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CANCER

AN OVERVIEW AND
DIETARY
MANAGEMENT
By
V.VYTHEESHWARAN
Cancer
• Cancer is the 2nd most common cause of
death in the US after heart disease.
• Cancer kills 1 out of every 4 Americans.
• The risk of developing cancer can be
reduced by changes in a person’s lifestyle.
What is Cancer?
• Normal body cells grow, divide and die in
an orderly fashion.
• Cancer cells are different because they do
not die, just continue to divide and grow.
• Cancer cells form as a result of damaged
DNA.
What is Cancer?
• These damaged genes can be passed on,
which accounts for inherited cancers.
• In other cases, the DNA is damaged by an
outside source such as smoking.
• Cancer usually forms a tumor.
What is Cancer
There are two types of tumors: Malignant
and Benign

• Malignant tumors spread to other areas


in the body. These are the dangerous
ones.
• Benign tumors stay in one place.
Types of Cancer
• Sarcoma-rise from connective tissue such
as muscle or bone and are more common
in younger people.
• Carcinomas-which occur in epithelial
tissue and are more common in older
people. It includes lung, breast, prostate,
and colon.
Types of Cancer
• Leukemia- cancers of the blood or blood
forming organs.
• Lymphomas- affect the lymphatic system.
The lymphatic system is a group of
vessels and nodes that act as the body’s
filter. It prevents bacteria and foreign
invaders from entering the bloodstream.
Causes of Cancer
80% are considered sporadic- meaning
the cause is unknown. There are several
risk factors that increase the chance of
cancer:

• Age- risk increases >50.


• Diet- high fat, high cholesterol diets
increase risk.
Causes of Cancer
• Obesity- no clear link but research
indicates it is a factor
• Cigarettes- increases lung cancer, other
tobacco products such as pipes and
chewing tobacco increase cancers of the
mouth.
• Long term exposure to chemicals-
asbestos, radon and benzene.
Causes of Cancer

• Exposure to high levels of radiation


• Harmful ultraviolet rays from the sun.
• Some viruses- Hepatitis B, C, HPV,
Epsteinn-Barr.
• Immune system diseases
• Heredity
Objectives
• Recognize the special nutritional
needs of cancer survivors during
active cancer treatment
• Advise cancer survivors about
nutrition and physical activity during
the recovery phase and beyond
• Resolve controversial nutritional
issues facing cancer survivors
Challenges of Cancer
Survivors
• Highly motivated to seek information
about diet and lifestyle changes.
• Often receive conflicting dietary advice.
• Claims abound on the use of dietary
alternatives.
• Currently there are many gaps and
inconsistencies in the scientific
evidence.
NUTRITIONAL DEFICIENCIES
There are several factors that may contribute to the type and
degree of nutrient deficiencies:

• The primary organ where the malignancy


occurs.
• The severity of the cancer at the time of
diagnosis.
• The symptoms experienced by the person with
cancer.
• The type and frequency of the cancer
treatment being used and the side effects
associated with that treatment (surgery, radiation,
or chemotherapy).
• The effect of the malignancy or disease on food
and nutrient ingestion, tolerance, and utilization.
Body Weight Changes
• Intentional weight loss during cancer
treatment is not recommended
• Some cancer survivors may gain
weight during and after treatments
• During treatment, a healthy eating plan
that meets but does not exceed caloric
needs (along with physical activity) is
advisable
• Healthy weight loss is best initiated
after the recovery phase
• Obesity is associated with increased
risk and poorer prognosis of breast
and colon cancers
The Phases of Cancer Survival
• Phase 1: Active Treatment

• Phase 2: Recovery from Treatment

• Phase 3: Preventing Cancer Recurrence,


Second Primary Cancers.

• Phase 4: Living with Advanced Cancer –


Dietary management
Phase 1: Nutritional Issues
During Active Treatment
• Energy balance is the most important goal

• ENERGY INTAKE
• ENERGY EXPENDITURE
• NUTRITIONAL SUPPLEMENTS
ENERGY INTAKE
– The need for caloric intake is usually
increased during cancer treatments
– Nausea, vomiting, taste changes, loss of
appetite, bowel changes all interfere wit
our usual eating patterns.
– Food choices at this time should be easy
to chew, swallow, digest and absorb and
should also be appealing.
– Adjust usual food choices and usual food
patterns.
ENERGY EXPENDITURE
– cancer treatment can cause fatigue
– light regular physical activity during
treatment should be encouraged to
improve appetite, stimulate digestion,
prevent constipation.
– Helps to maintain energy level and
muscle mass and provide relaxation
or stress reduction
NUTRITIONAL
SUPPLEMENTS
 Nutritional products such as Boost, Ensure
etc… can be helpful on a temporary basis
to assist with intake of calories and
nutrients.
 Other supplements is quite controversial.
For example, it is counterproductive for
patients to take vitamin supplements that
contain high levels of folic acid or to eat
foods fortified with high amount of folic
acid, when on Methotrexate. (metho
interferes with folate metabolism).
NUTRITIONAL
SUPPLEMENTS
 Antioxidants(Vitamins C, E and phytochemicals
or antioxidant minerals), may reduce the
effectiveness of RT or CX. May help protect
normal cells from treatment collateral damage
 No good answer or evidence at this time there
fore it would be prudent to advise patients not to
exceed the upper intake limits for vitamins and
to avoid other nutritional supplements that
contain antioxidant compounds.
Phase 2: Nutritional Issues
After Treatment is Completed

• Most important goal Rebuild muscle


strength and correct problems.

• Adequate food intake

• Physical activity
– Required to rebuild muscle strength.
– Consultation required for elder patients.
Benefits of Moderate Regular Physical
Activity for Cancer Survivors
• reduce anxiety
• reduce depression
• improve mood
• boost self esteem
• reduce symptoms of fatigue,
• beneficial effects on heart rate,
lean body mass and respiratory
capacity
Diet and Cancer
The American Cancer Society
recommends 4 rules of thumb for cancer
prevention
• Choose most of the foods you eat from
plant sources. 5 or more servings
• Limit intake of high fat foods, particularly
from animal sources.
• Be physically active.
• Limit alcohol intake.
Dietary Components
Associated with Cancer
THE BAD GUYS!!!
Excesses of Certain substances such
as:
• Fat- the end products of metabolism
have been found to be carcinogenic.
• Alcohol- has been connected with
liver, colorectal, and breast cancers.
Dietary Components
Associated with Cancer
THE BAD GUYS!!!
• Pickled and Smoked Foods- related
to cancers of the esophagus and
stomach. that may increase the risk.
• Cooking methods have also been
found to have a role in cancer. Frying
or charcoal-broiling meats at very
high temperatures creates chemicals
Protective Dietary Components
THE HEROES
• Certain foods and nutrients have been
shown to protect against certain types
of cancers.
• Vitamin C - has been shown to protect
against cancer of stomach, esophagus,
and oral cavity.
• Antioxidants- these are certain
protective substances found in fruits
and vegetables.
Protective Dietary Components
THE HEROES
• Fruits and Veggies- contain vitamins,
fiber and phytochemicals.
• Vitamin E and selenium- both
antioxidants that protect cells against
breakdown.
• Calcium- Calcium reduces cell turnover
rates.
• Water- drinking more than 5 glasses a
day has been associated with a lower
risk of cancer.
Diet and Cancer
• Fiber- Insoluble fiber is connected to
decreased risk of colon cancer.
• Beans, vegetables, whole grains and
fruit are good sources.
• Salt- some evidence links diets
containing large amounts of foods
preserved by pickling and salting to
increased cancers of the stomach,
nose and throat.
Diet and the Cancer Patient
• Nutrition is an important part of
treatment.
• Eating the right kinds of food
before, during and after treatment
can help the patient feel better and
stay stronger.
• Treatments can have an affect on
appetite.
Diet and the Cancer Patient
• People with cancer have unique
nutrition needs.
• Eating enough food is usually not
a problem. Treatment can have an
adverse effect on appetite.
• Nutrition suggestions often
emphasize eating high calorie,
high protein foods.
Diet and the Cancer Patient
Side Effects
Treatments kill cancer cells but they also kill healthy cells.
This can cause side effects such as:
• Loss of appetite
• sore mouth or throat
• dry mouth
• dental and gum problems
• changes in taste or smell
• Nausea
• Diarrhea
• Constipation
• fatigue
• depression.
Diet and the Cancer Patient
• It is very important to have good
nutrition to minimize the side effects of
cancer, prevent or reverse nutritional
deficiencies, and to maximize the
quality of life.
• The best method of calorie intake is by
mouth. Sometimes this is not possible.
Diet and the Cancer Patient

Other options of intake are:


• Feeding Tube
• TPN or total parental nutrition- this is
nutrition directly through a vein.
FIVE FOR CANCER
Five things you should remember about
preventing cancer.

• Eat lots of fruits, vegetables, and whole


grains.
• Discover the pleasure of physical activity.
• Stay tobacco free
• Enjoy a low-fat diet
• Protect yourself from the sun between
10:00 am and 4:00 pm.
COMMON DIET THERAPIES

• FULL FLUID DIET


• SOFT DIET
FULL FLUID DIET
• Initial diet. FOOD VEGETARIAN NON-VEGETARIAN

• Administered alongside
Corn flour 50 mg 50 mg
or immediately after
therapy. Dhal flour 30 mg ---

• Predominant diet for Milk 1000 ml 800 ml

oral, pharyngeal, Meat --- 50mg

oesophagal and GI tract Egg --- One


cancer.
Fruit juice 800ml 850ml
• Administered at regular
intervals (Every 2 Butter 2 Tbsps 2 Tbsps

hours). Sugar 100 mg 100 mg

The above table shows amount of food to be consumed per


day
SOFT DIET
• Secondary diet. FOOD VEGETARIAN NON-VEGETARIAN

• Administered following a Milled cereals 300 mg 300 mg

period of full fluid diet. Dhal 50 mg 30 mg

• Enriched with nutrients. Milk 1000 ml 600 ml

• Supplementation of Meat, fish, --- 100 mg

essential vitamins like Egg


sausages
--- 30 mg
folate and Vit C lost
during drug therapy. Tender
vegetables
50 mg 50 mg

• Meats can be avoided as Potatoes 100 mg 100 mg


far as possible as it Tender leafy 100 mg 100 mg
results in the formation of vegetables

nitrosamines in stomach. Fruits (Apples &


Oranges)
100 mg 100 mg

• This can be countered by Fats and Oils 30 mg 30 mg


administration of Vit C Sugar 80 mg 80 mg

The above table shows amount of food to be consumed per


day
Conclusion
• Cancer is a preventable disease in
most cases.
• Lead a healthy lifestyle.
• Be aware of your body.
FOR MORE RESOURCES
• http://www.cancer.gov
• http://www.cancer.org
• http://muextension.missouri.edu
THANK YOU