Colon cancer case study

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Dietetic case study on adult male patient with Stage III colon cancer

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Colon cancer case study

  1. 1. Colon Cancer Case Study Amy Good, Dietetic Intern
  2. 2. What is Colon Cancer? Medical Nutrition Therapy for Colon Cancer Contents Patient Overview Nutrition Care Process
  3. 3. • 57 year old male • Past medical hx: • 18” resection of colon two months ago • 20# weight loss over the past year • Has since gained the weight back • Port placement in right chest for chemotherapy • Current medical hx: • Stage III colon cancer Patient Overview
  4. 4. • Cancer of the large intestine • Typically begins as benign colon polyps that become cancerous overtime • Often called colo-rectal cancer which combines cancer of the rectum What is colon cancer?
  5. 5. •Can be found in men or women •Typically affects those 50+ years of age. •In 2013, 50,830 people died from colon cancer •Dietary risks include: •Diet high in red meat •Diet high in fat •Diet low in calcium, folate, and fiber. •Inactivity and obesity has been linked to higher risk of colon cancer as well. Prevalence of colon cancer Most Common Cancers in the U.S. Men Women 1. Prostate 1. Breast 2. Lung 2. Lung 3. Colon 3. Colon
  6. 6. Stages of Colon Cancer Stage Description Stage 0 Abnormal cells are found in the lining of the colon. These cells may become cancerous. Stage I Cancerous cells have formed and spread into the colon wall Stage II Divided into three stages -Stage IIA Cancer has spread to the outermost layer of the colon wall -Stage IIB Cancer has spread through the outermost layer of the colon wall but has not spread to nearby organs -Stage IIC Cancer has spread through the outermost layer of the colon wall to nearby organs Stage III Divided into three stages -Stage IIIA Cancer has spread to as many as 3 lymph nodes -Stage IIIB Cancer has spread to as many as 3 lymph nodes and has spread:  beyond the middle tissue layers of the colon wall; or  to nearby tissues around the colon or rectum; or  beyond the colon wall into nearby organs and/or through the peritoneum. -Stage IIIC Cancer has spread to 4 or more lymph nodes and has spread:  to or beyond the middle tissue layers of the colon wall; or  to nearby tissues around the colon or rectum; or  to nearby organs and/or through the peritoneum. Stage IV Cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs
  7. 7. Medical Treatment of Colon Cancer Chemotherapy •Use of chemicals to kill cells that divide rapidly, like cancer cells. Surgery •Tumor removal •Colon resection Radiation •A needle at the source of the cancer directs imaging technology Biological Therapy •Uses medicines made from living sources, rather than chemicals, to kill cancer cells
  8. 8. Goals of MNT for cancer patients Medical Nutrition Therapy Prevent or reverse nutrient deficiencies Preserve lean body mass Minimize nutrition-related side effects Maximize the quality of life
  9. 9. • MNT will depend on the individual patient’s clinical status. • RD will evaluate the following information: • Diagnosis • Medical hx • Treatment method • Laboratory data • Anthropometric measurements • RD will determine if the following is present • Malnutrition • Fever • Edema • Ascites • Vomiting • Diarrhea • Diuretics • The Registered Dietitian will use this information to determine calorie, protein, and fluid needs, as well as a potential need for supplementation. Medical Nutrition Therapy for Colon Cancer
  10. 10. Nutritional Assessment Pertinent Information Height 70” Weight 220 # Ideal Body Weight 166 # % Ideal Body Weight 132% Adjusted Ideal Body Weight 179.5 # Calcium 8.0 (low) Albumin 3.8 (normal) •No pertinent medications •Patient’s son lives with him every other week •Patient experiences decreased appetite, nausea on chemotherapy weeks (every other week) •Patient takes phenergan for nausea •Patient cannot eat/drink anything cold due to a chemotherapy side effect
  11. 11. • 25-30 kcal/kg of body weight • 2,500-3,000 kcal/d. • 30 ml of fluid/kg of body weight • 3,000 ml/d = 101 fl oz/d Nutrition Assessment • 1.2 g of protein/kg of body weight • 120g/d Due to inadequate intake every other week secondary to chemotherapy treatments, I recommend Ensure Clear for chemotherapy weeks
  12. 12. • Ensure Clear can be consumed at room temperature • Must be refrigerated upon 4 hours after opening ENSURE CLEAR Nutrition Facts Serving Size 10 fl oz Calories 180 kcal Protein 9 g Carbohydrate 35 g Total Fat 0 g Essential Vitamins & Minerals 21
  13. 13. Assessment Diagnosis InterventionMonitoring Evaluation Diagnosis •Increased nutrient needs related to compromised function of intestine as evidenced by dx of Stage III colon cancer,18” colon resection, low calcium, and diet history of poor intake during weeks of treatment. Intervention •High calorie/high protein diet education •Ensure Clear nutritional supplement Monitoring & Evaluation •Monitor weight, labs, PO intake •Follow up in 3 months Nutrition Care Process
  14. 14. References •"Colon cancer: MedlinePlus Medical Encyclopedia." U.S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 22 Apr. 2014. <http://www.nlm.nih.gov/medlineplus/ency/article/000262.htm>. •"Colorectal Cancer Overview." Colorectal Cancer Overview. Colon Cancer Alliance, n.d. Web. 22 Apr. 2014. <http://www.ccalliance.org/colorectal_cancer/overview.html>. •Mahan, L. Kathleen. "Medical Nutrition Therapy for Renal Disorders." Krause's food & nutrition therapy. 12th ed. St. Louis, Mo.: Saunders/Elsevier, 2008. Print. •Mayo Clinic Staff. "Colon cancer." Definition. N.p., n.d. Web. 22 Apr. 2014. <http://www.mayoclinic.org/diseases-conditions/colon-cancer/basics/definition/con- 20031877>. •"NAACCR | North American Association of Central Cancer Registries." Top 5 Cancers in the U.S.. N.p., n.d. Web. 22 Apr. 2014. <http://www.naaccr.org/DataandPublications/Top5USCancers.aspx>. •Rock, C. L.. "Dietary Counseling Is Beneficial for the Patient With Cancer." Journal of clinical oncology 23 (): 1348-1349. Print.

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