Cancer Management and Nutrition Quiz

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Questions and Answers

What is the primary method to manage xerostomia in patients undergoing head and neck radiation therapy?

Decreasing water intake

Use of artificial saliva products (correct)

Increase intake of sucrose-rich foods

Avoiding all types of nutrition supplements

Which of the following dietary changes is recommended to reduce the risk of caries in patients with xerostomia?

Increase alcohol consumption

Regularly eat sticky foods

Limit carbohydrate-containing foods (correct)

Consume more caffeinated beverages

What is the advised honey regimen for patients undergoing radiation therapy to help minimize mucositis?

20 mL before, after, and six hours postradiation (correct)

5 mL before radiation only

15 mL after radiation only

30 mL before and after radiation

What condition affects up to 25% of cancer patients and involves difficulty in swallowing?

Dysphagia Signup and view all the answers

In patients experiencing odynophagia, what is the common sensation during swallowing?

Pain while swallowing Signup and view all the answers

What percentage of cancer deaths each year is linked to nutrition and lifestyle behaviors?

33% Signup and view all the answers

Which of the following describes the 'Promotion' stage in the carcinogenesis process?

Multiplication of initiated cells to form a neoplasm Signup and view all the answers

What is the main feature of Grade 4 cancer cells?

Immature and undifferentiated Signup and view all the answers

Which type of cancer originates in supportive and connective tissues?

Sarcoma Signup and view all the answers

What is the correct definition of carcinogenesis?

A multistage biological process leading to cancer Signup and view all the answers

Which stage of cancer involves the spreading of tumor cells to distant tissues?

Metastasis Signup and view all the answers

Which of the following is NOT a characteristic of carcinoma?

Typically benign Signup and view all the answers

What does cancer staging primarily involve?

Classifying the extent of the disease Signup and view all the answers

What is the recommended protein intake for severely stressed individuals per kilogram of body weight?

1.5-2.5g/kg Signup and view all the answers

Which cancer treatment uses biological response modifiers to boost the body's natural defenses?

Immunotherapy Signup and view all the answers

What is a common side effect of chemotherapy that can adversely affect dietary intake?

Mucositis Signup and view all the answers

Which treatment primarily targets malignant tissue but also affects normal cells?

Chemotherapy Signup and view all the answers

The use of high-energy rays in treatment is a characteristic of which cancer therapy?

Radiation therapy Signup and view all the answers

Following surgery, what is generally required to support healing and recovery?

Additional energy and protein Signup and view all the answers

Which of the following treatments is least likely to have nutritional effects dependent on the site of treatment?

Immunotherapy Signup and view all the answers

What range of protein intake is recommended for individuals under mild stress?

1.0-1.2g/kg Signup and view all the answers

Study Notes

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.

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Description

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.