Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery

Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery

Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery

Chapter 40Chapter 40

© 2004, 2002 Elsevier Inc. All rights reserved.

CancerCancer

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.

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.


CarcinogenesisCarcinogenesis

Initiation-exposure to carcinogen-initiators 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

Initiation-exposure to carcinogen-initiators 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


Cancer—CauseCancer—Cause

Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.


Cancer—PathophysiologyCancer—Pathophysiology



Cancer—Medical and Nutritional ManagementCancer—Medical and Nutritional Management



Tumor Node Metastases (TNM) Staging SystemTumor Node Metastases (TNM) Staging System

T- size of original (primary) tumor

N- node involvement (spread to nearby lymph nodes)

M- presence of distant metastases

T- size of original (primary) tumor

N- node involvement (spread to nearby lymph nodes)

M- presence of distant metastases


Treatment 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

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


Prevention FactorsPrevention Factors

Energy balance and exercise

Fat

Protein

Fiber

Fruits and vegetables

Chemoprevention

Energy balance and exercise

Fat

Protein

Fiber

Fruits and vegetables

Chemoprevention


Prevention Factors—cont’dPrevention Factors—cont’d

Alcohol

Coffee and tea

Artificial sweeteners

Nitrates, nitrites, and nitrosamines

Method of food preparation

Alcohol

Coffee and tea

Artificial sweeteners

Nitrates, nitrites, and nitrosamines

Method of food preparation


Fruits and VegetablesFruits and Vegetables

Appear to have a protective effect against cancer

Thought to be due to the phytoestrogen and phytochemical content of the plant-based diet

Appear to have a protective effect against cancer

Thought to be due to the phytoestrogen and phytochemical content of the plant-based diet


FatFat

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

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


American Cancer Society’s Dietary Recommendations for Cancer PreventionAmerican 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.

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.


Pharmacological Agents for Anorexia-Cachexia Syndrome and Weight Loss ManagementPharmacological Agents for Anorexia-Cachexia Syndrome and Weight Loss Management

Appetite stimulants

Metabolic agents and cytokine blockers

Prokinetic drugs

Anabolic agents

Appetite stimulants

Metabolic agents and cytokine blockers

Prokinetic drugs

Anabolic agents


Factors That Affect AppetiteFactors That Affect Appetite

Reference: American Institute for Cancer Research: Food, nutrition, and the prevention of cancer: a global perspective, Washington, DC, 1997, AICR.


Nutritional Implications of Cancer TherapyNutritional 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

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


Nutritional Implications of Cancer Therapy—cont’dNutritional 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)

Bone marrow transplant

—Nausea, vomiting, diarrhea, mucositis, xerostomia, dysgeusia

Severe oral muscositis

Graft versus host disease (GVHD)

Veno-occlusive disease (VOD)


Marrow Transplantation—CauseMarrow Transplantation—Cause



Marrow Transplantation—PathophysiologyMarrow Transplantation—Pathophysiology



Marrow Transplantation—Medical and Nutritional ManagementMarrow Transplantation—Medical and Nutritional Management



Severe Oral Mucositis Following Marrow TransplantationSevere Oral Mucositis Following Marrow Transplantation


Guidelines for Oral Feeding During Antitumor TherapyGuidelines for Oral Feeding During Antitumor Therapy


Guidelines for Oral Feeding During Antitumor Therapy —cont’dGuidelines for Oral Feeding During Antitumor Therapy —cont’d


Commonly Used Complementary and Alternative TherapiesCommonly Used Complementary and Alternative Therapies

Macrobiotic diet

Vegetarian diet

Gerson therapy

Kelley/Gonzales regimen

Juice therapies

Macrobiotic diet

Vegetarian diet

Gerson therapy

Kelley/Gonzales regimen

Juice therapies

Shark cartilage

DHEA

Enzymes

Oxymedicine

Coenzyme Q10

Shark cartilage

DHEA

Enzymes

Oxymedicine

Coenzyme Q10


Commonly Used Complementary and Alternative Therapies—cont’dCommonly Used Complementary and Alternative Therapies—cont’d

Black cohosh

Echinacea

Flaxseed

Ginger

Iscador

Black cohosh

Echinacea

Flaxseed

Ginger

Iscador

Milk thistle

PC-SPECS

Saw palmetto

Soy and soy foods

Teas

Milk thistle

PC-SPECS

Saw palmetto

Soy and soy foods

Teas


Nutrition in the Etiology of CancerNutrition 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.

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.

Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery

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