Nutrition and Cancer

Lec 10
Prof Sonia A Habib
-Cancer may lead to serious protein energy
malnutrition.
-Cancer of GIT affects nutrition and has GIT
symptoms, e.g., vomiting, nausea, and
diarrhea
Cancer Cachexia: 
Due to altered metabolism  decreased cellular
mass in organs with high cell turnover 
malabsorption due to atrophy of GIT or due
to immunocompetence and increase risk of
infection.
Effect of Cancer Therapy:
Therapy whether surgery, chemotherapy,
radiation or immunotherapy could affect
appetite or mode of intake and leads weight
loss. Also it may alter metabolism or lead to
diarrhea and nutrient loss.
Surgery: Affects method of food intake or lead
to GIT symptoms
Chemotherapy: Leads to nausea, vomiting,
diarhoea and advise taste.
Radiation: Side effects related to area of cancer
Immunotherapy: Increases caloric requirement
leads to nausea, vomiting and diarrhea.

Bone Marrow Transplantation: Anorexia, effect

due to chemotherapy and immunotherapy,
e.g., chick saliva, constipation, mucositis,
intestinal damage with diarrhea and
malabsorption.
Total parentral nutrition may be needed for 1-
2 months after bone marrow transplantation.
Nutrition Therapy in Cancer Treatment:

Goals are:
 to minimize side effects
 to avoid loss of weight
 to promote healing
 optimize tolerance to treatment.

Nutrient needs varies according to clients age,

weight, type of cancer or, previous medical
condition and clients ability to perform
activities.
Nutritional support may help to restore body
weight. It includes protein, calories, vitamin
C, B and iron to promote healing.

Nutrition:
Increase protein and calorie intake:
Given as supplements in meals or in between
meals.
Products like ensure and boot come in high
protein.
Decrease side effects:
Decrease side effects:
a- Anorexia: Overeat during good days.
Avoid strong food odours.
b- Nausea and vomiting:
Eat high calorie, low fat food.
Take antiemetics.
c- Taste changes:
- Care to change metallic taste.
- Oral hygiene.
d- Food aversion: Fast completely before
recovering radiation or chemotherapy
e- Sore mouth: - Good oral hygiene.
- Eat blend diet.
- Cut food into small portions.

f - Dry mouth: - Avoid dry meals.

- Use straw to facilitate swallowing.
- Drink high protein high calories.
- Liquid between meals.

g- Diarrhea: - Replace fluid and electrolytes.

- Avoid greasy food.
- Take food high in pectin as
carrots, bananas, peeled appels.
- Limit caffeine or hot liquids.
Methods of Feeding:

1- Oral.
2- Enteral tube feeding.
3- Parentral: In case of malabsorption , short
bowl syndrome, fistulas or abscess.
Immunodeficiency and its effect on nutritional
status:
1) Wasting due to diarrhea,, malabsorption,
documented fever and secondary infections.
2) Change in metabolism: accelerated, increase, total
energy expenditure.
3) GI abnormalities: diarrhea and malabsorption may
occur secondary to intestinal infection. Drug
therapy, low serum albumin or AIDS entropathy.
4) Cytokine production: Causes metabolic
abnormalities, anorexia and wasting specially in
HIV infection
Nutrition Therapy:
1. Forestall or Reverse Wasting:
a. Calories:
- 30 cal/kg Stable (no secondary infection).
- 45 cal/kg Opportunistic infection.
- 55 cal/kg If client is loosing weight.
b. Protein: 1.2-2 g/kg.
100-150 g/day for men , 80-100 g/day for women.
c. Vitamins and Minerals:
Method of feeding depends upon condition of
patients. Untractable vomiting, diarrhea or bowl
obstruction indicates TPN.(total parentral nutrition)
- Try to minimize side effects as due to malabsorption
(use medium chain triglycerides) for calories.
2- Supplementation:
Metabolic lipodystrophy is controlled by
nutritional therapy (Mediterranean diet), low
fat, rich fiber, whole grain, fruits and
vegetables.

3- Prevent Foodborne Illness

4- Enhance effectiveness of drug therapy.