1. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 21 Diet and Cancer

2. 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

3. 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)

4. 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

5. 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)

6. 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)

7. 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

8. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Classifications of Cancer Majority fall under these headings: –Carcinomas –Sarcomas –Lymphomas –Leukemias

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Skin Cancer Becoming more prevalent Three types: 1.Basal cell Most common 2.Squamous cell 3.Melanoma Most serious Deadliest

10. 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)

11. 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)

12. 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)

13. 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

14. 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

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Treatment of Cancer Surgical removal, radiation, chemotherapy, or combination of methods Side effects can affect nutrition (continues)

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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

17. 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)

18. 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)

19. 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)

20. 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)

21. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutritional Care Several small meals may be better tolerated than three large meals Control nausea and pain Nutritional supplements may be needed

22. 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)

23. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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

24. 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)

25. 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