1. Colorectal Cancer with Chemotherapy Cristal Alatorre Perez Blanca Contreras Silvia Martinez What is Colorectal Cancer? Colorectal cancer (colon cancer) is cancer of the colon or the rectum in which abnormal cells in the colon or rectum divide uncontrollably, ultimately forming a malignant tumor. The colon and rectum are parts of the body’s digestive system, which takes up nutrients from food and water and stores solid waste until it passes out of the body. Symptoms: Early stages of colorectal cancer don’t usually have symptoms. This means that someone could have polyps or colorectal cancer and not know it. Later on, people may have these symptoms: · Bleeding from the rectum or blood in or on the stool · Change in bowel habits · Stools that are more narrow than usual · General problems in the abdomen, such as bloating, fullness or cramps · Diarrhea, constipation or a feeling in the rectum that the bowel movement isn’t quite complete · Weight loss for no apparent reason · Being tired all the time · Vomiting Who is at Risk? · People age 50 and older · People who smoke · People who are overweight or obese, especially those who carry fat around their waists · People who aren’t physically active · People who drink alcohol in excess, especially men · People who eat a lot of red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts) · People with personal or family histories of colorectal cancer or benign (not cancerous) colorectal polyps · People with personal histories of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease) · People with family histories of inherited colorectal cancer or inherited colorectal problems What is Chemotherapy? Chemotherapy is the use of drugs to kill cancer cells. These medications interrupt different stages of cell cycle replication. They are very strong and circulate in the bloodstream and directly damage the cells that are actively growing. Since cancer cells generally grow and divide faster than normal cells, they are more susceptible to the action of these drugs. However, damage to healthy cells is unavoidable, and this damage accounts for the side effects linked to these drugs. Treatment: The treatment given depends on the stage of cancer one is in. The goals of administering chemotherapy before (neoadjuvant) or after (adjuvant) another treatment are as follows: Adjuvant chemo is chemo that is used after surgery to remove the cancer. This chemotherapy has the theoretical advantage of eliminating any residual or metastatic cells Neoadjuvant chemo is used for some cancers and is given (sometimes with radiation) before surgery to try to shrink the cancer and make surgery easier. This treatment is used when the tumor is too big for an effective resection. The Goals of Chemotherapy: The goals of treatment with chemotherapy, as determined by cancer type and stage, are: · To control the cancer · To cure the cancer · To relieve symptoms caused by the cancer Chemo can also be used to help shrink tumors and relieve symptoms for cancers that have spread to other organs, such as the liver. Although it is not likely to cure the cancer, it often helps people live longer.

2. Colon Cancer & Nutrition Good nutrition is especially important if you have cancer because both the illness and its treatments can change the way you eat. Cancer and cancer treatments can also affect the way your body tolerates certain foods and uses nutrients. The nutrient needs of people with cancer vary from person to person. Your doctor, nurses, and/or a registered dietitian can help you identify your nutrition goals and plan ways to help you meet them. Eating well while you are being treated for cancer might help you: · Feel better. · Keep up your strength and energy. · Maintain your weight. · Maintain your body’s store of nutrients. · Better tolerate treatment-related side effects. · Lower your risk of infection. · Heal and recover faster. Eating well means eating a variety of foods that will give your body the nutrients needed to help fight cancer. These nutrients include protein, carbohydrates, fat, water, vitamins, and minerals. Tips to Alleviate Side Effects of Chemotherapy Discuss any side effects you experience with your Colorectal cancer health care team. Medications may be necessary to lessen the severity of some side effects. Different side effects require different dietary strategies to manage. To Alleviate constipation: · Drink plenty of fluids, including prune juice and small amounts of caffeinated beverages · Eat high fiber foods, including bran cereal, oatmeal, and raw fruits and vegetables. If making a change in diet does not work for the patient, medications might be necessary. To Alleviate diarrhea: Drink clear liquids, eat low fiber, low fat foods, and avoid heavy, greasy foods, raw fruits and vegetables, strong spices, and caffeine. To Alleviate Gas: · Eat slowly, use a straw and drink out of a glass instead of a bottle, and try Beano®, if necessary. · Avoid eat cruciferous vegetables, including broccoli and cabbage, beans, eggs, garlic, onions, or foods with fructose or sorbitol added. · Don’t drink carbonated beverages To Alleviate Sore Mouth and Throat: · Eat soft, creamy foods; adding gravies, sauces, and dressings to anything to help soften the food. · Drink through a straw, and drink liquid supplements, such as meal replacement drinks. · Avoid eating or drinking anything very hot or very cold, and should not eat crispy, crunchy, sour, acidic, or very salty foods or spices, such as pepper, curry, or peppermint. · Alcohol and caffeine should also be avoided. To Alleviate Taste Changes: Try to eat anything that is tart and sour, such as lemonade, limeade, etc. Sourballs tend to help, as does adding spices, herbs, and marinades to food, to give it the strongest flavor possible. · If you are experiencing a metallic taste, use plastic silverware and drink with a straw. · Eat and drink things that are cold, cool, or room temperature. Patients are encouraged to keep trying a food because taste continually changes. As a patient’s gastrointestinal tract adapts to colorectal cancer treatment, and repairs and replaces lost tissue, symptoms will resolve slowly. Patients are encouraged to add items in slowly, to add one new food or drink at a time to assess tolerance. Diet Before & After Treatment All of the nutritional recommendations for patients who have completed colorectal cancer treatment are the opposite of what is recommended for patients during treatment. During treatment: Diet is dictated to a great extent by the side effects a patient experiences. After treatment: Patients need to follow eating patterns that will maintain good health and prevent cancer and other chronic diseases, such as heart disease, hypertension, and diabetes. Patients who have completed their treatment regimen and whose side effects have subsided should: · Eat fruits, vegetables, and whole grains · Limit fats, and choose good fats versus bad fats · Eat lean meats and poultry; and eat low-fat dairy products. · Reduce or restrict alcohol intake. Diet and nutrition also play a part in complementary and alternative medicine. Besides monitoring diet, palliative care may also be useful to alleviate pain and discomfort comprise. Additional Information Resources: American Cancer Society: http://www.cancer.org/cancer/colonandrectumcancer/ Johns Hopkins Colon Cancer Center: http://www.hopkinscoloncancercenter.org/ Cancer Treatment Centers of America: http://www.cancercenter.com/colorectal-cancer/nutrition- therapy/