Section 3 Medical Nutrition Therapy. Chapter 21 Diet and Cancer.

Section 3

Medical Nutrition Therapy

Chapter 21

Diet and Cancer

Chapter 21 Copyright © 2003 Delmar Learning, a Thomson Learning company 3

Objectives

Discuss how nutrition can be related to the development or the prevention of cancer

State the effects of cancer on the nutritional status of the host

Describe nutritional problems resulting from the medical treatment of cancer

Describe nutritional therapy for cancer clients


Cancer

Cancer is the second leading cause of death in the United States.

It is a disease characterized by abnormal cell growth and can occur in any organ.

Cancerous tumors are malignant, affecting the structure and consequently the function of organs.


Cancer

The mortality rate for cancer clients is high, but cancer does not always cause death.

Oncology is the study of cancer.

An Oncologist is a physician who specializes in cancer.


Causes of Cancer

Precise etiology of cancer unknown.

Heredity, viruses, environmental carcinogens, and possibly emotional stress may contribute to its development.

Cancer is not inherited, but some families appear to have a genetic predisposition for it.


Causes of Cancer

Environmental carcinogens include radiation (x-rays, sun, nuclear wastes), certain chemicals (ingested in food, water or touched by skin) and certain substances that are breathed in (tobacco smoke and asbestos).

Carcinogens cause cancer after repeated exposure.


Causes of Cancer

Viruses linked to cancer: Epstein Barr, hepatitis B, and herpes simplex II.

• Epstein Barr: nasopharyngeal cancer, T-cell lymphoma, Hodgkin’s disease and gastric carcinoma

• Hepatitis B: liver cancer• Herpes Simplex II: cervical and uterine

cancer


Classifications of Cancer

Majority of all cancers fall under these headings: carcinomas, sarcomas, lymphomas, and leukemias.

Skin cancer is becoming more prevalent.

There are three types of skin cancer: basal cell, squamous cell, and melanoma.


Relationships of Food and Cancer

Both good and bad relationships between food and cancer exist.

Carcinogens include nitrates in cured and smoked foods such as bacon and ham. Regular ingestion associated with stomach and esophagus cancer.



High-fat diets associated with uterine, breast, prostate, and colon cancers.

Excessive caloric intake associated with gallbladder and endometrial cancer.

Smoking and drinking alcohol associated with lung, mouth, pharynx, and esophagus cancer.



Diets high in fiber help protect against colorectal cancer.

Diets rich in vitamin C may protect against stomach and esophagus cancer.

Diets high in vitamin A may protect against lung, bladder, and larynx cancer.



Flavonoids, phenols, and indoles are phytochemicals. These are substances that occur naturally in plant foods and are thought to be anticarcinogenic.

Eat five or more servings of fruits and vegetables each day.



Legumes such as soybeans, dried beans, and lentils contain vitamins, minerals, protein, and fiber and may protect against cancer.

High intakes of soy foods are associated with a decreased risk of breast and colon cancer.



An immune system that has been damaged—possibly through malnutrition—may be a contributing factor in the development of cancer.

Excessive protein and fat intake, however, may be a factor in the development of cancer of the colon.


The Effects of Cancer

Unexplained weight loss, weakness, anorexia.

Loss of muscle tissue and hypoalbuminemia.

Sense of taste and of smell becomes abnormal.


The Effects of Cancer

Satiated earlier than normal.

Abnormal insulin production with hyperglycemia.

Hypercalcemia, renal stones, impaired kidney function

Cachexia: severe malnutrition and body wasting.


Treatment of Cancer

Surgical removal, radiation, chemotherapy, or a combination of these methods used to treat cancer.

Side effects of these treatments can affect nutrition.

These include xerostomia (dry mouth) and dysphagia (difficulty in swallowing).


Treatment of Cancer

Tooth decay and loss of teeth sometimes occurs.

Radiation and chemotherapy may depress appetite.

Anorexia (loss of appetite), nausea, vomiting, and diarrhea can lead to fluid and electrolyte imbalances.


Nutritional Care

Kcal needs of the cancer client are greater than before the illness.

Clients on high-protein and high-kcal diets tolerate the side effects of therapy and higher doses of drugs better than those who cannot eat normally.


Nutritional Care

Clients can form aversions to food making anorexia worse.

To help with aversions:• Hold chemotherapy 2 to 3 hours before

and after meals• Include favorite foods served

attractively in familiar ways


Nutritional Care

If chewing is a problem, use a soft diet.

For diarrhea, use a low-residue diet.

High-protein, high-kcal diets and plenty of fluids recommended for clients undergoing radiation or chemotherapy.

45 to 50 kcal per kg of body weight per day.


Nutritional Care

Carbohydrates and fat will be needed to provide energy and spare protein for tissue building and the immune system.

1.0 to 1.2g of protein per kg of body weight a day.

Malnourished clients may need from 1.3 to 2.0g of protein per kg of body weight a day.


Nutritional Care

Vitamins and minerals are essential.

During chemotherapy and radiation therapy the recommendation is to eliminate vitamin A and vitamin E in supplemental form and in the diet. Intake of these vitamins may prevent cancer cells from self-destructing and work against cancer therapy.


Nutritional Care

Encourage food that will increase appetite.• Foods brought from home• Cold foods may be more appealing than

hot foods• Milk, cheese, eggs, and fish may be

more appealing than meat (can taste bitter)

• Add sugar if foods are not sweet tasting


Nutritional Care

Salad dressings, gravies, sauces, and syrups appropriately served on foods can be helpful for dry mouth.

Several small meals may be better tolerated than three large meals.

Use drugs to control nausea and pain.

Nutritional supplements may be needed.


Stop and ShareStop and Share

A client with cancer may feel that comments to encourage eating are depressing reminders of the cancer and the situation.

How can the health care professional be helpful to the client?


Stop and ShareStop and Share

At appropriate time, explain why it is important that the client eat.

Encourage the client to eat foods the client enjoys.

Recommend the client avoid eating at the time of day nausea is likely to occur.

Refrain from food that gives off odors that contribute to nausea.


Conclusion

Cancer is a disease characterized by abnormal cell growth.

Energy needs increase because of the hypermetabolic state and the tumor’s need for energy nutrients.

Surgery, radiation, and chemotherapy can cause side effects that affect nutrition.


Conclusion

Improving the nutritional state is difficult because of the illness and anorexia.

Parenteral or enteral nutrition may be necessary.

Health care professional can help the client improve nutrition.

Section 3 Medical Nutrition Therapy. Chapter 21 Diet and Cancer.

Documents

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