Cancer Management and Nutrition Quiz

Medical Nutrition Therapy for Cancer

• Cancer is a global health concern
• In 2018, there were 17 million new cases and 9.5 million cancer deaths worldwide
• One-third of cancer deaths are attributed to lifestyle behaviors and nutrition

Carcinogenesis

• A multi-stage biological process, progressing on a continuum
• Initiation: Cells transform due to chemical, radiation or virus exposure
• Promotion: Triggered cell multiplication to form a neoplasm
• Progression: Fully malignant tumor, invades tissues and organs
• Benign tumors also exist

Classification of Cancer

• Histology: Examines tissue origin
• Carcinoma: Cancer of internal or external body linings (epithelial origin)
• Sarcoma: Cancer of connective tissues (bones, tendons, cartilage, muscle, fat)
• Grading: Assesses abnormal cell differentiation following biopsy
• Grade 1: Slightly abnormal, well differentiated cells
• Grade 2: More abnormal, moderately differentiated cells
• Grade 3: Very abnormal, poorly differentiated cells
• Grade 4: Immature, undifferentiated cells
• Staging: Classifies disease extent
• Stage 0: Cancer in situ (surface limited)
• Stage I: Cancer limited to organ of origin, evidence of growth
• Stage II: Limited spread of cancerous cells
• Stage III: Extensive local and regional spread
• Stage IV: Distant metastasis

Obesity and Cancer

• Obesity increases cancer risk and recurrence (e.g., colon, breast, prostate)
• Physical activity reduces cancer risk
• Excess body weight increases estrogen, androgen, insulin levels, contributing to cell and tumor growth

Food Preservation and Cancer

• N-Nitrosocompounds (NOCs)/Nitrosamines: Formed during food preservation (e.g., pickled, cured, smoked foods)
• NOCs are sometimes created from the interaction of nitrates/nitrites with amines and amides in food
• Some food additives (e.g. in hot dogs/luncheon meats) can boost their pink color.
• Acrylamide: A byproduct of high-temperature food preparation that can be carcinogenic

Nutrients for Cancer Prevention

• Calcium and Vitamin D: Found in coffee & tea (green tea is better)
• Folate and Folic Acid: Essential for DNA synthesis and repair
• Fruits and Vegetables, Especially Non-starchy ones: Protective against various cancers
• Soy and Phytoestrogens: Potentially protective against breast and prostate cancer(more research is needed) .

Nutritional Implications of Cancer

• Treatment regimens often cause anorexia and weight loss due to depleted nutrient stores
• Even small amounts of weight loss before treatment is a predictor of poor prognosis. It is therefore important to screen early.
• Metabolic changes: Elevated resting energy expenditure, increased use of glucose, accelerated protein and fat breakdown, and reduction in muscle mass occur in cancer patients.

Cancer Cachexia

• Progressive, significant weight loss, reduction of body's muscle and fat stores
• Results from cytokines, notably tumor necrosis factor (TNF), interleukin-1 & 6, and interferon-a
• Accompanies advanced cancers
• May result from poor nutrition

Cancer Treatment and Nutritional Implications

• Cancer Treatment Types: Chemotherapy, Immunotherapy, Radiation Therapy, Surgery, Steroid Therapy, Hematopoietic Stem Cell Transplantation (HSCT)
• Nutritional assessment is crucial, as the effects of treatment can severely impair nutrition

Common Side Effects

• Constipation, diarrhea, taste and smell changes, nausea and vomiting, xerostomia, mucositis, dysphagia, and neutropenia are observed side effects due to various forms of cancer treatment.

Diarrhea

• Can significantly impact patients' functional capacity and nutritional status
• Dietary interventions: Restoring balance of fluids, electrolytes; restricting high-carbohydrate items, high-fiber foods
• Use of oral rehydration solutions and IV hydration may be needed

Nausea & Vomiting

• A common side effect of chemotherapy and/ or radiation treatment.
• Antiemetic medications are commonly prescribed to manage this condition.
• Dietary adjustments to allow sufficient time before meals are needed to help control this issue.

Taste & Smell Alterations

• Common side effect of treatment, especially radiation and chemotherapy
• Related issues such as hypogeusia, ageusia, and dysgeusia
• Dietary adjustments such as using spices and herbs to mask undesirable flavors may be necessary

Mucositis and Stomatitis

• Ulcerative lesions in the mucous membranes (mouth and other regions) resulting from chemotherapy or radiation.
• Soft, moisture-rich diets are often recommended
• Supplementation may be required

Xerostomia

• Dry mouth, common consequence of cancer treatment.
• Increased fluid intake is recommended
• Limitation of certain foods for dental health is required.

Dysphagia/Odynophagia

• Difficulty swallowing or pain while swallowing
• Nutritional adjustments or enteral nutrition might be required to maintain adequate nutrition when this condition exists

Neutropenia

• Low neutrophil count, increasing susceptibility to infection
• Specific diet recommendations and precautions to prevent infection are required.

Neutropenic Diet

• Elimination of hazardous foods from the diet (raw meats, unwashed produce, etc,)
• Special precautions to avoid infections and maintain food safety are required

Conclusion:

• Nutrition plays a pivotal role in the care and recovery of cancer patients
• Individualized nutrient management plans are essential to meet patients' diverse needs
• Patient participation and communication with healthcare professionals are paramount.

Test your knowledge on the management of xerostomia and nutritional strategies for cancer patients. This quiz covers key concepts related to the effects of radiation therapy, mucositis, and carcinogenesis. Ideal for healthcare professionals and students in oncology and nutrition.