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

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

Chapter 21

Diet and Cancer


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


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

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Cancer

• High mortality rate– But does not always cause death

• Oncology– Study of cancer

• Oncologist– Physician who specializes in cancer


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

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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

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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


Classifications of Cancer

• Majority fall under these headings:– Carcinomas

– Sarcomas

– Lymphomas

– Leukemias


Skin Cancer

• Becoming more prevalent

• Three types:1. Basal cell

• Most common

2. Squamous cell

3. Melanoma• Most serious

• Deadliest


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

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• 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

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• 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

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• 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


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


Treatment of Cancer

• Surgical removal, radiation, chemotherapy, or combination of methods

• Side effects can affect nutrition

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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


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

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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

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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

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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

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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


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?

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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


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)


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. Chapter 21 Diet and Cancer.

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