B2.066 Intro to Oncology Nutrition

Question 1

carcinoma

Answer 1

most common type
arise from epithelial cells (internal or external)
lung, breast, colon

Question 2

sarcoma

Answer 2

supporting tissues

bone, cartilage, fat, connective tissue, muscles

Question 3

lymphoma

Answer 3

lymph nodes and immune system tissues

Question 4

leukemia

Answer 4

immature blood cells that grow in the bone marrow and accumulate in bloodstream

Question 5

what are the 4 types of cancer staging?

Answer 5

clinical
pathologic (only in surgical patients)
post therapy
restaging

Question 6

what are some cancer treatment options?

Answer 6

surgery
radiation
chemo
targeted therapy
differentiating agents
hormone therapy
immunotherapy

Question 7

primary surgery

Answer 7

cancer is found only in one part of body

likely to be entirely removed

Question 8

radiation

Answer 8

one of most common

high energy radiation to destroy or damage cancer cells

Question 9

chemo

Answer 9

used to shrink tumors and stop growth/spread

target cells at different phases of cell cycle

Question 10

targeted therapy

Answer 10

block or turn off chemical signals
change proteins
stop making new blood vessels
trigger immune system
carry toxins to cancer cells

Question 11

differentiating agents

Answer 11

act on cancer cells to make them mature into normal cells

Question 12

hormone therapy

Answer 12

used to slow growth of breast, prostate, and uterine cancers which normally grow in response to natural sex hormones

Question 13

immunotherapy

Answer 13

boost immune system or train immune system to attack cancer cells specifically

Question 14

identify the mechanism of methotrexate

Answer 14

prevents cells from using folate to make DNA and RNA
slows proliferation of cancer cells
antimetabolite

Question 15

list the hallmarks of cancer and associated drugs that target each hallmark

Answer 15

sustaining proliferative signaling- EGFR inhibitors
evading growth suppressors- CDK inhibitors
avoiding immune destruction- immune activating anti-CTLA4 MAb
enabling replicative immortality- telomerase inhibitors
tumor promoting inflammation- selective anti-inflamms
activating invasion/metastasis- inhibitors of HGF/c-Met
inducing angiogenesis- inhibitors of VEGF
genome instability and mutation- PARP inhibitors
resisting cell death- pro-apoptotic BH3 mimetics
deregulating cellular energetics- aerobic glycolysis inhibitors

Question 16

sarcopenia

Answer 16

results from chronic inflammation associated with age

Question 17

cachexia

Answer 17

results from inflammation associated with a primary disease

Question 18

results of cachexia and sarcopenia

Answer 18

muscle atrophy and loss of muscle mass
disability
diminished quality of life
mortality

Question 19

what are the stages of cachexia?

Answer 19

precachexia
cachexia
refractory cachexia (<3 mo expected survival)

Question 20

distinguish precachexia from cachexia

Answer 20

pre:
weight loss <5%
anorexia and metabolic change
cachexia:
weight loss >5% or BMA <20 w >2% 
reduced food intake/ systemic inflammation

Question 21

describe metabolic alterations that take place in cancer patients during tumor growth

Answer 21

1. protein degradation stimulated in muscle
2. circulation AA efflux
3. liver increases gluconeogenesis
4. tumor takes up glutamine and uses it for protein

same process from TAG breakdown in fats

tumor generates a lot of lactate from glucose utilization, lactate used for gluconeogenesis in liver

Question 22

what are some organs other than muscle affected by cachexia

Answer 22

white adipose- wasting
liver- acute phase response
gut- malabsorption
heart- cardiac dysfunction
brown adipose- thermogenesis
brain- anorexia

Question 23

what are 3 supportive issues to consider with cachexia?

Answer 23

1. ensuring sufficient energy and protein intake
2. maintaining physical activity to maintain muscle mass
3. reducing systemic inflammation

Question 24

what % of cancers can be prevented?

Answer 24

50%

Question 25

what cancers are increasing in incidence?

Answer 25

12/13 obesity related cancers

Question 26

what foods can decrease cancer risk?

Answer 26

5-9 servings of fruits and veggies

Question 27

what are the 10 recs for cancer prevention

Answer 27

1. be as lean as possible w/o being underweight 2. be physically active (30 min/day) 3. avoid sugary drinks and energy dense foods 4. eat more veggies, fruits, whole grains, legumes 5. limit red meats and avoid processed meats 6. limit alcohol 7. limit sodium 8. don't use supplements to protect against cancer 9. breastfeed for up to 6 months 10. follow these after cancer treatment as well

Question 28

surgery

Answer 28

eat sufficient protein and calories to maintain weight get up and walk after start w liquids then soft foods after

Question 29

chemo/targeted

Answer 29

generally healthy diet | regular activity as tolerated

Question 30

alleviating appetite/weight loss

Answer 30

5-6 smaller meals protein/fat containing snacks add more healthy fats for calories drink caloric drinks between meals

Question 31

alleviating bloating

Answer 31

5-6 smaller meals cooked foods instead of raw tea, broth, warm water w lemon limit spicy/greasy/high fiber foods

Question 32

alleviating change of taste/smell

Answer 32

``` choose foods that look/smell good marinate try tart foods and drinks make foods sweeter eat w plastic utensils ```

Question 33

alleviating constipation

Answer 33

8 cups of liquid per day hot liquids high fiber foods be active

Question 34

alleviating diarrhea

Answer 34

drink water to replace fluids let carbonated drinks lose their fizz before drinking 5-6 smaller meals Na and K replacement low fiber foods room temp foods avoid spicy/greasy/sugary/milk products/alcohol/caffeine/sugar alcohols

Question 35

alleviating dry mouth

Answer 35

sip water suck on candy or ice chips have sweet or tart foods and drinks

Question 36

alleviating nausea

Answer 36

``` eat foods easy on stomach 5-6 smaller meals liquids room temp foods avoid spicy/greasy/sugary/milk products/alcohol/caffeine/sugar alcohols ```