1. Lymphoma treated with chemotherapy
By Allie Kruger

2. Cheesy Jokes What do you call bugs with cancer? An ON- CALLogist
MalignANT and BEEnign
What do you call a doctor who is always on the telephone?
An ON- CALLogist
How can nurses stand to work in busy hospitals?
They have lots of patients

3. Denise Mitchell 21 years old Female Caucasian 5’6’’ Tall 120 lbs
Full time college student
Denise had the flu several weeks ago and says she has never fully recovered. She will occasionally get a fever, still has a cough, feels fatigued, and has severe night sweats.

4. Lymphoma Cancer of the Lymph Node
Lymph nodes can be found in the chest, abdomen, neck, and armpit
Starts as a growing mass in a lymph node, but can spread to other areas such as intestine, bone, brain, or spinal chord

5. 2 Types of Lymphoma
Hodgkin’s Lymphoma- spreads in an orderly manner from one group of lymph nodes to another. Also Hodgkin’s contains a special type of cell that NH does not
Non-Hodgkin’s- spreads through lymphatic system in no orderly manner

6. Stage Criteria Stage I Stage II Stage III Stage IV
The lymphoma is in a lymph node or nodes in only 1 region, such as the neck, groin, underarm, and so on.
The cancer is found only in 1 area of a single organ outside of the lymph system (IE).
Stage II
The lymphoma is in 2 or more groups of lymph nodes on the same side of (above or below) the diaphragm..
The lymphoma extends from a single group of lymph node(s) into a nearby organ (IIE). It may also affect other groups of lymph nodes on the same side of the diaphragm.
Stage III
The lymphoma is found in lymph node areas on both sides of (above and below) the diaphragm.
The cancer may also have spread into an area or organ next to the lymph nodes (IIIE), into the spleen (IIIS), or both (IIISE).
Stage IV
The lymphoma has spread outside of the lymph system into an organ that is not right next to an involved node.
The lymphoma has spread to the bone marrow, liver, brain or spinal cord, or the pleura (thin lining of the lungs).
This is supported by positive lymph nodes and a chest x-ray indicating a possible tumor.

7. Classic Signs of Lymphoma
Denise’s Symptoms
Enlarge Lymph Nodes
Abnormal Lymph Nodes
Shortness of breath or cough
Cough
Fever
Weight loss
Night sweats
Night Sweats
Fatigue
Swollen abdomen
_________
Feeling full after small amounts of food
Chest pain or pressure

8. Treatment
Chemotherapy – Blocks mitosis, or stops cells from dividing, limiting cancer cell production
Radiation – used when a large amount of cancer cells have accumulated in one area of the body. It damages genetic material (DNA) within cells
Patient is on prescribed CHOP, which is a combination of 4 chemotherapy drugs often used to treat lymphoma.

9. Burning during urination Severe diarrhea Platelets Thrombocytopenia
Affected Cell
Result
Symptoms
Red Blood Cells
Anemia
Fatigue
Shortness of breath
Chest pain
White Blood Cells
Neutropenia
Fever
Chills
Cough/sore throat
Skin or mouth rashes
Burning during urination
Severe diarrhea
Platelets
Thrombocytopenia
Easy bruising
Bleeding from skin >10 minutes or poor clotting ability
Blood in urine or stool
headaches
Any rapidly reproducing cells in the body
Hair follicles, mucous membranes, gastrointestinal cells, and bone marrow.
Hair loss
Nausea
Ulcers
Mouth sores
Radiation and chemotherapy also affect healthy tissue. In lymphoma, red blood cells, white blood cells, and platelets can also be killed along with the cancer cells.

10. Factors Affecting Nutritional Status of Cancer Patient
Constipation, diarrhea, inhibition of bowel mobility, taste abnormalities, chewing and swallowing problems, corticosteroids causing tissue breakdown, excessive loss of urinary protein, calcium, and potassium
Cancer- cachexia may occur, which is characterized by weight loss, anorexia, muscle wasting and weakness, and immunosuppression. Patients with cachexia will require increased energy and protein in their diets.
Until the tumor growth is under control, it will continue to increase the body’s protein, carbohydrate, and fat metabolism

11. Nutrition Therapy for Symptoms from chemotherapy
Compromised immune system-safe food practices, avoid communal foods, proper hygiene
Loss of calcium and potassium: take a multivitamin or a nutritional supplement.
Chewing and swallowing problems: softened or pureed foods.
Taste abnormalities: Try different seasonings or bland tasting foods.
Constipation: increased fiber and fluids
Diarrhea: increased fluids, reduced dietary fat, sugar, caffeine, and spicy foods which may irritate the problem
Cancer-cachexia: increase protein and caloric intake

12. Body Weight Evaluation
BMI
120lbs/2.2 = 54.5kg
66in x 2.54 = 168/100 = 1.68 m
54.5/(1.68)(1.68) = 19.7 kg/m2
%UBW
120lbs/130lbs x 100 = 92% UBW
Patient lost 8% body weight over 2 -3 months
>7.5% weight loss in 3 months is considered significant

13. Factors contributing to the weight loss
Severe night sweats causing water loss and dehydration
Fatigue causing lack of physical activity
Sore throat causing less caloric intake
Glucose, protein, and fat are metabolized at a faster rate to aid the tumor in growth

14. Possible Nutrition Problems
Increased Nutrient Needs (N1-5.1)
Inadequate Protein-energy intake (N1-5.3)
Inadequate Fluid intake (N1-3.1)
Increased energy expenditure (N1-1.2)

15. Resources
American Cancer Society. ( ). Non-Hodgkin Lymphoma. Center for Disease Control and Prevention. ( ). Hematologic (Blood) Cancers. Leukemia and Lymphoma Society. ( ). Disease Information and Support. Mahan, K. L., & Scott-Stump, S. (2008). Krause’s Food and Nutrition Therapy. St. Louis, Missouri: Sanders Elsevier Schmidt, Char. Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery. [PowerPoint]. Retrieved from D2L website.