Transcript Chapter 21 - Delmar

Chapter 21
Diet and Cancer
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Objectives
• Discuss how nutrition can be related to
development or prevention of cancer
• State effects of cancer on nutritional status of
host
• Describe nutritional problems resulting from
medical treatment of cancer
• Describe nutrient therapy for cancer clients
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Cancer
• Second leading cause of death in U.S.
• Characterized by abnormal cell growth
– Can occur in any organ
• Cancerous tumors:
– Malignant
– Affect structure
• Consequently, affect function of organs
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Cancer
• High mortality rate
– But does not always cause death
• Oncology
– Study of cancer
• Oncologist
– Physician who specializes in cancer
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Causes of Cancer
• Precise etiology unknown
• Contributing factors:
– Heredity, viruses, environmental carcinogens, and possibly
emotional stress
• Not inherited
– But some families appear to have genetic predisposition
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Causes of Cancer
• Viruses linked to cancer:
– Epstein Barr
• Nasopharyngeal cancer, T-cell lymphoma, Hodgkin’s disease, and
gastric carcinoma
– Hepatitis B
• Liver cancer
– Human papillomavirus (HPV)
• Cervical cancer
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Causes of Cancer
• Environmental carcinogens
– Cause cancer after repeated exposure
• Radiation
– X-rays, sun, and nuclear wastes
• Certain chemicals ingested in food and water or touched by skin
• Substances breathed in
– E.g., tobacco smoke, asbestos
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Classifications of Cancer
• Majority fall under these headings:
–
–
–
–
Carcinomas
Sarcomas
Lymphomas
Leukemias
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Skin Cancer
• Becoming more prevalent
• Three types:
1. Basal cell
•
Most common
2. Squamous cell
3. Melanoma
•
•
Most serious
Deadliest
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Relationships of Food and Cancer
• Certain substances in foods considered
carcinogenic:
– Nitrates in cured and smoked foods associated with
stomach and esophagus cancer
– High-fat diets associated with uterine, breast, prostate, and
colon cancer
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Relationships of Food and Cancer
• Certain substances in foods considered
carcinogenic:
– Excessive caloric intake associated with gallbladder and
endometrial cancer
– Alcohol and cigarettes associated with lung, mouth,
pharynx, and esophagus cancer
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Relationships of Food and Cancer
• Certain diets seem to have health benefits:
– High-fiber helps protect against colorectal cancer
– Vitamin C-rich may protect against stomach and esophagus
cancer
– Vitamin A-rich may protect against lung, bladder, and
larynx cancer
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Relationships of Food and Cancer
• Health benefits:
– Phytochemicals occur naturally in plant foods
• Considered anticarcinogenic
– Legumes contain vitamins, minerals, protein, and fiber
• May protect against cancer
– High intake of soy foods associated with decreased risk of
breast and colon cancer
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
The Effects of Cancer
• Depend on location of tumor
• May cause unexplained weight loss, weakness,
early satiety, and anorexia
• May lead to loss of muscle tissue,
hypoalbuminemia, and anemia
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Treatment of Cancer
• Surgical removal, radiation, chemotherapy, or
combination of methods
• Side effects can affect nutrition
(continues)
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Treatment of Cancer
• Radiation and chemotherapy may cause:
– Xerostomia
• Dry mouth
– Dysphagia
• Difficulty swallowing
– Anorexia
– Nausea and vomiting
– Diarrhea with possible fluid and electrolyte imbalances
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Nutritional Care
• Calorie needs greater than before illness
• Clients who can eat normally tolerate side
effects of therapy better
• Clients can form aversions to food
– Making anorexia worse
• Soft diet if chewing problems
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Nutritional Care
• Low-residue diet for diarrhea
• High-protein, high-calorie diets and plenty of
fluids for clients undergoing radiation or
chemotherapy
• 45 to 50 calories per kg of body weight per day
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Nutritional Care
• Carbohydrates and fat needed to provide energy
and spare protein for tissue building and
immune system
• 1.0 to 1.2 g of protein per kg per day
• Malnourished clients may need from 1.3 to 2.0 g
of protein per kg per day
• Vitamins and minerals essential
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Nutritional Care
• Encourage foods that increase appetite:
– Foods brought from home
– Cold foods
• May be more appealing
– Milk, cheese, eggs, and fish
• May be more appealing than meat
– Can taste bitter
(continues)
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Nutritional Care
• Several small meals may be better tolerated
than three large meals
• Control nausea and pain
• Nutritional supplements may be needed
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Stop and Share
• Consider the following scenario:
– A client with cancer feels that comments to encourage
eating are depressing reminders of the cancer and her
situation. How can you be helpful to her?
(continues)
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Stop and Share
• At appropriate time, explain why eating is
important
• Encourage her to eat foods she enjoys
• Recommend avoiding eating at time of day
nausea is likely to occur
• Recommend refraining from food that gives
off odors that contribute to nausea
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Conclusion
• Cancer
– Disease characterized by abnormal cell growth
• Energy needs increase
– Due to hypermetabolic state and tumor’s need for energy
nutrients
• Surgery, radiation, and chemotherapy can
cause side effects that affect nutrition
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Conclusion
• Improving nutritional state difficult
– Due to illness and anorexia
• Parenteral or enteral nutrition may be
necessary
• Health care professional can help client
improve nutrition
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.