B2.066 Intro to Oncology Nutrition Flashcards
carcinoma
most common type
arise from epithelial cells (internal or external)
lung, breast, colon
sarcoma
supporting tissues
bone, cartilage, fat, connective tissue, muscles
lymphoma
lymph nodes and immune system tissues
leukemia
immature blood cells that grow in the bone marrow and accumulate in bloodstream
what are the 4 types of cancer staging?
clinical
pathologic (only in surgical patients)
post therapy
restaging
what are some cancer treatment options?
surgery radiation chemo targeted therapy differentiating agents hormone therapy immunotherapy
primary surgery
cancer is found only in one part of body
likely to be entirely removed
radiation
one of most common
high energy radiation to destroy or damage cancer cells
chemo
used to shrink tumors and stop growth/spread
target cells at different phases of cell cycle
targeted therapy
block or turn off chemical signals change proteins stop making new blood vessels trigger immune system carry toxins to cancer cells
differentiating agents
act on cancer cells to make them mature into normal cells
hormone therapy
used to slow growth of breast, prostate, and uterine cancers which normally grow in response to natural sex hormones
immunotherapy
boost immune system or train immune system to attack cancer cells specifically
identify the mechanism of methotrexate
prevents cells from using folate to make DNA and RNA
slows proliferation of cancer cells
antimetabolite
list the hallmarks of cancer and associated drugs that target each hallmark
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
sarcopenia
results from chronic inflammation associated with age
cachexia
results from inflammation associated with a primary disease
results of cachexia and sarcopenia
muscle atrophy and loss of muscle mass
disability
diminished quality of life
mortality
what are the stages of cachexia?
precachexia
cachexia
refractory cachexia (<3 mo expected survival)
distinguish precachexia from cachexia
pre: weight loss <5% anorexia and metabolic change cachexia: weight loss >5% or BMA <20 w >2% reduced food intake/ systemic inflammation
describe metabolic alterations that take place in cancer patients during tumor growth
- protein degradation stimulated in muscle
- circulation AA efflux
- liver increases gluconeogenesis
- 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
what are some organs other than muscle affected by cachexia
white adipose- wasting liver- acute phase response gut- malabsorption heart- cardiac dysfunction brown adipose- thermogenesis brain- anorexia
what are 3 supportive issues to consider with cachexia?
- ensuring sufficient energy and protein intake
- maintaining physical activity to maintain muscle mass
- reducing systemic inflammation
what % of cancers can be prevented?
50%
what cancers are increasing in incidence?
12/13 obesity related cancers
what foods can decrease cancer risk?
5-9 servings of fruits and veggies
what are the 10 recs for cancer prevention
- be as lean as possible w/o being underweight
- be physically active (30 min/day)
- avoid sugary drinks and energy dense foods
- eat more veggies, fruits, whole grains, legumes
- limit red meats and avoid processed meats
- limit alcohol
- limit sodium
- don’t use supplements to protect against cancer
- breastfeed for up to 6 months
- follow these after cancer treatment as well
surgery
eat sufficient protein and calories to maintain weight
get up and walk after
start w liquids then soft foods after
chemo/targeted
generally healthy diet
regular activity as tolerated
alleviating appetite/weight loss
5-6 smaller meals
protein/fat containing snacks
add more healthy fats for calories
drink caloric drinks between meals
alleviating bloating
5-6 smaller meals
cooked foods instead of raw
tea, broth, warm water w lemon
limit spicy/greasy/high fiber foods
alleviating change of taste/smell
choose foods that look/smell good marinate try tart foods and drinks make foods sweeter eat w plastic utensils
alleviating constipation
8 cups of liquid per day
hot liquids
high fiber foods
be active
alleviating diarrhea
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
alleviating dry mouth
sip water
suck on candy or ice chips
have sweet or tart foods and drinks
alleviating nausea
eat foods easy on stomach 5-6 smaller meals liquids room temp foods avoid spicy/greasy/sugary/milk products/alcohol/caffeine/sugar alcohols
