Unit 22 – Diet and Cancer1
Cancer2       Group of >100 different diseases       Characterized by uncontrolled cell growth       Individual cancers...
Cancer Progression3
Estimated Cancer Prevalence 20074                  Urinary Bladder                Thyroid       Testis    Stomach         ...
What Causes Cancer?   80-90% of cancers are    initiated by environmental    factors that alter DNA   Most factors are  ...
Causes of Cancer6       Aflatoxins – toxin made my       Arsenic        Aspergillus fungi                Asbestos     ...
What Causes Cancer?   Diet accounts for approx. 40% of cancer risk-   Westernized dietary intake and lifestyle increase r...
Nutrition and Cancer8                 Prevention  1/3 of all cancers are                  related to dietary factors    ...
Nutrition in Cancer Prevention   Eat a variety of fruits and veggies    - 5-9 servings per day   Antioxidants and anti-i...
Nutrition in Cancer Prevention              Limit red meats and processed               meats              High intakes ...
Nutrition in Cancer Prevention11     Excess body weight and physical inactivity      ↑ risk of esophageal, colon/rectal, ...
Nutrition in Cancer Prevention12        Link between excess body weight,         exercise, and cancer risk so strong that...
American Institute for Cancer Research13     Recommendations        Avoid sugary drinks        Limit foods high in salt ...
Impact of Cancer on Nutrition14 Site            Potential Effects Brain/CNS       Eating disabilities, chewing/swallowing ...
Impact of Cancer on Nutrition15     Metabolic Changes      alter use of fuels (CHO, pro, fat)      promote loss of weigh...
Impact of Cancer on Nutrition16     Anorexia      Contributing factor to weight loss and malnutrition      Potential cau...
Impact of Cancer on Nutrition17     Cachexia:      wasting syndrome marked by weakness,     progressive loss of body weig...
Nutrition Therapy During Treatment18        Improve tolerance to treatment        Enhance immune function        Aid in...
Nutrition Therapy during Treatment19        Calories         - Nonambulatory/sedentary             25-30 kcal/kg body wei...
Nutrition Therapy during Treatment20        Protein         - Nonambulatory/sedentary             1.0-1.2 g/kg body weigh...
Tips to increase kcals and protein21        Add cheese         - to toast, crackers, sandwiches, baked potatoes,         ...
Altered Taste/Smell22                    Taste/smell impairment occurs in                     more than ¾ PTs            ...
Strategies to Reduce Food-borne23     Illness Risk – Neutropenic Diet        Proper hand washing        Cook meat to “we...
Low-Bacterial / Low-Microbial Diet24        Order is up to the discretion of the physician        Foods not allowed:    ...
For More Information25        www.cancer.org
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HLT 138 Unit 22

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HLT 138 Unit 22

  1. 1. Unit 22 – Diet and Cancer1
  2. 2. Cancer2  Group of >100 different diseases  Characterized by uncontrolled cell growth  Individual cancers differ by: - where they develop - how quickly they grow - type of treatment - impact on nutritional status  2nd leading cause of death in the US
  3. 3. Cancer Progression3
  4. 4. Estimated Cancer Prevalence 20074 Urinary Bladder Thyroid Testis Stomach Prostate Pancreas Ovary Oral Cavity and Pharynx Lymphoma Multiple Myeloma Melanoma of Skin Lung Liver and bile duct Leukemia Larynx Kidney Hodgkin Disease Esophagus Endometrial/Uterine Colon/Rectum Cervix Breast Brain/CNS
  5. 5. What Causes Cancer? 80-90% of cancers are initiated by environmental factors that alter DNA Most factors are modifiable
  6. 6. Causes of Cancer6  Aflatoxins – toxin made my  Arsenic Aspergillus fungi  Asbestos  Ethanol - alcoholic  Chromium hexavalent cpds beverages  Hepatitis B and C virus  Coal-tars  Human papilloma viruses:  Herbal remedies containing some genital-mucosal types plant species of the genus Aristolochia  Mustard gas  Salted fish (Chinese-style)  Solar radiation  Soot  Sunlamps or sunbeds  Tobacco, smokeless  X-radiation and gamma radiation  Wood dust  Nitrates
  7. 7. What Causes Cancer? Diet accounts for approx. 40% of cancer risk- Westernized dietary intake and lifestyle increase risk of many types of cancer Genetic factors account for approx. 5-42% of risk for some cancers- Prostate, breast, and pancreatic cancers
  8. 8. Nutrition and Cancer8  Prevention  1/3 of all cancers are related to dietary factors  Intake/utilization Cancer and/or impairment of nutrients treatment  Absorption/metabolism impairment
  9. 9. Nutrition in Cancer Prevention Eat a variety of fruits and veggies - 5-9 servings per day Antioxidants and anti-inflammatory compounds may protect DNA from damage Damaged DNA may direct abnormal cell multiplication
  10. 10. Nutrition in Cancer Prevention  Limit red meats and processed meats  High intakes of saturated fats from meat and dairy products increase cancer risk  Plant proteins provide unsaturated fats plus vitamins, minerals, fiber, and phytochemicals
  11. 11. Nutrition in Cancer Prevention11 Excess body weight and physical inactivity  ↑ risk of esophageal, colon/rectal, postmenopausal breast, endometrial, and renal cancers  Increases hormones that promote cancer cell growth  Promotes insulin resistance and hyperinsulinism  Promotes low levels of inflammation which can promote cancer cell growth and development
  12. 12. Nutrition in Cancer Prevention12  Link between excess body weight, exercise, and cancer risk so strong that:  Recommended BMI range: between 21 and 23  Limit energy-dense foods: (particularly processed foods high in sugar and fat, and low in fiber)  Physical activity: at least 30 minutes every day
  13. 13. American Institute for Cancer Research13 Recommendations  Avoid sugary drinks  Limit foods high in salt  Limit alcohol to 1-2 drinks per day (if any at all)  Don’t use supplements to protect against cancer  Breastfeed up to 6 months  Do not smoke or chew tobacco
  14. 14. Impact of Cancer on Nutrition14 Site Potential Effects Brain/CNS Eating disabilities, chewing/swallowing difficulty Head and Neck Chewing/swallowing difficulty Esophagus Dysphagia related to obstruction, GERD Stomach Early satiety, N&V, impaired motility, obstruction – may require EN or PN Bowel Maldigestion/malabsorption, obstruction – may require EN or PN Liver Diarrhea Pancreas Maldigestion/malabsorption, DM
  15. 15. Impact of Cancer on Nutrition15 Metabolic Changes  alter use of fuels (CHO, pro, fat)  promote loss of weight and lean body mass  Glucose intolerance / insulin resistance  Increased energy expenditure  Increased protein turnover  Reduced muscle protein synthesis  Accelerated fat breakdown  Kcal and nutrients  redirected to supporting growth of tumor vs. fueling the body  Increased inflammatory/immune response  increase metabolism
  16. 16. Impact of Cancer on Nutrition16 Anorexia  Contributing factor to weight loss and malnutrition  Potential causes: - pain, depression, anxiety, fatigue, early satiety, N&V  Treatments contribute: - taste alterations, loss of taste, sore mouth, dry mouth, thick saliva, esophagitis, fatigue  Optimizing intake: - texture/temp modification, scheduled eating, meds to
  17. 17. Impact of Cancer on Nutrition17 Cachexia:  wasting syndrome marked by weakness, progressive loss of body weight, fat, and muscle  Present in approx. 80% cancer related deaths  Hard to reverse  Nutrition aimed at preserving muscle and fat stores - improves quality of life - does not guarantee increased length of survival
  18. 18. Nutrition Therapy During Treatment18  Improve tolerance to treatment  Enhance immune function  Aid in recovery  Improve quality of life  Enhance well-being
  19. 19. Nutrition Therapy during Treatment19  Calories - Nonambulatory/sedentary 25-30 kcal/kg body weight - Hypermetabolic/weight gain 30-35 kcal/kg body weight - Hypermetabolic, severely stressed, malabsorption 35 kcal/kg body weight
  20. 20. Nutrition Therapy during Treatment20  Protein - Nonambulatory/sedentary 1.0-1.2 g/kg body weight - Hypermetabolic/weight gain 1.2-1.5 g/kg body weight - Hypermetabolic, severely stressed, malabsorption 1.5-2.5 g/kg body weight
  21. 21. Tips to increase kcals and protein21  Add cheese - to toast, crackers, sandwiches, baked potatoes, veggies, soups, and noodles  Add peanut butter - to toast, bread, English muffins, fruit - blended into chocolate or vanilla milkshake  Add nuts and seeds: - sprinkled over cereals, fruit, desserts, veggies, salads, and pasta
  22. 22. Altered Taste/Smell22  Taste/smell impairment occurs in more than ¾ PTs  Can interfere with enjoyment of eating  ↓ tolerance of bitter foods  ↑ tolerance of sweet foods  Can significantly reduce intake
  23. 23. Strategies to Reduce Food-borne23 Illness Risk – Neutropenic Diet  Proper hand washing  Cook meat to “well-done”  No raw eggs, even in dressings, “over-easy” eggs  No sushi, raw seafood, raw meats, unpasteurized milk  Wash fruits/veggies thoroughly  Thaw food in fridge-not on counter or in sink  Refrigerate leftovers immediately and discard after 3d  Avoid salad bars and buffets when eating out
  24. 24. Low-Bacterial / Low-Microbial Diet24  Order is up to the discretion of the physician  Foods not allowed: - fresh fruits and vegetables - nuts and dried fruits - foods from multi-serving containers - deli meats and undercooked meats
  25. 25. For More Information25  www.cancer.org

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