Oncology Nutrition PDF

Oncology Nutrition Cheshire J. Que, RN, RND-RDN  Causes of Cancer Mutation – exposure to mutagen Chemical carcinogens Radiation Oncogenic virus Epidemiologic factors Stress – affects thymus gland and immune system, hormonal effects and hypothalamus ...

Oncology Nutrition Cheshire J. Que, RN, RND-RDN  Causes of Cancer Mutation – exposure to mutagen Chemical carcinogens Radiation Oncogenic virus Epidemiologic factors Stress – affects thymus gland and immune system, hormonal effects and hypothalamus  How Cancer Cells Develop Exposure to carcinogen Entry of carcinogen into the cell Initiation – cell genetic mutation Promoters enhance development Disruption of body functions  Cancer Prevention Primary prevention – general prevention Secondary prevention – early stage detection and treatment Tertiary prevention – rehabilitation, prevent recurrence  Nutritional Substances Retinoids Soy - phytoestrogens Vitamin E Fish oils – omega 3 Selenium Calcium Fat Fibers Flaxseed Tea – (EGCG)  Carcinogenic Foods Natural components formed during processing or storage Intentionally added Accidental contaminants  Dietary Risk Factors Cancer Sites Dietary Risk Factors Oral cavity and Esophagus Alcohol Larynx Alcohol Breast Total energy, total fat, animal & saturated fat, PUFA Linoleic Acid, fried foods Stomach Salt, salt-pickled food, nitrate-cured meat, charcoal-boiled/smoked fatty foods Colon Total fat, PUFA (Omega 6), cholesterol, alcohol Pancreas Meat, Total fat, PUFA (Omega 6) Liver Moldy food (Aflatoxin) Prostate Total fat, animal & saturated fat, possibly fried foods, animal protein Ovary Total fat, animal & saturated fat, possibly fried foods Endometrium Possibly fried foods  Protective Properties of Food Vitamins A,C,E Carotenoids Selenium Dietary fiber Phytochemical Eating Problems in Cancer Patients Loss of appetite Oral problems – pain, thrush, dental problems, salivary secretions Upper GI problems – Nausea, vomiting, indigestion, bloating, dumping syndrome Lower GI problems – diarrhea, constipation, flatulence, lactose intolerance  Cancer Therapy Surgery Radiation Therapy Chemotherapy – infusion, injection or pill Combined therapy Adjuvant therapy  Toxic Effects of Chemotherapy Bone Marrow – low red blood cells, white blood cells, platelets GI – nausea, vomiting, stomatitis, anorexia, ulcers and diarrhea Hair follicle – alopecia, hair loss  Chemotherapy Nutritional imbalances similar to radiation therapy Body fluid and electrolyte imbalances (corticosteroids and hormones) Specific intestinal damage from drugs Swallowing ability and saliva production Nausea and vomiting Ulceration of buccal mucosa  Chemotherapy Diarrhea Weight and protein loss Pain Anemia Taste changes and food aversions Milk intolerance  Radiation Therapy Area of Treatment Nutrition – Related Side Effects Head and Neck – brain, mouth, Fatigue, loss of appetite esophagus, thyroid Irritation of mouth, tongue, esophagus Alteration in taste and smell Dry mouth, tooth decay, loss of taste, lock jaw, stricture of esophagus Abdomen – stomach, pancreas, liver, Stomach irritation, diarrhea, milk gallbladder, kidney intolerance, nausea, vomiting, fatigue, loss of appetite Upper Torso – breast, lung Stomach and esophagus irritation, fatigue, loss of appetite Lower Torso – colon, rectum Diarrhea, fatigue and loss of appetite Pelvis – prostate, uterus, ovaries, cervix, Diarrhea, malabsorption, fatigue and loss bladder of appetite  Surgical Therapy Cancer and surgical site Possible side effects Head, neck and tongue Difficulty chewing and swallowing, tube feeding Jaw Tube feeding Esophagus Lung aspiration, narrowed esophagus, tube feeding directly into digestive tract Stomach High blood glucose, Vit. B12 deficiency, tube feeding directly into digestive tract Small intestine Malabsorption, salt and water imbalance, blocked bowels, Vitamin B12 deficiency Pancreas Malabsorption and diabetes Large intestine Malabsorption of nutrients and water, diarrhea Immunotherapy or Biological Therapy The immune system fights cancer or help control side effects  Nutrition Therapy Curative stage – Treatment related side effects of the medical/surgical therapy and symptoms of the disease Palliative stage – Less restrictive diet therapy, patient’s informed preference Terminal stage – Follow the wishes of patient and relatives, comfort  Dietary Management of Cancer Manage nutrition related problems: anorexia, nausea, vomiting, altered taste perception, dry mouth, esophagitis, malabsorption, diarrhea) Hypercatabolic state – enteral or parenteral nutrition support  Feeding Cancer Patients Alcohol to stimulate appetite, need doctor’s order Cold food and beverages Salt, sugar, lemon juice and spices Offer food when pain is at the lowest level Little chewing required for easily tired patients Mouth inflammation – cold, bland, semisolid  Cancer Prevention 30% or less of fat intake from TER 20 to 30g dietary fiber per day Variety of fruits and vegetable daily Avoid obesity Moderate alcohol consumption (2 drinks for men and 1 drink for women) Minimize consumption of salt-cured, pickled or smoked food 30 minutes daily physical activity Don’t use supplements for cancer protection Exclusive breastfeeding for 6 months Cancer survivors follow recommendations for cancer prevention  Cancer Prevention Whole grains Legumes Vegetables Fruits Limited red meat Low-fat dairy products Low in simple sugars Thank you and God bless!