賴怡君 營養師Cancer induced malnutritionCause of cachexiaNutrient substrate requirementManaging side effects during treatmentFAQ and Myths
The prevalence of malnutrition in cancer Pancrease 80−85% Gastric 65−85% Head and Neck 65−75% Esophagus 60−80% Lung 45−60% Colon 30−60%1. Stratton R et al. Prevalence of disease‐related malnutrition. In: Stratton RJ, Green CJ, Elia M (Eds), Disease‐related malnutrition: An Evidence‐based Approach to Treatment. CABI Publishing, Wallingford, Oxon, UK, 2003;35‐92. 2. Muscaritoli M et al. Prevention and treatment of cancer cachaxia: New insight into an old problem. Europ J Cancer 2006;24:31‐41 Cachexia: A new definition. Clinical Nutrition V.27(6), 2008
The pathophysiologic role of cytokines in the production of cachexia AJCN 2006 83: 923-924 Side effects and nutrition impact during treatmentOral ulcers Dry mouth Taste changes Nausea Constipation / Vomiting /DiarrheaDifficulty in swallowing Anorexia Absorption Weight loss
Infections & Medications Mouth sores Diarrhea Decreased appetite Too tired Eat less to eat CYCLE OF Lose weight Too tired MALNUTRITION to cook Tire out quickly Lose strengthCancer deaths: Up to half are malnourished and 20% die from malnutrition rather than cancer1. Capra S, Bauer J, Davidson W, Ash S: Nutritional therapy for cancer-induced weight loss. Nutr Clin Pract 2002;17(4):210-213.2. Ottery FD: Cancer cachexia: Prevention, early diagnosis, and management. Cancer Pract 1994;2:123-131.
癌症病人常見的營養不良治療階段最常發生營養素缺乏、熱量不夠臨床表現 體重下降 貧血 免疫力差 、白血球低下 營養性的水腫 疲倦、體力耗弱 Feel better Keep up your strength and energy Maintain your weight and your body’s store of nutrients Better tolerate treatment-related side effects Lower your risk of infection Heal and recover faster
Goals of nutrition therapy for cancer patients in treatment and recovery Prevent or treat nutrition problems, including preventing muscle and bone loss. Decrease side effects of cancer treatment and problems that affect nutrition. Keep up the patients strength and energy Help the immune system fight infection Help the body recover and heal Keep up or improve the patients quality of life 高存活率 完成療程 好體力 易吸收 Avoid Cancer‐ 吃得好related cachexia 吃得下
The Claim: Sugar feeds cancer ?The Facts: All cells (including cancer cells) in our body use sugar (glucose) from thebloodstream for fuel. But that blood sugar comes from all carbohydrate foods,including healthful vegetables, fruits, whole grains and low fat dairy sources; someglucose is even produced within our bodies from protein. While avoiding sugar completely will not slow cancer growth, eating a lot of highsugar foods may mean excess calories in your diet which leads to excess weight andbody fat. And excess body fat is linked to greater risk of several types of cancers.