapy water.
  • Don’t reuse marinades used on raw foods unless you bring them to a boil first.
  • Consider using one cutting board only for raw foods and another only for ready-to-eat foods such as bread, fresh fruits and vegetables and cooked meat


Thawing your turkey in the refrigerator:

Size of Turkey   Days to Defrost
4 to 12 lbs 1 to 3 days
12 to 16 lbs 3 to 4 days
16 to 20 lbs 4 to 5 days
20 to 24 lbs 5 to 6 days
Turkey breast 1 to 2 days
Turkey parts 24 hours

Thawing your turkey in cold water:

Size of Turkey   Hours to Defrost
4 to 12 lbs 2 to 6 hours
12 to 16 lbs 6 to 8 hours
16 to 20 lbs 8 to 10 hours
20 to 24 lbs 10 to 12 hours



Undercooked turkey is a particular danger because of the risk of food-borne pathogens.

  • Set oven for 325° F (never lower).
  • Cook fully; never partially cook ahead of time.
  • Use a thermometer ALWAYS.
    • Place in thickest part of meat.
    • Make sure turkey is 100 percent defrosted before cooking.
    • Do not rely on pop-up gauge thermometer.
  • If you plan to stuff the turkey, stuff loosely. The stuffing should be moist and not dry, since heat destroys bacteria more rapidly in a moist environment. The stuffing must reach 165° F, whether cooked inside the bird or in a separate dish.
  • All turkey meat, including any that remains pink, is safe to eat as soon as all parts reach at least 165° F.
  • Let turkey stand 20 minutes after taking out of the oven.


 Cooking time - unstuffed:

Size of Turkey Hours to Prepare
8 to 12 lbs 2 3/4 to 3 hours
12 to 14 lbs 3 to 3 3/4 hours
14 to 18 lbs 3 3/4 to 4 1/4 hours
18 to 20 lbs 4 1/4 to 4 1/2 hours
20 to 24 lbs 4 1/2 to 5 hours

Cooking time - stuffed:

Size of Turkey Hours to Prepare
8 to 12 lbs 3 to 3 1/2 hours
12 to 14 lbs 3 1/2 to 4 hours
14 to 18 lbs 4 to 4 1/4 hours
18 to 20 lbs 4 1/4 to 4 3/4 hours
20 to 24 lbs 4 3/4 to 5 1/4 hours



  • Hot foods should be held at 140° F.
  • Cold foods should be held at 40° F.
  • When serving food:
    • Keep hot food hot with chafing dishes, warming trays.
    • Keep cold food cold on ice, or in small amounts and replenish as needed.
  • Food should not be left out for more than two hours or one hour  if at room temperature. (> 90° F)



  • Boil gravy and soups for five minutes.
  • Leftover gravy must be boiled the next day; never use a microwave to reheat it.
  • Never let food cool on counter; put it directly into the refrigerator in small shallow containers.
  • Remove turkey from bone; store separately from stuffing and gravy.
  • Food should be refrigerated, in a shallow dish, within two hours of being left at room temperature in a shallow dish.
  • Refrigerate for four days only.
    • Otherwise freeze it. The exception is stuffing and gravy, which should be used within two days.
  • Reheat leftovers to 165° F and liquid leftovers to a rolling boil for five minutes.
  • Toss what you don’t finish.

Acknowledgments: Denise Ackerman, M.S., R.D., C.S.O., and Dhvani Bhatt, M.S., R.D., C.D.E., from City of Hope's Department of Supportive Care Medicine; National Cancer Institute; USDA


Helpful Resources



Learn more about getting a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673)


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