Dated ase emptying ty persist for ont ‘ce natn warplane Yrs ee acts ofl ‘medical problems, facudng immunosappreson organ Sjtaeto, and Inetons. Ate GVHD pat eon tHatoccurnthe ft 10 dossier HSCT ison whee "onic GVHD ir grat recon that ora ater dy 10 that induce uate dagen esi Ieee Gace ‘Skin manestatos may ile sto severe erythema ‘our ppl rath Liver aniston ay nee dct Ahage wth cholestatic ivertet sherman, The tet. fn Be affected anyhere fom the mou othe ana Gk Inclodesthewbeafone or more mmanesuppesvandat toplist pets monalonal antody ibod mn Nutrition Therapy lems lated 10 metalic Gangs sche ancer cache, {nd w ede interventions teat he dense aie ance deh" Oral nrton iterations ae elect st Increasing mateo nae and ipoving ve anes of tly of fen patents wih cance wh se mantra {ky Nation therapy has Ben ls ete in improving tiontheap incane teste mut ale be weg pte is posse stimulation tumor powth and metas” Nutritional implications Cini titans need to be svar of thine cance diagnoses {nd eaten that ae only eure ti Te Aca: Malnatiton Is more prevent the wh hare bee sik for longer erode fe, ad ie etme ied and net and ovarian cance Coe sea pa lems ar aus vomiting ely satya ahs ltgu. Nation problems tnd with head a neck can cectao due phapis nd odynophapa Aol hes se tects have the potential to pace nda nto on In adn patos may eck ot Complemeary ad Atherativemedline (CAN) therapies Chap 1) wot ‘thot inering tire ce prover Some tapes tay be ttn adequate wih omental Nutrition Assessment “The Paes Generited. Subjective Global Assessment (QHUSY have wn ad to sceen ener potent for nt ‘inal rk The Scored PG-SGA hasbeen show be ‘ecurt at distinguishing wel-nouchted patents om mal Nateion seamen methods ate cand a Chapter 3nd lene for asing cache ae fared in Cpe 22, Batt shouldbe calcd isthe Saved PGS Ide the following weight and weight charges infomation inthe constipation, sbi ui ery ety, mows tals bit wo chews and condition o the teh gums nd ‘Simpertnt to determine wht Kind scene le. Nutrition Diagnosis eds nae Ol nts neque ald intake Ganction realowingo ting chev ‘Sty niente npn eer fer patent wath pated srry ek hoy a {spent or pected food-melation intercon pec Nutrition Intervention Interventions for Common Side Elects ‘of Cancer and Treatment Nowa and Voting The rt comon case of mes ad ‘omiting in cance tnt chemother thd ‘sehr ln tes an emting (IN) Noses {nl woratng hive mulfctoaleloges ee Cape 18) The most emetogent chtherspenr nents nae ee st, meats oso neyo fs ‘hble237) Newer ad voning ec wih chem {oy eas be aida scat dele eran ee Attu al von ocr with 9 eure itn sf chemotherapy Deed rae an vor use beg 2 hour ar the het bas ben aes ad mays upto a week: Delayed mene ving are ast en hates enn atin aoe {nd vomting mort eommanly ear ble the natn of ‘erates. But a abo scr ig ear ilatn Thistypeof psa and vom fn fem ne even andr pry contd es and ontingsgt rcheapy 03 Incade groing older tbseco ue expomae to ang Imones fray sory of ance leak ons, poor ato dese (6VN0)—» ‘omophage por satoney Cancer GeneticsFigure 23.1 2014 Estimated US. Cancer Cases and Deaths ora iraopase —/— =" ae Noten — —an i “There are wo mor ype of ges that e thought to Infience the development fence oncogenes and amor sep gne hs hop thoes ‘pressor gnts ermal ancl eth (spoptoi) b t "rts orm they ma le ths ition, net pane, “also the capcty to prolate at they diferente nd ‘ete enconal apt Norma claves mumber af ‘entra mecanisne to reer guint genet seats the fat (2) phe of the call vision el, wich ep Inte by merous mechs a pnts tel prepares te replte he genetic materi end check for muons Sh adequate resurface figure 212 nating the tee ‘eye chelate inated nse In the § phase the DNA i ropes, A the en oS pase secon chek pevlrmed toconkem hat the chommsomes wee dpsed ‘erect theyre the cl roca tp Co In phase {Gy the cell prepare or vio by syrthering mite spindle nate rte need to produ two cel aera | ate = ey Ly \ | nei ‘ny polo damage sere cll progression sop and (ca dnt to prevent plain of damaged cll Cancer through oncogene andlor mutated tuner peso goes ‘lei uncool roth besa of sora ells ‘heckpoint,inadegate DNA rea in fare oper “Changs inthe cll cycle atocited with cancer may also rel trom aberrant pene exrsion,Epigenetie ! the ty of changes in gene acy tat ae ot cnaed by changes i the DNA sequence Caromatin she com Pee of DNA and. proteins primal histones—in the cou of cll (et Figure 283) On function of hr ‘Changes ingen expression can rer om aeration in ts dinaleotdes apd modifston ose by ce nor methylation Hyperetyaion of rmeter ronsTle 23.1 Canc Preantion Guidlines Rens indie Cs and mani sey wiht ought He * ft gon tale aC to we enc Seisetaptonp aris yy active Line str tr hat og don. sg ashe det wth an epson plat od yo ink salty, “Entrar ncn pe vonn ory AC Aecommandatons or Communty cn ube prhat an commanty renin sould work ‘Sh rn ies ery cll art Heras nutrients aed in ethan ‘ch a fle cd cn alter gene expo tthe transsp onal lee epigenetice has great portance wih te fai of watson Other altered gene expression promoter inde ho tones shat androge Tike to rote ete ad ‘srogen linked fo best td endometrial cancer. Chem "any: Compound meetin chemoprevetn ies hae Table 23. Signs and Sto of aner etre Wao ons tue fg may bm pra sya of rc ay ape ty rerte nex amples sada cnc Area Stn changer Figure 23.2 Regulation ofthe Mitotic Cell CycleFigure 33 DNA and Otromatin Structure Cancer and Nutrition methods such ‘eecontal tie and timing and sbi promote the m renting hot vel a se ‘conor amnion ee Cpe 2 Medical Diagnosis ‘Semic ans eos sr une and other ‘Shae tumor BomarTable 23. Tumor Mika ferSlcted Cana ‘ava ec yet Ar mun ee rss is lal Pcp ps Yeas mastonwayas Colca ama aig aer arte wah estan en sae = eet ae ge ey Seat ao ene oe save Blt ce! weer ate et wane ‘or rescton and asst ofthe anatomical sen ofthe Figure 234 Needle Biopsy Proce Geese. Tuer imaging ncn ac vale fo it ng techniques inde agate resonance nang MR, ination thats chal ust neering he ase fe ‘hacer: the etn oes inthe body tnd the umes poten a eer Calling ts iomaton compass the “hich pro technique sed depends on nmber of cor ing te pens peeing 2 seatnen when dion tad, bloc carat ble in the communi and Insurance approval of diagnostic foo ep ae ae lcci he ered or ‘eociel Sance a ancora ae he ded mt suc: 0 3018 Grons nin,Table 23.4 names of elec Cances +a ng rn i cur uc ers nen) “heen a ecco neste aac pas! See TR Z34 ‘Sremuml canr peed ares The tayo then ad ad aigned “age” on tebe fel tp te of ng, wheter sens ‘lignan darn of eifeentitog, aan Se an fan {onthe NM Comite ofthe mention Union Ags Cancer nt he Ameren Jolt Commit on Cancer hae freed on the Temor Node Metastases CENM) Staging Sater peste inBox 7 (1 = depth of tumor mason ‘xtra renal enh node M = alee or pres ‘Eten metantaes) Staging of tos le to ais tester planning ovdes prognostic nfemation, ast intrentment auto, and belp to day nda ag tay be ig fr clic wae ‘Treatment A patient may undergo one oF more ote ftlwrng te nets depending onthe cancer gros surge edition thepy chemaberpy induding hormonal therpy and oeelatageted erp abnor Craig tmuncteray and one therapy very cancer eaten imtoxicy bec they have a mal rape ides the fege of separation between tne ant therpete on, ‘sinfued ino te body crsliton ll clothe bay toe expned fo the tne eet ofthe dra and neta ‘Tumor Node Metastases (TNM) Staging System Sea eo doen nay re ter agra per Spear haaicay (Grn tu The ror ety sates earth urbe, Sem reny on Mane ‘cain ety gh re + tx rn te ty yh nese + Noe ty moh oe co nt entero ten yey os ‘tape cape woh a oe ‘torent ay es Pabody systems wl be aed. Chemotherapy aft ply aking cai ence, the rp dividing ane! ‘cl le signfcayafected by mort ehemotherspetic ‘unt This rome rensn mos patents undergoing chem robles daring ter cours of teat Because ae ters contain opi viding cll slope hi as) Isao a common side eect of chemotherapy heeft rg atnent nd ration therapy depend on hep tear dagnoss Thetype arsine peri dopens on umber of ‘str acaing ton the tray sof he amon ‘he eath the ina In eral lage ty ans ae rot cule with dregs. Drape ayo Be let penetrate into asa amor nace atic ol he cl Aly tote uly toe map not beeping the ine eet and ths suet esis he aor a. Theloner atmos hsbc pent the renter toed thatthe etactaed eign ieee dg ‘herpy Understanding the eatin peer ane The ent aod fpr of tetent pln wl dterne the pel eee efecto the patie tions at surgery Serger nda cancr prevention: goss aging re met (rbot caland and metastatic das) plist nt ‘ebb Sergey may be performed an nial has Shinceased ik oer eg a arial bet ence, The ethos obtain seo Serine wht th sor ‘benign cr malgant depends onthe ype fants bon Collected malignant ne ples can apolar ‘Sonen he tumors ptr of growth dogs fe sb Srgrytconsdered theron ode of et {the cancer har ey tetas removing the aoe (aebutking may mp quay fe an permit aint therapy ome more ceive For expe emoving ue ‘king the exphag wed alow the patent tat ne ‘ally Palate surgery ase otis dee andlor treatment elated ype witht tempting to cae the ‘ord comprssion ea expla pli therapy Advances in gry fave slowed ran reds ‘ter eonery. Peer hgh nde aye fo teri ‘cer cals pad) ae ing somone than te pt {nd pone nly theft ring Ip ode» prea ing taor woud encounter removed Chemotherapy 2 ‘aaton olen emploted blr gil econ In rer ‘Sai hin mig nae Reni Cancer Diagnoses Requiring Surgery Thi scion ees the mae cmon doses teste with geal Poudre that ipect on mtn nae gestion, sn Sgucat aang tem nti side fects occur ‘ost ten with cancer surgere nveving the head ec, tnd omsch (partial nd ttl prety Stil proce: tires may potently aera duals sya appen. {nce (mastectomy) ake oat anton (ony) orth (rea neck daecton), which an contate to depeson ‘nd vst in edued fod inte and weight los. Suga treatment that invtes sina ofthe Homach or all Intestino enoval ete eopagu or ong il hve he Cancers of the Head and Neck Sagry tht inves the eal and neck sre may el ny felt chew sel and day vith speaking nado, patent ih Ind and nck cancers pil hve Nr of tance andlor substance bas and sigan weight ost fon is etiated ht 6 of tet th ea ad nck ances il preset eth maluton she ine a dino $0 Sua procedres rhe ad neck cancerscan sg ante both appearance and ncn. depending the ‘rp and econo prods ened son We the pry surgery the pet may eo under aph ‘emo of all mph nodes on So side ofthe mek with Preservation of the spl scoemary eve, itera alt ‘ein andlorsernocldomac msc Sete nec {clones oct mond oon or more ph ode National Comprehensive Cancer Network (NCCN) guide nes vecmimend mentoring of ton ae for weight los restr tan 108 a el by weigh anor icy swallowing peta treatment” Esophageal Cancer Exopagelcancer itll uncon ‘nonin the United Sates However the progenies ‘ot patent preset Rik fae for expe ance td Bares ctphag econo eine by get ‘strosophogel eh dae ee Chapter 1) = treatment or esophageal ance Many pans with eso fealcacedeveey ccs some yttinthe prngrecion tthe dacse" Trane hat and ane torce ephapse tony file controvesi aete mnt oon reer sch rue for recom the sop I the de ‘be esophagus canbe reconsited frm pat he sal lrg insti Suri procedures for esophageal ea tents requ placement oa oding tbe ding Sastre Cancer Ath not a coramon in the Und ‘Ste gst cance rman te fit non common cao try fee Chapter 1) the only petal curve therapy forte etn of gat caeneIntestinal Cancers Cancers ofthe small nstine ae rea anv sipficant eects on the sbieyt digs and absorb ‘on the amount of smal bowel hat is resected the ability of {he emating pton to nop and wheter the Heel ‘ve could be spre dig dhe srgery See Chape 15 or “onal inormaion. ‘Cobra cans talib thin mot ominan cane: concer othe enon and sect te etd pal ith Sarr and come, Sarees perfor for elrec See Chope sor dato norton Pancreatic Cancer Pence ance the fourth lending ‘hcl cence elated eth or bath en a ee, ‘ope rh of al cance ranted eats: Benue pa ‘Creu cancer cn selon ago when ttl oe ited and mal eset ad eect seme thepes tc loking te Ices ees evita he sane the mot tee" Purest eancer Geen dlagaosed Ute tothe vague and non spel ymptoms tha aco tan the esse ever wow an anaes recon {Rim aburcton ofthe panera dct oman esas in labora nd steatonres, Mls tents with pane tance ao have byperseemi. epecioy alo kun athe Whipple proce. Hixon aly the suey involved temoval the pancteatc head ‘luca allan sd le dct with o without the {ue anu Amor wet modem ths prose Frese th paca otc ant ‘atc surgery, patent shouldbe towed anormal ee iat rection Intake sl be erased a oletted Ter t-t dine. Tike feng shoud be administered only Crepes nications and pastel nation sould not [temple rutin The to mos common port Bel Pots ow ths pocodare the acon jean supplements se reommended based on theca 9g {eh ofeuorchen and eight lane” See Chapters. 15 {dT for aoa! ifration on naeton diagnos nd Chemotherapy Chemotherapy Isa stem teste ad ier from a {ro alton nt sec he whole body Over 100 ‘Xcmotherapy dap are sel olay carlo o eo trate the cave, Re soe and pean alle Stee the symptoms Tey can alo be gen a a avant eine ean ete by radiation orsrpery™ Chemotherapy gts cane rope it four bod ct ove thse hat ast DNA fargrepeatos 2) sal ‘Mineo ological (ah a node or crn) Cloned ancl deeloped to nerat wah» me at (8) ormonal therapies for aberrant cellar behav, ch a Src eget char etolines or anebodes hat ete ‘Jot of tumor elie dae how inane eons oi Ideal, chemotherapy twatmet shoul il he cancer {nos cancer drugs have 4 elatiey narrow therapetic nde, {O'lower doves are mecca flv. Chemotherapy ‘gens cm be spect lao cet DNA mods ‘erase inhibitors), indirect DNA ages (antimetabolites and Stumm target ger etn rected mom of he normal cl the body ena reting ap they are ore poate ror he eal efecto most dyer ar scope tthe fect thse hal agents tole the tat Ande legen sch a the cel af be ‘one mato (ed lod cl, wht Dood cl, and plate Tey, the epi Uing of the geiestinl oc nd the ha lies The mow comnon se est, herelr tte dct tony to the cll apd lode netopen thrombocytopenia dah, macs (seus Ite nt hap) and alopecia” Some corterapete ‘eet ae ale font sate crt, euro ea neprotnety Table 225 atthe common de eet Radiation od sar tse seman tyres rca aed cance the hea and nes, ad ances of Oe ‘viens tumarcamarberoned spa oc wheal feral asta present orton be eb propia {o preven lela nts ofthe ano palo Te dled with ectromagnte ye (a de) and charged pitiless) aod de ca al by tring clr and wader materi hy DNA he mt afl oe aration a She fonting nation ras he strands ofthe DNA ‘sing to et) eae Raton danmge sugested ‘yp and cal na hpontette les 1ceah Withchamotherpy tae celta contin rl Aisa ets thse nde ephelal cals Doe felts mph ts snd ai els at ane hed fou ec tony of RT i lad to thee Imodited. Toy may be exacerbated whenceTable 235 Choterpy Agen ade ets ‘in btn tesa ‘Scare, heute oan, ‘nepaanouta ‘Ppsomase tite cn ‘The goal of texment planning isto unr eadite Ing ocmal tes Neca cela wall the oa cls ae scape to the fai af thee, ‘asormmade lead backs te developed bor ch pn etc alain that yb inthe RT idan at ns be dag doring RET maybe amined eater inurl ete ane oi combination eral bor {tether administra y incr nclert os ay Sassi an uta sing) uly Say pore fa eid of tine appomatty 6 mc) depending othe "anor beng rete Brachytherapy ime the eens lacie sores ether with a cing et (tthe vagina n close roi tthe tao econ Inusatty bachrbeapy sedan cancer otter ‘ate and cers pany aderans nd aan nes Intros brachytherapy my be ed to wet ep ‘acarinoma river metstsesRadaton ane ci ‘othe tat tse via rinucdes Fareunge ean atu take wp by the dhyrald Rademunrherapy et the dene ation to petite toh tector, ‘22 monoclonal antibody (MAB) ooh Pasney. ‘ai therapy igh dered by ser) res cance coe aes sce ym OU oe es esi te Atay eda ren ut tat ia ar hen 26 ‘gsc son See iy arse Radlaon therapy is conmonly administered slong with I maybe piven rr faving (ose per)oe Sarg when is wed t combi wih sumer, apecal maybe administered price wo ncoahranh, daring aoe oma fllowing RE (nntenanee) = RT may Sse sed conto incr sing fo meat ds inorder top alte pain, Whle- ban BT fn means lease is ot ed with th intention of eatng eds butter to conta symptr suchas hah nde problems Paliaive herpy fen dlncred at igh ose for shorter periods fine A senda cet yn aaa faceted raclonation which te oer tino ‘dinistation ie reduces however te mune o factor, sorta dose othe radon tnt ceed aoe ination isan estate nd secede a hosp forbend and neck concer Toes nm Beeatee oe, ‘alan thon rcringcomamitantchemotiony Common averse eects Rots head a ec ara include tig, muon dpgeune, nevatomis seed a tosalvary hand destruct dyophagia, otproohogy tnd severe esophagitis. Sp al mnt by soenar ‘ately day 10 of HT and coon untlsbont 23 ete see RT hasended, Macon zerostoml and oyophagis ue to esophags maybe tert nd ditt cee eet 22 etwarrants emporary iacomtnuntion of KI The inal [Bac high if aeyation det adeqate eid nae snd may awed tenuis for ydetion and lect ine eovecton, Esophageal ss may become exten) {Tadd able tothe cee tat rl nae Is mpos Sle sup placed fing tbe may be dete to Feeding tues may be contndeated de to the Fogle tutu he esophopssndlorebtuction ofthe sophags TT whe sbomial nd plc a can rena rad thonenterin aevere often debating dese at an ake ple year A toast” Symposia severe ‘ares and malabsorption, Media therapies ae primary Sportive, Bowel inure tha esi nfl, scr uP Shtoic libenepton are poentaly fe deaening Cmplestions aba sgt impacton ay oe Biological and Targeted Therapy og therapies Table 23.6) my be wed eat the anc ive he see fects father cance eaten Seen bleed thot the nmane sytem natura capac Toft dtc nd ety sboroalel prevent the dere teed detection by sing ae OF mote stg. Some Doge therapies fr cancer ae vases or bteria to fells These types of Wola therapy, which re sometimes ‘ele fo calestvely st lnmanoterapy” or weal ‘ponse modes da nat rt cancer eli die ‘ihe ileal herp, sah as antibodies eget fence aaa (OA DNA), get anc cls ety. Frog thersps tat intertvewth spece molecules Inobed in tamer owt sd progression ar ab ferred teased raps” Immunotherapy Monoconal anodes (MADS) are labor precedes cht ind Yo specie at feo expened by ater calls MAbs silat a nae Ropons thet deste cancer cl in seserl way ncllng ‘ing the fenton oft es, garg apopton, [ahbinglgaltht revert nsmane cele atch he tyson toes edi canc nding with the devpment of tmor ood wads by wreting pees that are near or tno growth bing teal uice (gow fcr rcpt and peventingthe rgd cers Cytokines Cytokine ae signlngpretentht are proce ‘ote Blot xls an np mde and ete mene Feepnssfarnton, and hematite bod cl Teruton. Two per fine ae aro ret patie teh canteens (NF) aed ek 1). hd ‘ype enatopatic owt facts. ae sed to counteract ‘me ofthe ie ef of erin chernotarpy ronan INF mayabotahisthe pth afeaner allo prom i death as ben spe or he stent of mele ‘soma apn soma ad sever hematlog eaees Ticmatooit: grwth for ae 3 spec das of aly oesurng etki Al Dod cells ase from ematopolet stem clin the bane marom Baca che: Irotesyy age lrg prlraing cl, nclng no tml blood stom cell chemathengy depts thee stern els andthe ood as a the produce: this rol nei, detested ating abit nd lower white ‘icons tt make chemotherpy patients vaneble nections Seve! Rematopoleic powth for ave Bek opened or lal ne Eeropoitin simules Bind el formation and IL-l erases pact produc tin, Gramlneytemacrophage clon sulting lacer [G-CSF and panne colony-nulating eto CSF) Seth merase the mambo of wht od celled he Fao necons G-CSF and GMCS can ao enhance he Immune syste pci ncn response by nce the mmber af xoce-fightingT cell GMCCS apd CSE ‘ee wed i combination wah eter boll terse ta ‘Meta loge tery cc Bone pi tus, ee hoe th te ofnecton and ike symp ‘Gause voring chile ve ndanores) Hematopoietic stm Cl Waniplntaton Hews see epson SCT ete opm ‘ree ahemnaage ants ns teog ‘Rel oe prem th ney peel et scrns parce ee hen sprites edn eet eno and pon cane oan ao ke Soalne punch ran core on go or yates torn fe rer cia Ione cl ned wre cone Sa Sem HSCT mabe buted fom oe ase) er leo sad) et oy crs rte ne tl eS enema red sap fcr edo spn ite set tn alr rls ses SCE anu andepong nso RSC ht cence tabla ed wy ad no seeeceti ated tl he tm ceeds np sn a il bya pc dope Pineal ce te eed Arar pore ig Rc dees hts ery se Sa iraaton aoc smd he ei teeorconcing pienso ened oe dusts copie consnng ee ‘Sheree npn poe ue rine Fronts btn on a sl eget of Sc td ome mt oe Nae GcTacthated wih th ena 8 ic ny ao exp nici et ton tno gett hot ne HD inca cpl eed ne ac Cvt sya inte nade rei Monet HSC Newer de hese! soa) Table 23.6 Biogas harp Agents Tet oe hear ta some Sagi ope cet SE Sand vrncion yen ations rat ree Gene aan nea a acer nx? row aa apr non stone deaayeses OOACS er Zl, ec apogee aa ant rom ato EG hie “age ttm toes Dorey sn + Moron sin DAE rd at okies soon 16 i ‘Theepybitaen pang he 12 BS Ans ony se cela be contami wth tamer cell which oud ed oom setts {etter art an grt om aes esp oun een de, tn Na anes MX etn ae non dy oe pg oe eget es ‘irae wher kr eet withthe high dose of ehemethengy land 180) oausen oting, mucositis dates, aneeopent eligi pel) levees and ineeonrtypily dewey ed. ily aftr the condoning regimens dese Severo “heer dopends on the tena ape of grt wed Late complications are mo commonly abered after am alogene HSC, and cur as conan ote otng ten damage orl se, ae om the so ‘GVHD Long term sompiestoninclad owt eration, Intron fle, rae ont mero eter ‘fects nerocoate defend econdary mignonone mato transplant CD ich cu i a Wah pn of se sical problems, including. Immunosuppresson, ongan ‘stunctin, ad nfetione. Ate GVHD tal reject {fatorernthe st 10 dyer HSCT ffson. whereas {hon GVHD i rf jection tocar ater day 100. {GVIED is thought te be mented Wy donor yphocytes Shot indace ote drag nthe sh ver alor Gat Skin manflesatne may inde sido Severe een toon paar rah Liver anfettons may nde uct ‘mage wth cette eres sboormaiies. The Lact ane afected anys om the moth ote aus. ‘unestatone sane rm dy oath and ofl weratons ta i mon! ge ns Se ‘opie sens mamta ant, bois ie Nutrition Therapy Jems related to metabolic chang, such as cancer cachexia, tin and eight lo have lng been known to conte to Nutrition Assessment the PaiensGenrsted Subjective Glo Asiesnet {@G-5GA) andthe Manus Unive Sreing Too tecurtatdtingishingwe-noursbed patent res a toured alent and high entity and spect ‘Nurion sessment methods are coveted in Chap 3a Eatin for auessng caches ae fvared a Chae 22, Bin thu shuld colsed the Soved SGA cade the flowing web and wet hanes norman: i Atcha Constipation bora sin ear ste, mou ‘ove monte changes, or dpogni tay ality to chews and coin of teeth uns aad ingus Avevow ofan inva mostecet tary inake tan to determine what Kindo ode can ete ied and wha any peal ise abe on ading Inet or tina epee Nutrition Diagnosis Nutiion diagnoses sociated with malpancy wil ay stlerly dependent onthe prarytmor sie exe ot buen and treatments modal Pose ngs Include lua weigh os nan eer) and prec Take aheredGlfanction swallowing and/or biting chewTable 237 Rte Emetogei Potent aninepasi ag. HenIOR) cone ant jepheema 1500 m7 aon Pas arn Dana) Petree encores or ced Tsuna een ing the fi chemetay seton and more cron sen pel pets Deed ti mening an edoymptoms feat tay Hao mporaat onthe ld being Almost 100% patents sender ‘Mapua KT casa etn ann and voting staring Santa anaes a orn yl in itn inga patents nuttinaiile Patents ten presrbed TEthold e aen teat 30-43 mites bef els ‘vad evn patie oo fel nant a the tine since ths manages both eed and atpatory CIN SeeTabe Tait in Chater Iv fe a Ist of meditons drproned to at nase and voting, Marana i ‘Naac fro cooing dor canbe tian by ing, ings walk when mel ae bing cooked nd avidin fy ingot oo which emits moe odors than most ther ems cooking, Patents shoul an ends and ly members to odd prunes when hey ae wating See TB Tain {Chapter 1 for addon! ps A carmon ese of aa seeing he lc ml rn "hater thre pnts eae wth chon use. Recommended titan therapy for east et 2 al fw armel he orig ofthe fie este an 9 ‘Noi ie, rs an ort oo for eer dns 00% ie the eaten A de gud dt forthe ft hours ‘Salina, consumpsonaf lect fotedbeverags dnd nom acl rat di apple td grape jie nears) ‘ould be encouroped ic hpertan ents to 0d [vce at ny tthe cance foremens i igh ice ‘once favorite ao har been vite the Helo of ‘rcqoet consump low. The same prince apples {Othe wae of"eay” gd ntitna rink A pte ‘thos vomited monal beverage il sce vr prcubly coed by thee Prokinetcr may ab be rset omiinineomtng ‘No pharmacist methods hat hve been sed th aig ster to provet oe et apes nd Pants byposs, and gaded mage ee Box 232}, The tol Concern poles eucaton materia On dhtary suggetons fade ees fear ant etmek {wmeacergovtanertgnaopiapetingunts) a wl 05 Early Stety A commen comping exposed by cancer penis ie rt cate at mach aed Tg ll hae start eating” Ts desc the spo feyProxsz cmcaamucanons Botanical/Herbal Products and Nutritional Supplements Used by Cancer Patients Spm cdc te cy, V_—T en egy ve Cerny Myttere settemy otectee ap, en rm yt se Noun nse ety which s case rma by delayed ga mpg. onan stents ee Figte 23.5) sd sald Be eonaned between mens rathr than eth ma so ma 0d {cig of nem. Cnsmpaon low ep cho fal" Metolopaide fr ramps nal see ih ate thea sey Aorta ec of tents that are aledy afr denen EFFigure 225 An Appeting and Nutent Dense Smoothie “nfectea bythe many ges that ner Studs nro weanincie suse ight nay cous you may ne ins the man vue of cane tetmet-rdated pa, Shh fs frm 40% to 70 af patent receg chemo. They orrditherapy bar been ropses hat macont ‘ana dean recteyotoncty lol sue caine ‘Chemotherapy induced macotis commonly cu 5-7 day alter chemothepy tated and ay eomtioue (free tthe adi) Spnpoms vl cade pan and thing wth chewing and swallowing Maco may Be Severe tomgh to cue the ptt to complet fr ny odor fanly which can lead to depuration abd sa ‘rei ose Good era yee is ipcrtant fr he ptt “ioral contin order to pete infection. Box 23 ‘itn the NS recommen or eventing sd et tine sopplementation daring radiation therapy to help et pane mac herpes Inclading nets such a fe, yt an ten and soe no cy lc (pa vcore re ctl 1 Uelgtain years bcome remasterted atton dant pre guns reneged the mucositis ese. The pent fold be nursed ‘ately sat oe n scots otfals al be ded shy can bathe macs, Liga sto eta to pee ees no-cc ke ss ‘ects may be all High sere high poten ‘Sates or musionalSpplements maybe bree ss time ce Te 25, Dahon Antincopttc gets get hoc thi ne « igh repletion xe inading he nthe at eulng Ie fey §-Aemourscl tbe nap erat The pate with dares shold be encourage to dink sal ano of i eit roa a age an excite dates, Char hglénutstonalbeerges shouldbe encouraged se stare ection ange sexbed by herp. ntti the patient enero Fis ore intake foo gh slble oer may help the tater of ares weve fen thee pte are 2 por ape and may hv dca tine ices ina of foods i snr (arth deas on ats Table 23.8 High Koco Hh ron Nutenl Beveages Drenthe ey acing ae ‘be relied to anther pics matical pois ean ‘ects changes even befor sags ade ge pesto scion ody ving by inproving endurance Table 23.8 tston herp he ett of ea “haem ep ore ae ‘ie re agents hve Ben eos afl er pete ‘Mimlaon’ meget sceate an conrad agen {Ser Tible 113 in Chaper 1h) Catster shuld be Interventions during Chemotherapy and Ration Sreatmant Specs sutton suport oxprenra shoul ot be wed rotny a an aint Sudan or chematerapy ain spp in patients ‘and who are atipated to be unable ingest andor absor> ‘Megat nutrets oa pong prof of tine” Pants hater change to ele he nto ested dele hatin ocurred shold eid oon Noe the loc tan ehanger in Soy weigh dng, treatment ae oe 2 fra dco freon concer torch undergoing cemtherap leer er DE Childhood Leukemia Colette LaSalle, PhO, RD san ose State University Inorwng eter rae ype eters AL) pce auton to et dy competion ek Sh ayn a re ‘on he inaton he chFigure 23.6 Example ofa Food Related Program for Cancer Pains Patents sould be advised nt take antodant sp plement dering ration ements, Raden damage Cancer ell Ir amend by eypen and anna "hog to reduce the etenyoesnent Interventions before and after Surgery Nurtion sp port betresurgery ny be ential inmate sr) alocried ptt if deed or 18 days prepe, 2h) bute beret of ut on ppt mt fe weed ‘it it potent ks Pos peste ener eon [Spreered since hs ls oe for competion snd a been fund to preserve gu ineity snd mane a Studies gest ha pene etenn maybe bef ‘when sed peroperatilyn ser malnred patents Torkead nd neck cancers hich myo ete by ml tiple malts, propbyac cing abe placement ‘omen ar patents + ongoing dearation depo, noes, pin that Interest the aby ink aeguately + sgutcant combs. ining sew station o ‘vee dep ‘role or in patcnts who he compromised cadopa + high ik oflong-te salon dds ining thos atipted to rece lage Belief igh done radiation othe scan and scent connie ses fargnne, ns xh and eset ty xe my be ba ‘Gch nator patenting ma cance oper ‘one aes who hive fing ae pen sol be courage toconsne ods oy they cn swan withsprain Aerts vallowingfnction can oc long ‘Mer tresmeat (pec fer aati sed eaten! and ‘See Chars 1 an 15 fr information on ution serpy le eres Interventions for Hematopoietic Cell Transplantation Inno the sbve pes elated tse ASPEN ‘eommends the fallwing fr ptt ener era ovr cll enplntaion seh meta conning + Nutton apport i appropriate in pets ndegsing Femotopoet cal raneplatton who ae malourisied And whe tiated be nal ingest and aor adequate tet fr prolnged pete oF Sine When pemeral atone shoul be {continua eso toes ave sed afer tomes engament. Femctoning Gt tat or whom ral takes adequate + Mharmacsoge dones ofparetral gutamine may bent pets unegeing beatport + Patent shold ese dtry oaneingreaing fonds fhntimy pe nection reac sl hing daring the pr of expense Box 15 Chap 13) «Nuttin supports ppp for pent underoing Teatopnat cl transplantation who devbp mere {sees pat east dsesesecompaniel By poor ‘alma andlor sgncantmalabepon Determining Nutrlent Requirements Adequate ergy Intake ceri ia cuenta andor preven treatment ov disse auocied lo. The flowing cms eo equtons or the Nin. er eatin ay Be we {Daktemne the ori node of ane patients” 1 Nonambultry or sodenary adult: 25-30 kal + Slight hypermetbol panto thos pains who tea togun weight ore mbobe30-35 alg + Hypermeablc reery stead patents those ‘ek malbsorpion 2s lig oe eer a eed Adequte poten is important preset of reduce ete nitrogen bance and meet poten sae ees Prin eed se epi slevsted those pte (ih sore dirhea andlor malabsorption Protin needs (par be clad based on ody weigh the long + Nowmalor maintenance protein eed 04-10 gig Many cancer patients expecially thos nding che matherpy anos anon can Become darted a Fld neviecan be called ong he sure formulas wed formosa aliens witht eal eas ee Cage) erontent teqlcents fae not ber eebebed or thos dingo wth ener Us of dal ult ‘amin and mint suplement ht contans “220% ofthe Dt my be beneficial for ow patents anergpng cheno therapy andlor ation therapies Monitoring and Evaluation Meitring and evan preter shal be tse the nuuoedagoses and terventos inglemeted to kes the main prbleme Most kaye and wiht “hangs wil be meaner nd poten intakes wil be {eed paleo wile eve, Tolrnce the det should [cirmine nd any changes nylons Went Conclusion acer becuse any tesement options ean sient Mec spoons nustonal sue Obsiing adequle ergy. protein, Gude, sami, and mrs and pre ‘ug weight lows, which ocuts ecue n ane Favens ny help to improve quality of ie for many of Those undergoing sre no harmaclogi eaten teancer Resench the arts of grooms and Dg thorpes should provide a beer anersnding a6 0 the tng for ance an opel merece pen Dena Champion MS, RO, LO, CNSC cpa cn Din Art es ac ot an Rh Sr smh ine Wee bs Cantera On Ste Une When wos your fist epainc as a tan vetng 2 pen th cance? What was your ath eben on trcigy rong ad er is He ag snr feed ge yarn oe Seouaton am sey amaze teenth an 8