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NUTR 4040 > CANCER > Flashcards

CANCER Flashcards

1
Q

What is cancer

A

uncontrolled cell growth, not faster rate of growth

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2
Q

what is a neoplasm

A

abnormal growth of cells

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3
Q

etiology/pathophysiology of cancer

A
  1. carcinogen
  2. initiation
  3. promotion ‘
  4. tumour formation
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4
Q

main cause of death in cancer

A

cachexia

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5
Q

sarcoma

A

connective tissue

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6
Q

carcinoma

A

epithelial tissue

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7
Q

lymphoma

A

lymphatic tissue

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8
Q

TNM diagnosis system

A

T- how big is the tumoir
N- node involvement
M- metastes?

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9
Q

med management of cancer

A

surgery
chemo
immunotherapy
radiation

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10
Q

why is chemo given in cycles

A

resistance
also need time for healthy cells to rebuild
toxic to bone = wbc loss, platelets, anemia

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11
Q

main types of chemo

A
  1. dna synthesis inhibitors
  2. dna replication inhibitors
  3. hormones
  4. immunotherapy
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12
Q

types of radiation

A

external beam therapy
brachytherapy
systemic radiation

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13
Q

external beam therapy

A

machine outside body, targets cancer area

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14
Q

brachytherapy

A

radioactive material placed inside, taget area closley

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15
Q

systemic radiation therapu

A

radioactive drugs via oral or veins

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16
Q

radiation side effects

A

fatigue
anorexia
dysguisia

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17
Q

dysguisia

A

altered sense of taste

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18
Q

immunotherapy types

A

immune checkpoint inhibitors
t cell transfer therapy
monoclonal antibodies
cancer treatment vaccines

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19
Q

what is the main goal in nutr managament of cancer

A

prevent malnutrition

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20
Q

how is nutr managament affected by cancer

A

via cancer itself
via medical management

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21
Q

why is MN concerning in cancer

A

effects the effectiveness of treatment
- surgery = dont recover quick
- chemo = decreased tolerance
- radiation = wt changes = tattpp accuracy
- immunotherapy = immune sustem not working as well

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22
Q

why woukd chemo not work well if ur MN

A

meds are metabolized in lean muscle tissue
mn = loss of tissue = toxic
= treatment delays = poor effieciency

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23
Q

caxechia

A

type of protein energy MN ‘
its wt loss bc of metabolic changes

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24
Q

signs of cachexia

A

severe wt loss
anorexia
nuausea
early satiety
muscle wasting
increased REE
immunosuppression
fluid retention

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25
Q

what makes caxechia special?

A

its metabolic changes that cause equal mobilization of fat and muscle protein even tho ur eating properly when normally it should be only fat

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26
Q

an obese cancer pt is still at risk for caexchia

A

yes - bc the pt loses muscle mass but retains fat mass
- losing wt but still obsese
- low mucles/high fat mass = problem

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27
Q

when woudl you see hypometabolism ina cancer pt

A

when there is muscle wasting
less muscle = less metabolically active tissue = hypometabolic

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28
Q

how is EE affected in cnacer

A

can cause hypo, hyper and normo metabolism

29
Q

starvation REE vs cancer REE

A

starvation = losing mass but low M rate
cancer = losing mass but high M rate

30
Q

fat metabolism in cancer

A

increased lipolysis
decreased lipgenesis
= fat loss and hypertriglyceridemia

31
Q

why increased fat breakfown in cancer

A

cancer = release cytokines = signals tissues to release fat

32
Q

cho

cho metabolism in cancer

A

everything working to increase glucose levels bc cancer cells love it
- IR, glucose intolerance
- gluconeogensis
- cori cycle
- =pt usually hyperglycemi

33
Q

usual glycemic state for cancer pt

A

hyperglycemic

34
Q

how does improper cho metabolism drive caxechia

A

over reliance on fat and protein for energy source
inflamm cytokines= ir
glucoeoegensns = skm breakfown for glucose formation

35
Q

what happens to pro metabolism in cancer

A

overall increased depletion of FFM

36
Q

drivers of FFM loss in cancer

A
  • AA not spared
  • increased proteolysis, decreased synthesis
    = muscle wasting
  • AA leftover prioritized for acute phase proteins since they respond to stress/inflammation
37
Q

cho metabolism in starvation vs cancer

A

starvation
- protein spared from being used as fuel
= less proteloysis = less FFM depleton
-preferred breakdown of fat over muscle

cancer
- protein AA not spared
- both fat and muscle breakdown preferred

38
Q

cancer nutr management; how do we adjust EE

A

REE x 0.7-1.7 (stress factor)

39
Q

cancer nutr management; how much protein

A

0.5-2 g/kg

40
Q

cancer nutr management; how much cho

A

individualized

41
Q

cancer nutr management; how much fat

A

individualized

42
Q

cancer nutr management; how much Mv

A

RDA levels but nooooo antioxidants

43
Q

cancer nutr management; how much fluid

A

35 mL/kg

44
Q

what do chemo and radiation affect mostly?

A

side effects related to GIT
bc they are dividing quick cells

45
Q

Non metabolic contributors to MN in cancer

A
  1. hypermetabolism
  2. anorexia
  3. malabsorption/diarrhea
  4. mucositis/esophagitis
  5. dysgeusia
  6. xerostomia
46
Q

treatment for hypermetabolism

A

high protein high energy intake

47
Q

causes of anorexia in cancer

A
  • psycological state
  • tumour in GIT =obstruction
  • tumour releasing cytokines
  • side effect of treatment
48
Q

ways to treat anorexia in cancer

A
  • max kcal in every bite
  • limit low e foods
  • limit high fiber foods
  • small frequent meals snacks
  • cold foods better tolerated
  • avoid meal prep/smell of food
49
Q

malabsorption and diarrhea causes in cancer

A

tumour obstruction
MN cuases villi to flatten
nature of therapy

50
Q

treatment of diarrhea in cancer

A
  • meds
  • small frequent meals
  • limit bowel stimulant foods
  • decrease fat intake, lactose
  • more soluble fibre = bulking
  • k rich foods
51
Q

mucositis and esophagitis causes in cancer

A

bc of treatment

52
Q

treating muscositis esphogitis

A

no hot, spicy salty sharp foods
soft moist foods
fluid intake
rinse mouth often
antacids for esophagitis

53
Q

causes for dysgeusia

A

bc of treatment
rapidly dividing cells always affected

54
Q

treatment for dysgeusia in cancer

A
  • rinsing mouth before after eating
  • drinking w meals
  • experiment w food flavours
  • mild tasting foods
  • adding mixed foods with meat or acid
  • plastic cutlery
  • avoiding fav foods
55
Q

xerostomia causes cancer

A

treatment

56
Q

treating xerostomia in cancer

A
  • water intake
  • oral sprays
  • saliva subs
  • humidifier
  • chew gum, candiesm
  • xylotol pastilles
57
Q

Non Nutr related issues in cancer

A
  1. eutopic hormones
  2. hypercalcemia
  3. osteomalcia
  4. hyponatremia
  5. anemia
58
Q

whats the issue with increased eutopic H

A

cancer makes toooo much release of these hromones = metabolic issues

59
Q

examples of eutropic H issues in cancer

A

breast cancer = too much insulin = hypoglycemia
lung cancer = too much calcitonin = ca metabolism

overall metabolic rate affected

59
Q

how can we treat eutrophic h issues in cancer

A

glucose metabolism = meds similar to t2d treatment
closely minitor needs

59
Q

causes of hypercalcemia in cancer

A

overall increased bone breakdown via hormones that promote resorptoon
- bone mestastis
- PTH increase
- calcitriol oroduction

60
Q

how do u treat hypercalcemia in cancer

A

never reduce diet Ca
- increase fluids = excrete Ca
- calcitonin in meds = increases excretion and decreasing resorption

61
Q

osteomalacia causes

A

bones soft n weak
due to tumours releasing less calcitriol, pth, hypocalcemia, hypophospahtemia

62
Q

treatment of osteomalacia

A

remove tumour

63
Q

causes of hyponatremia

A

tumor or treatment

64
Q

treating hyponatremia in cancer

A

fluid restriction
meds
saline infusion

65
Q

anemia causes in cancer

A

nutr def
hemolysis via chemo
bone marrow failure

66
Q

anemia tratment in cancer

A

fix underlying problem
suppmelentation

NUTR 4040 (4 decks)

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