Cancer characterized by an uncontrolled growth of abnormal cells that can lead to formation of mass or tissue called tumor Causes

s Carcinogens any substance that is directly involved in the promotion of cancer that would bind to your body Family history Radiation Chemicals (nuclear) Virus/ bacteria (HPV) Associated with metabolic disorders Excess carbs, pufa, saturated fats -r/t to hyperinsulinemia: breast, prostate, uterine, pancreatic, renal cancers - possible when there is dec in iron intake with inflammation Non dietary risk factors Low level activities : idle/emotional Dec ADL (activity of daily living) : no more eating; resolve to do something else: drugs, and alcohol intake UV exposure Chronic inflammation with high C-RP (c-reactive protein) Carcinogenesis 1. Initiation 2. Promotion -> Transformation 3. Progression

Stage when CA cells cross blood barrier that can lead to metastasis

BENIGN vs MALIGNANT Benign tumor cells grow locally, and not spread by invasion or metastasis Malignant invade nearby tissues, enter bloodstream and metastasize in other organs Different Kinds of Cancers carcinoma lung, breast, colon, bladder, prostate, choriocarcinoma Lyomas CNS, blood Lymphoma- nodes, Hudgkins lymphoma Sarcoma bones, muscle, fats Men prostate, colorectal, lungs, skin Women breast, colorectal, lungs, skin Different Types of Cancer Screening for Early Detection Ultrasound Mammography -> 40 and above annually Pap smear -> lithotomy, vaginal inspection, sterile vag swab: NORMAL = regular, same shape Choose diet: Plenty of plant based foods: veg and fruits antioxidants Drink alcohol in moderation Select foods low in fat and salt Inc vit D intake : 1000 IU Linear acceleration specific radiation therapy Gamma knife radiation therapy, closed Chemotherapy oral (maintenance and prevention of malignancy) and IV (IV can cause n/v, diarrhea, anorexia) HOW DO CANCER AND CANCER TREATMENT AFFECT THE NUTRITIONAL STATUS OF THE HOST? Anorexia from chemotherapy, pain, surgery, radiation or depression Dysphagia, nausea, vomiting, diarrhea Decreased nutrient intake CANCER CACHEXIA severe muscle wasting Tumor competition for nutrients

Cancer Treatments Nutritional goals Short term: prevention of weight loss Long term: achieve and maintain normal wt, replace losses: fluid and electrolyte from vomiting, diarrhea, and malabsorption Provide adequate amt of kcal, vitamins, minerals, fat Nutrient Needs Progression proliferation Increasing CHON and calories(individualized)

Initiation eating junk foods, aspartame, coke, nicotine, salitre, grilled with charring; virus, etc Abundant in body -> binds in DNA Promotion growth of CA cells

High CHON diet of 1.5-2.0g/kg High calorie needs -by using gravies; Changing cooking methods to include more butter or good oils. 25-35cal/kg- weight maintenance 40-50 cal/kg- replenish body stores E.g. Add skim milk powder to milk to make double strength milk; chill before serving.

d.

Specialty products- vary in terms of specific amino acid, CHO and fat content/ for patients w/ hepatic or renal failure

How to minimize side effects fatigue = prepare easy meals: scrambled eggs, toast, and canned fruits eat good breakfast drink commercial liquid supplements, milk shakes and pasteurized eggnogs lack of appetite = emphasize SFF, high kcal drinks like sherbet and blended juice (shake with milk, sherbet no milk) keep sugar based candy on the bedside: hard candies brush teeth regularly and oral care n/v = use anti emetic meds 30 mins before meals salty foods tolerated sip liquids slowly avoid reclining directly after meals avoid foods with strong odor for stomatitis and esophagitis? = eat soft foods, add gravy and butter, sauces for dry foods for diarrhea: avoid lactose containing bev, use lactose free products avoid roughage emphasize soluble fiber foods: cooked oatmeal, peeled apple, cooked carrots, bananas avoid extremes of hot and cold liquids for constipation: walking if possible, fluid intake for altered taste/ dysguesia: juices, cold food like ice cream, popsicles, pudding keep canned fruits in ref experiment with spices and marinades for meat add bacon bits to add flavor different methods of feeding oral nutrition for able to chew and swallow chewed feeding orogastric tube, PEG tube, enteral per IV: commercial prepared, sodium, chloride, potassium, calcium, vit c TPA: used when digestive tract not fxning, absorbed intravascularly Tube Feedings a. b. c. Complete products- meal replacements that require digestion and absorption Chemically defined products- minimal or no digestion/ for pancreatic cancer patients Modular products- used in combination with other tube feeding products to enhance calorie or CHON intake

Neutropenic Diet A diet for people with weakened immune system.( >1000mm3 neutrophil) Helps protect them from bacteria and other harmful organisms found in some food and drinks. Guidelines: Avoiding undercooked meats, fish and eggs. Ensuring that raw fruits and vegetables are washed well and/or peeled. Eat or drink only pasteurized milk and dairy products Follows appropriate sanitation guidelines for food preparation and storage.

Prevent recurrence of cancer Promote positive nutrition behavior high fiber diet, mufa, encourage moderate kcal intake to manage weight, avoid excess salt, encourage high quality diet mypyramid food guide system Promote positive lifestyle encourage regular physical activity, avoid excess alcohol, avoid tobacco use