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- 1. Homework Help https://www.homeworkping.com/ Research Paper help https://www.homeworkping.com/ Online Tutoring https://www.homeworkping.com/ click here for freelancing tutoring sites DE LA SALLE UNIVERSITY - DASMARIÑAS COLLEGE OF INTERNATIONAL HOSPITALITY MANAGEMENT HOTEL AND RESTAURANT MANAGEMENT DEPARTMENT ACADEMIC YEAR 2010 -2011, 2nd SEMESTER A Case Study Presented to Ms. Marichou F. Señorin In Partial Fulfillment of the Requirements in Culinary Nutrition
- 2. Group Six Silvestre, Jazmine D. Tapawan, Faire Jessica Serias, Neil Umali, Erryl Zalameda, Winzhel HRM 16 March 10, 2011 CASE STUDY I. Introduction A. Name: Paul C. B. Age : 35 years old C. Gender: Male D. Height: 5’5 E. Weight:59 kg F. Family Medical History: Aunts and uncles died from Colon Cancer at early age. II. Pathophysiology
- 3. Colorectal cancer, also called colon cancer or large bowel cancer or "CRC", includes cancerous growths in the colon, rectum and appendix. With 655,000 deaths worldwide per year, it is the fourth most common form of cancer in the United States and the third leading cause of cancer-related death in the Western world. Colorectal cancers arise from adenomatous polyps in the colon. These mushroom-shaped growths are usually benign, but some develop into cancer over time. Localized colon cancer is usually diagnosed through colonoscopy. Invasive cancers that are confined within the wall of the colon (TNM stages I and II) are curable with surgery. If untreated, they spread to regional lymph nodes (stage III), where up to 73% are curable by surgery and chemotherapy. Cancer that metastasizes to distant sites (stage IV) is usually not curable, although chemotherapy can extend survival, and in rare cases, surgery and chemotherapy together have seen patients through to a cure. Radiation is used with rectal cancer. On the cellular and molecular level, colorectal cancer starts with a mutation to the WNT signaling pathway. When WNT binds to a receptor on the cell, that sets in motion a chain of molecular events that ends with β-catenin moving into the nucleus and activating a gene on DNA. In colorectal cancer, genes along this chain are damaged. Usually, a gene called APC, which is a "brake" on the WNT pathway, is damaged. Without a working APC brake, the WNT pathway is stuck in the "on" position. From : http://en.wikipedia.org/wiki/Colorectal_cancer Incidence And Mortality Colon cancer ranks 6th overall, 5th among males and 7th among females. An estimated 2,963 new cases, 1,548 in males 1,415 in females, together with 1,567 deaths will be seen in 1998. Colon cancer increases markedly after age 50. Risk factors & prevention
- 4. Personal or family history of colon cancer; personal or family history polyps in the colon; inflammatory bowel disease. Evidence suggests that colon cancer may be linked to a diet high in fat and deficient in whole grains, fruit and vegetables. Warning signals A change in bowel habits such as recurrent diarrhea and constipation, particularly with the presence of abdominal discomfort, weight loss, unexplained anemia, and blood in the stool. Early detection Unfortunately, early colon cancer is asymptotic, and there is still no efficient screening method for early detection. The aim should be earlier diagnosis of symptomatic patients who complain of changes in bowel habits, vague abdominal pains, and unexplained weight loss and anemia, particularly among patients 50 years old and above, by means of barium enema or colonoscopy. The mistaken obsession of our physician with amoebiasis and other forms of inflammatory bowel disease had for decades been a major factor that had delayed diagnosis of colon cancer. The wider availability of antidiarrheal, antibiotics and amoebecides may have worsened the situation. Too many physicians still insist in giving vitamin preparations and hematinics for chronic unexplained weight loss and anemia without carefully looking for the cause. Treatment Early colon cancer is curable, and surgery is the most effective method of treatment. From : http://www.doh.gov.ph/healthadvisories/coloncancer/ What is Hereditary Non-polyposis Colorectal Cancer?
- 5. HNPCC is an inherited colorectal cancer syndrome and accounts for 5 percent of all cases of colorectal cancer. The “H” stands for hereditary, meaning it is inherited or can be passed from parent to child; “N” stands for non-polyposis, contrasting it to the inherited condition FAP where hundreds to thousands of polyps develop in the colon; “CC” stands for colorectal cancer, the most frequent cancer that develops in these families. Patients with HNPCC have an 80 percent chance of developing colorectal cancer. The cause for HNPCC is due to an inherited mutation (abnormality) in a gene that normally repairs our body’s DNA. There are at least 5 genes that have been found to cause HNPCC. They are called Mismatch Repair Genes. If part of the DNA is not matched properly cancer can occur. Because the HNPCC gene mutation is present in every cell in the body’s other organs can develop cancers too. Cancer of the uterus (womb or endometrium) is very common and may be the main cancer in some HNPCC families. Other cancers can occur in the rest of gastrointestinal tract (stomach, small intestine, and pancreas), urinary system (kidney, ureter) and female reproductive organs (ovary). Although the risk to develop cancer in HNPCC is high, knowing about the risk of cancer and getting appropriate check-ups and treatment by experts in this disorder can save lives and prevent cancer. How is HNPCC diagnosed? Family History The first step in suspecting someone belongs to an HNPCC family is by reviewing the family history. The strictest definition of an HNPCC family is called the Amsterdam criteria. It includes: • 3 relatives with colorectal cancer (one first degree relative to the other two) • 2 successive generations • 1 colorectal cancer occurring in someone 50 years old or less
- 6. The colon cancers are often found in the right colon and usually occur before the age of 50. Other clues to an HNPCC family include multiple relatives with colon cancers, including relatives who have had more than one colorectal cancer, or a colon and endometrial cancer, and clusters of colorectal and other cancers of the gastrointestinal, urinary or female reproductive system. Genetic testing Colon examinations What lifestyle changes can be expected? Most patients are able to eat normal diets and lead normal lives following surgery. Some people notice more frequent bowel movements. Otherwise, their lives will be perfectly normal. Their sexual and social activities are unaffected. None of the procedures affects a man’s ability to father children or a woman’s ability to have a normal pregnancy. However, the way in which a baby is delivered may be affected by the type of surgery and should be discussed with the surgeon. What testing is needed to keep patients with HNPCC or at risk of HNPCC healthy?
- 7. III. Nutritional Assessments Desirable Body Weight = Height - 5”5 5x12 = 60 + 5 65 x 2.54 = 165.1 – 100 65.1 x .90 = 58.59 kg DBW = 58.59 kg Nutritional Status = (59kgs / 58.59kgs) x 100 NS = 100.70Normal IV. Dietary Requirement Diet for Colon cancer patients: Moving away from red meat, fatty foods, foods high in sugar, and refined grains to more fruits, vegetables and dietary fiber. A colon cancer diet many patients tolerate well includes: Whole grains Fresh, raw vegetables and fruits Legumes such as beans and lentils Non fatty fish, chicken and meats, free of hormones and additives These foods supply your body with: Complex carbohydrates Vitamins, minerals and enzymes Easily digestible protein
- 8. Vegetables with cancer preventive compounds include: Broccoli Cabbage Cauliflower Kale Winter squash TOTAL ENERGY REQUIREMENT TER =DBW x PA TER =58.59 x 30 *sedentary = 1757.7 kcal TER =58.59 x 27.5 *bed rest =1611.23 kcal CHO 60% 1758 X .60 1054.8 /4 263.7g CHON 20% 1758 X .20 351.6 /4 87.9g FAT 20% 1758 X .20 351.6 /9 39.1g FOOD EXCHANGE Food Items Exchange CHO CHON Fat Total Energy Calories Veg A 7 21 7 - 112 Veg B 6 18 6 - 96 Fruits 5 50 - - 200 Milk - - - - - Whole 1 12 8 10 170 Low Fat - - - - - Skimmed 2 24 16 Tr 160 Rice 5 115 10 - 500 Meat - - - - - Low 3 - 24 3 123 Medium 1 - 8 6 86 High 1 - 8 10 122 Fat 2 - - 10 90 Sugar 2 20 - - 80
- 9. TOTAL 260 *1040g 87 *348g 39 *351g 1739 kcal V. Sample Meal Plan Day Breakfast A.M. Snack Lunch P.M Snack Dinner Midnight Monday Veggie – Meaty sandwich, Low fat milk Pineapple slice Fresh fruits with sweet milk Menudo Rice Mango slices Water Papaya slice Nilagang baka Rice Melon slice water Milk Tuesday Mixed greens with croutons Orange juice Oranges Milk chocolate latte crackers Macaroni Lemon- Chicken Mango slices Mixed green salad Beef steak Milk or yoghurt Wednesda y Chicken Salad/ oats with fruits Honey dew chills Protein crackers Bangus friend Yangchow rice with veggies Vegetaria n delight Jasmine tea Oatmeal bars Milk banana Thursday Omelets Wheat bread Yellow tea Lumpiang sariwa Buko juice with milk Naicha Beef in chinese noodles Tomatoe delight bread Chopsuey in chicken Fresh milk Friday Caesar salad with thousand island dressing Maruya Choice of greens and fruits shake Vegetarian platter Four seasons squeeze Strawberr y tea Soft crackers Fish crouquette in sweet sauce Milk youghurt Saturday Pandesal Ham, bacon or eggs Inihaw na bangus Rice buko Crab louie delight Lumpiang ubod Pancit bihon milk Sunday Fish and potatoes Hot Chocolate Paella Mano shake Laing Water rice Green tea Embotido Crab soup Rice water cranberri es *** All meals should have glass of water. *** More vegetable dishes than red meat dishes. ***eat more white meat than red meat. *** Juices should be in form of fresh rather than can.
- 10. VI. Diagnosis & Goal Since the colon cancer is patented from the family genes. The family members should be conscious of their health lifestyle not only Paul. Dietary Plan should be taken care of to avoid aggravating the colon cancer cells. To extent patients longevity existence. To make and enable the person do simple tasks in daily intake. To ensure short term recovery goals be achieve and long term recovery goals be observe and imply the measures to the patient’s lifestyle. VII. Recommendations Undergo these procedures to confirm the level of the colon cancer rather than considering it as advance stage. There may be more than the illness stated or provided, if there are there will be more test to undergo before the surgery will be conducted. Digital rectal exam (DRE): The doctor inserts a lubricated, gloved finger into the rectum to feel for abnormal areas. It only detects tumors large enough to be felt in the distal part of the rectum but is useful as an initial screening test. Fecal occult blood test (FOBT): a test for blood in the stool. Two types of tests can be used for detecting occult blood in stools i.e. guaiac based (chemical test) and immunochemical. The sensitivity of immunochemical testing is superior to that of chemical testing without an unacceptable reduction in specify. Endoscopy: Sigmoidoscopy: A lighted probe (sigmoid scope) is inserted into the rectum and lower colon to check for polyps and other abnormalities.
- 11. Colonoscopy: A lighted probe called a colonoscope is inserted into the rectum and the entire colon to look for polyps and other abnormalities that may be caused by cancer. A colonoscopy has the advantage that if polyps are found during the procedure they can be removed immediately. Tissue can also be taken for biopsy. Homework Help https://www.homeworkping.com/ Math homework help https://www.homeworkping.com/ Research Paper help https://www.homeworkping.com/ Algebra Help https://www.homeworkping.com/ Calculus Help https://www.homeworkping.com/ Accounting help https://www.homeworkping.com/ Paper Help https://www.homeworkping.com/ Writing Help