Cancer Flashcards
What is cancer?
The abnormal division and reproduction of cells that can spread throughout the body, creating dysfunction within the body
Cancer cells are ____.
Abnormal
A dietician who specializes in oncology would need a ______ certification.
CSO- Certified specialist in oncology
An RD must have an ___ license before specializing in oncology.
RD
What are the 3 stages of carcinogenesis?
Initiation
Promotion
Progression
Oncology is the study of _____.
Cancer
Carcinogenesis is the ________ of cancer.
Development
- Initiation is where the initial ____ to the cells occur.
Damage
The ______ phase is where cells convert from a normal cell to an abnormal cell from either a mutation or DNA damage.
Initiation
- The promotion phase is when cells can develop into a ____, but may not be cancerous yet.
Mass
- During the progression phase, cells are considered to be ______ and create a cancerous tumor.
Malignant
T/F: Metastasis is a phase of carcinogenesis.
False, it refers to the spread of cancer, not the development
Cells that develop from the initiation, promotion and progression stages are a ______ type of cancer cell. During metastasis, it is still the _____ type of cell despite where the cells may have spread.
Specific, same
_________ MUST occur for the cancer to metastasize.
Angiogenesis (Cancer cells develop their own blood supply to help spread the cancer)
Angiogenesis in cancer is when the tumor begins to …
Develop new blood vessels
The top 10 cancers by rates of prevalence:
Breast - women
Prostate - men
Lung/Bronchiole
Colorectal
Uterine
Melanomas
Bladder
Lymphoma
Kidney
Thyroid
The top 10 deadly cancers are:
Lung and bronchiole
Breast - women
Prostate - men
Colorectal
Pancreatic
Ovarian
Liver/bile ducts
Leukemia
Lymphoma
Uterine
Americans can prevent ____ of the most common cancers with _______.
1/3, lifestyle
3 components of a healthy lifestyle include:
- Healthy diet
- Regular physical activity
- Maintaining a healthy/normal weight
Why is obesity a risk factor for cancer?
- Hormones
- Growth factors
- Leptin
- Adiponectin
Some cancers are exacerbated by a _______ in hormones (breast, pancreatic, endometrial).
Fluctuation
____ tissue is the main site for estrogen synthesis in post-menopausal women. The more body fat, the more estrogen produced, which may increase the risk for hormone dependent cancers.
Fat
Men with excess body fat tend to have ____ testosterone levels, which is associated with an increased risk of prostate cancer.
Lower
Excess body fat _____ estrogen synthesis in women and _____ testosterone synthesis in men.
Increases, decreases
Obesity ____ levels of IGF-1 and insulin (resistance), which increases proliferation of cancer cells, decreases the death of cancer cells and may promote growth of certain cancer cells.
Increases
______ is secreted from fat cells and promotes the growth of cancer cells.
Leptin
________ has anti-cancer effects but obese people have decreased levels in the body.
Adiponectin
_____ is considered an inflammatory biomarker.
Leptin
Obese people have low levels of ______ and high levels of leptin.
Adiponectin
______ can lead to Barret’s esophagitis and eventually esophageal cancer.
GERD
Known carcinogens in food:
Alcohol
Arsenic
Pesticides (PCB’s)
Processed meats (salted, cured, smoked)
Probable carcinogens in food:
Nitrates/Nitrites (can be converted in the body into a carcinogen)
Acrylamide
Polycyclic aromatic hydrocarbons
Red meat (high amounts of heme)
Very hot beverages
BPA (possibly but conflicting evidence)
Alcohol is a carcinogen because it is metabolized into the toxin ______ and hydrogen, promotes _____ stress.
Acetaldehyde, oxidative
The metabolism of acetaldehyde from drinking acetaldehyde damages cells as it is toxic. This would be part of the _______ phase of carcinogenesis.
Initiation
Alcohol acts as a ______ which increases the _______ of other carcinogens, increasing the damage done to the body (alcohol + smoking).
Solvent, solubility
Alcohol ______ levels of hormones which effects estrogen, increasing the risk of breast cancer.
Alters
Arsenic is normally found in soil, but in foods it is found in ____ and pear seeds, pits of cherries, and rice.
Apple
Nitrates/Nitrites in food are found in:
Cured meats
Processed foods
Deli meats
But also includes green leafy veggies which is why they are probable carcinogens
Consuming fish from ______ waters, increase PCB’s risk.
Contaminated
PCB’s accumulate in the ____ of fish.
Fat
Ways to reduce the risk of PCB’s:
Don’t eat the skin/fat of fish
Eating fish that are not from contaminated waters
PCB’s are _____, but still leak into the water where fish accumulate PCB’s in their flesh, mainly their fat.
Banned
Acrylamide is the compound that forms when ____ foods are cooked at really high temperatures (ex. French fries, chips, burnt toast, coffee).
Starchy
Coffee may have some acrylamide, but is also associated with _____ cancer risks due to antioxidant properties.
Reduced
________ blocks the conversion of nitrates/nitrites into nitroamides and nitrosamines, preventing their carcinogenic effect.
Vitamin C
Nitrates/nitrites combine with amino acids in the body to form nitroamides and nitrosamines which are ______.
Carcinogenic
Some processed meats include ______ acid to limit carcinogenic effect.
Ascorbic
Polycyclic aromatic hydrocarbons are formed when meat is _____. The smoke from fatty meats and char on meat are both carcinogens.
Grilled
Grill _____ fat or _______ meats to reduce carcinogenic effects, also adding herbs/marinating.
Lower, skinless
______ helps prevent the meat from absorbing excess smoke when grilling, reducing the carcinogenic effect.
Marinating
High amounts of ____ in red meat can damage the inner lining of the stomach, resulting in possible stomach cancer.
Heme
Very hot beverages may result in ________ cancer.
Esophageal
BPA is found in _______ foods, wrappers, and plastics.
Canned
_______ fats (flax, hemp, chia seeds, walnuts) inhibit carcinogenesis.
Omega 3
Omega 9 (olive oil and avocado oils) are ________ and may decrease carcinogenesis.
Anti-inflammatory
Animal proteins tend to contribute to carcinogenesis, while plant proteins may ______ carcinogenesis.
Inhibit
Non-dietary factors that may initiate cancer cells:
Oxidative stress
UV rays/radiation
Aging
Genetics
Exposure to toxins: tobacco, pollution
BPA chemicals/pesticides
Metabolic stress
Viruses (HPV - cervical and head/neck cancers)
T/F: Sugar is carcinogen.
False, but sugar overconsumption can lead to weight gain, and excess body fat is a risk factor for cancer
Non-nutritive sugars approved by the FDA are (6):
Saccharine (sweet n low)
Aspartame (Equal)
Acesulfame K
Sucralose/Splenda
Stevia
Monk fruit
_______ was previously banned by the FDA due to increasing cancer in rats, but it is now allowed.
Saccharine (Sweet n low)
Artificial non-nutritive sweeteners
Saccharine (Sweet n low)
Aspartame (Equal)
Acesulfame K
Sucralose (Splenda)
Natural non-nutritive sweeteners
Monk fruit
Stevia
T/F: Fiber alone significantly reduces cancer risks.
False, but high fiber foods may reduce cancer risks
Benefits of fiber:
Regulates blood sugar and satiating (helps prevent weight gain)
Helps decrease transit time, carcinogens are excreted at a faster rate
Fermented fiber in the colon creates SCFA (butyrate) which are fuel sources for the microbiome and immune system
________ deficiency is associated with an increased risk of almost all cancers.
Vitamin D
_________ inhibits tumor angiogenesis (which is necessary for cancer cells to metastasize), which prevents the tumors ability to produce new blood vessels.
Vitamin D
We should be in the ______ range for vitamin D.
Optimal
T/F: Phytochemicals are nutrients.
False, but they have antioxidant properties
We should eat a _____ of fruits and vegetables to encourage phytochemicals and reduce cancer risks.
Variety
Phytochemicals reduce cancer by 3 mechanisms:
Antioxidant: neutralize free radicals
Anti-inflammatory
Promotes a diverse microbiome
Probiotics and ______ may help reduce cancer.
Prebiotics
Excessive ________ may increase cancer risks, which is why we do not encourage supplements.
Anti-oxidants
_______ beverages are empty calories that lead to weight gain.
Sweetened
T/F: To prevent cancer, limit alcohol consumption.
False, avoid it
Breastfeeding reduces the risk of ______ cancer in mothers and all cancers in babies.
Breast
T/F: Use supplements for cancer prevention.
False, unless vitamin D. Try to get adequate nutrients from food sources first instead of high dose supplements.
Diagnosis of cancer depends on the type of cancer, but usually follows the _______ guidelines.
CAUTION
C in CAUTION
Change in bladder or bowel habits
A in CAUTION
A sore that doesn’t heal
U in CAUTION
Unusual bleeding or discharge
T in CAUTION
Thickening or lump
I in CAUTION
Indigestion or difficulty (chewing/swallowing)
O in CAUTION
Obvious change in wart or mole
N in CAUTION
Nagging cough or hoarseness
Patients with cancer may present with (6):
Anorexia
Fatigue
Weight loss
Anemia
Fever
Sweating
Imaging for cancer (3):
CT
MRI
PET scan
Biopsy
- also depends on the areas
Stages of cancer
0-4
Cancer surgery nutrition requirements
Increased energy and protein for recovery
Site specific for nutritional side effects
Radiation therapy
Site specific for nutritional side effects
(ex. Intestinal radiation may cause malabsorption, esophageal cancer may cause trouble swallowing)
Anti-neoplastic therapies (3):
Chemotherapy: kills cancer cells
Biotherapy: helps boost immune system to fight cancer
Hormonal therapy: estrogen blocking
- All have side effects
Anti-neoplastic therapies are ______, and can create side effects throughout the entire body.
Systemic
Hematopoietic are cell transplantations used for ____ cancers.
Blood
Palliative care discontinues comfort care, but still gives patients ____ management medications.
Pain
Malnutrition during cancer may cause complications:
Increased mortality
Increased disease severity
Poor surgical outcomes
Decreased continuation of treatment
Increased side effects/toxicities
Increased cancer recurrence
Cancer is a ______ illness, resulting in hypermetabolism. Patients need an increase in energy and protein depending on their weight and needs.
Catabolic
Supplements for cancer:
Multivitamin
Vitamin D
Omega 3 fatty acids
MNT for cancer main goal:
To prevent malnutrition
Surgery and radiation are both ____ specific, while anti-neoplastics are systemic.
Site
Side effects of cancer treatment:
Anorexia (loss of appetite)
Nausea
Vomiting
Diarrhea
Constipation
Altered taste/smell
Neutropenia
Xerostomia
Mucositis
How to treat anorexia (loss of appetite):
Oral beverage supplements (Ensure/Boost)
Calorie/protein/fat dense foods
SFM
Appetite stimulants
Liquids between meals (to prevent fluids taking up too much space)
Eating by the clock (whether or not they’re hungry)
Types of appetite stimulants (3):
Megace (hormonal)
Marinol (marijuana)
Remeron (anti-depressant)
How to treat N/V:
Zofran - antiemetic, helps vomiting
Ginger - helps nausea
Peppermint oil/tea
Bland and simple foods
SFM
Cold/room temp foods to limit smell
Keep head elevated after eating (promote digestion)
Replace fluid and electrolytes
How to treat diarrhea:
Imodium
Anti-diarrheal medication
BRAT diet: Bananas, rice, applesauce, toast
Clear liquids/White starchy foods
More soluble fiber to slow transit time
Foods that add bulk to stool/Tea
Avoid sugar/sugar alcohols
Probiotics - specific strains
Replace fluid and electrolytes
How to treat constipation:
Lots of fluids and fiber
Mg citrate supplements
Laxative
Prunes
Physical activity
Probiotics - specific strains
How to treat altered taste (metallic) or smell:
Marinades and sauces to mask metallic taste of meat
Other protein sources that are not meat
Serve food cold or at room temp
Non metal plates and utensils
How to treat neutropenia (low wbc count)/immunocompromised:
Concerns: foodborne illness
Wash produce
Peel/cook produce
Fully cooked and pasteurized foods/juices
Proper hygiene
How to treat xerostomia (dry mouth):
Sour/hard candies to stimulate saliva production
Fluids throughout the day
Frozen foods
Avoid dry foods: crackers
Sauces/gravies
Poaching/steaming
Avoid diuretics: alcohol, mouthwash, coffee
Humidifier when sleeping (bloody noses, dry oral cavity)
How to treat mucositis (inflammation of mucosal lining in oral cavity):
Fluids
Soft foods to prevent roughage
Avoid acidic/spicy foods
Avoid hot foods
L-glutamine supplements: promotes healing in the lining of the oral cavity
Cancer cachexia is characterized by:
Severe malnutrition
May be due to cancer and treatment
Anorexia
Weakness
Hypermetabolic
Increased energy expenditure
Immunosuppression
Muscle wasting
Cancer cachexia causes (2):
Increased inflammation which breaks down protein excessively
Increased immune response
Patients with cancer and HIV often seek complementary and ______ care.
Integrative
Potential risks of alternative cancer therapies:
Adverse reactions with chemotherapy
Cancer therapy supplements that show promise:
Medicinal mushrooms, selenium, vitamin D, curcumin, omega 3 fatty acids
Foods that may cause an adverse reaction with chemotherapy:
Garlic, green tea, mistletoe, Chinese herbs, St. Johns wart
Compared with people with a healthy body weight, the overall risk of cancer in people with obesity is _____.
Higher (hormone imbalance, increased estrogen, lower testosterone, higher leptin, lower adiponectin, increased IGF1 and insulin resistance)
Examples of a dietary component that inhibits carcinogenesis includes _________.
Phytochemicals
The best way to ensure intake of a variety of phytochemicals is to:
Includes fruits and vegetables with a variety of colors (we recommend food sources over supplements)
T/F: Sometimes cooking enhances the phytochemicals in fruits or vegetables, like in tomatoes.
True, which is why its important to include both cooked and raw
