Transcript Chp 40 newCancer Krause

Chapter 40
Medical Nutrition
Therapy for
Cancer
Prevention,
Treatment,
and Recovery
Cancer

When cells divide and reproduce
abnormally and have the potential to
spread throughout the body, crowding out
normal cells and tissues

One third of the cancer deaths in the
United States each year can be attributed
to nutrition and other lifestyle factors.
© 2004, 2002 Elsevier Inc. All rights reserved.
Carcinogenesis

Initiation-exposure to carcinogeninitiators begin altering cellular DNA,
remains dormant until activated by
promoting agent

Promotion-initiated cells activated by
promoting agents to multiply

Progression- tumor cells accumulate &
grow independently, capacity for invasion
& metastasis
© 2004, 2002 Elsevier Inc. All rights reserved.
Cancer—Cause
Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
© 2004, 2002 Elsevier Inc. All rights reserved.
Cancer—Pathophysiology
Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
© 2004, 2002 Elsevier Inc. All rights reserved.
Cancer—Medical and Nutritional Management
Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
© 2004, 2002 Elsevier Inc. All rights reserved.
Tumor Node Metastases (TNM)
Staging System

T- size of original (primary) tumor

N- node involvement (spread to nearby
lymph nodes)

M- presence of distant metastases
© 2004, 2002 Elsevier Inc. All rights reserved.
Treatment

Primary- definitive, indicates that it will be the
only therapy ie: surgical removal of a small
tumor

Adjuvant- usually treatment “in addition to”
initial treatment ie: using chemo after surgery
as part of treatment regimen

Combination- use of 2 or more therapeutic
agents/processes for treatment

Salvage- additional treatment used in hope of
cure to prolong life, in pt with recurrence of CA
after initial treatment
© 2004, 2002 Elsevier Inc. All rights reserved.
Prevention Factors

Energy balance and exercise

Fat

Protein

Fiber

Fruits and vegetables

Chemoprevention
© 2004, 2002 Elsevier Inc. All rights reserved.
Prevention Factors—cont’d

Alcohol

Coffee and tea

Artificial sweeteners

Nitrates, nitrites, and nitrosamines

Method of food preparation
© 2004, 2002 Elsevier Inc. All rights reserved.
Fruits and Vegetables

Appear to have a protective effect against
cancer

Thought to be due to the phytoestrogen
and phytochemical content of the plantbased diet
© 2004, 2002 Elsevier Inc. All rights reserved.
Fat

Research, although controversial, has
shown evidence that high-fat diets are
linked to an increased risk of cancer of
the breast, colon, lung, and prostate
© 2004, 2002 Elsevier Inc. All rights reserved.
American Cancer Society’s Dietary
Recommendations for Cancer Prevention
1. Eat a variety of healthful foods, with an
emphasis on plant sources.
2. Adopt a physically active lifestyle.
3. Achieve and maintain a healthy body weight
throughout life.
4. Limit consumption of alcoholic beverages.
© 2004, 2002 Elsevier Inc. All rights reserved.
Pharmacological Agents for Anorexia-Cachexia
Syndrome and Weight Loss Management

Appetite stimulants

Metabolic agents and cytokine blockers

Prokinetic drugs

Anabolic agents
© 2004, 2002 Elsevier Inc. All rights reserved.
Factors That Affect Appetite
Reference: American Institute for Cancer Research: Food, nutrition, and the prevention of cancer: a global perspective,
Washington, DC, 1997, AICR.
© 2004, 2002 Elsevier Inc. All rights reserved.
Nutritional Implications of Cancer
Therapy

Chemotherapy
—Taste abnormalities, diarrhea, constipation

Radiation therapy
—Fatigue, loss of appetite, skin changes

Surgery
—Fatigue, pain, loss of appetite

Immunotherapy
—Flulike symptoms, decreased food intake
© 2004, 2002 Elsevier Inc. All rights reserved.
Nutritional Implications of Cancer
Therapy—cont’d

Bone marrow transplant
—Nausea, vomiting, diarrhea, mucositis,
xerostomia, dysgeusia

Severe oral muscositis

Graft versus host disease (GVHD)

Veno-occlusive disease (VOD)
© 2004, 2002 Elsevier Inc. All rights reserved.
Marrow Transplantation—Cause
Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
© 2004, 2002 Elsevier Inc. All rights reserved.
Marrow Transplantation—Pathophysiology
Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
© 2004, 2002 Elsevier Inc. All rights reserved.
Marrow Transplantation—
Medical and Nutritional Management
Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
© 2004, 2002 Elsevier Inc. All rights reserved.
Severe Oral Mucositis Following Marrow
Transplantation
© 2004, 2002 Elsevier Inc. All rights reserved.
Guidelines for Oral Feeding During Antitumor
Therapy
© 2004, 2002 Elsevier Inc. All rights reserved.
Guidelines for Oral Feeding During Antitumor
Therapy —cont’d
© 2004, 2002 Elsevier Inc. All rights reserved.
Commonly Used Complementary
and Alternative Therapies

Macrobiotic diet

Shark cartilage

Vegetarian diet

DHEA

Gerson therapy

Enzymes

Kelley/Gonzales
regimen

Oxymedicine

Coenzyme Q10

Juice therapies
© 2004, 2002 Elsevier Inc. All rights reserved.
Commonly Used Complementary
and Alternative Therapies—cont’d

Black cohosh

Milk thistle

Echinacea

PC-SPECS

Flaxseed

Saw palmetto

Ginger

Soy and soy foods

Iscador

Teas
© 2004, 2002 Elsevier Inc. All rights reserved.
Nutrition in the Etiology of Cancer

Epidemiologic research has evaluated the role
of diet in the etiology of cancer in different
population groups.

Diets contain inhibitors and enhancers of
carcinogenesis.

Laboratory studies have served as models to
test the effect of food and nutrition on cancer
development.
© 2004, 2002 Elsevier Inc. All rights reserved.