Chapter 1: Cancer & Nutrition-Significance & Background

Question 1

5 most common types of cancer in the US for men

Answer 1

Prostate
Lung
Colorectal
Urinary Bladder
Melanoma

Question 2

What fraction of cancer deaths are related to obesity, physical activity and poor nutrition?

Answer 2

1/3

Question 3

Which 2 nutrients play a role in DNA repair?

Answer 3

Selenium and Folate

Question 4

T or F: TNM Classification for tumor staging refers to — Tumor Nodes Mass

Answer 4

False

Question 5

“Apoptosis” refers to

Answer 5

Programmed Cell Death - “a programmed sequence of events leads to the elimination of cells”

Question 6

One of the most widely used tumor staging tools is known as:

Answer 6

TNM - The Tumor, lymph Nodes, and Metastasis classification system

Question 7

Grade G2 is associated with what type of differentiation?

Answer 7

Intermediate Grade

Question 8

T of F: A palpable tumor can still be classified as T1 Disease?

Answer 8

False - T1 is defined as “not palpable or visible by imaging”

Question 9

73 year old male diagnosed with T3N2Mx Squamous cell carcinoma of the oropharynx. Summarize the primary tumor via the TNM system

Answer 9

Tumor extends to the neighboring tissue

Question 10

Food components such as Curcumin may play a role in carcinogenesis by inducing apoptosis and by inhibiting angiogenesis. What food product should be recommended to increase intake of Curcumin?

Answer 10

Tumeric

Question 11

There is evidence that nutrients may play a protective role in carcinogenesis. What nutrient can be both protective of carcinogenesis and alternatively accelerate cancer cell proliferation, depending on the stage of carcinogenesis the cell is in?

Answer 11

Folate - adequate folate has been shown to be associated with lower cancer risk however, once carcinogenesis has begun folate can accelerate it

Question 12

Which nutrient in the form of calcium leucovorin may be used to “rescue” patients from methotrexate toxicity or alternatively enhance the effectiveness of drugs such as 5-fluorouracil?

Answer 12

Folate

Question 13

A new oncology fellow asks you how you can help a cancer patient using nutrition. You tell her that nutrition intervention during cancer treatment is associated with:

Answer 13

Fewer side effects, fewer hospitalizations, and better quality of life

Question 14

The cause of most cancers can be attributed to?

Answer 14

Internal factors - like hormones and immune system

External factors - like infection, environmental toxins, and behaviors like smoking, sunlight exposure and unhealthy diet

Question 15

A 55 year old woman diagnosed with cancer. What nutrition issue may she encounter in the early post-treatment time?

What long term side effects might effect her cancer survivorship?

Answer 15

Early post-treatment: Fatigue, Endocrine disorders, and Cognitive deficits

Long term post treatment: Weight Changes, cognitive deficits, and endocrine disorders

Question 16

Supplementation of this nutrient is suspected of increasing rate of colorectal cancer?

Answer 16

Folate

Question 17

What does the TNM stand for when used for staging?

Answer 17

T: size and/or extent of the tumor
N: extent of spread to local lymph nodes
M: presence of distant metastasis

Question 18

What is the term for the process by which normal cells transform into cancer cells, usually as a result of accumulating genetic damage?

Answer 18

Carcinogenesis

Question 19

Which nutrient can help prevent methotrexate toxicity? In what form?

Answer 19

Folate — in the form of calcium leucovorin

It is also used to enhance the effectiveness of drugs that target enzymes that use folate as a cofactor such as 5-fluorouracil.

Question 20

What are the 5 most common cancer types in the U.S for women?

Answer 20

breast
lung
colorectal
uterine
thyroid

Question 21

What nutrients may have an effect during cell cycle arrest and aptosis?

Answer 21

selenium and curcumin

Question 22

Food components that have protective effects in carcinogenesis. What mechanism of action is found for the following components?

Folate
Curcumin
Indole-3-Carbinol
Selenium

Answer 22

Folate - DNA synthesis and DNA repair

Curcumin - Induce apoptosis and inhibit angiogenesis

Indole-3-Carbinol - Influence estrogen regulation and induce cell cycle arrest

Selenium - Alter hormone regulation

Question 23

What are potential nutritions issue during initial cancer treatment?

Answer 23

Anorexia
Taste changes
GI symptoms (i.e. N/V/D)

Question 24

Name different types of cancer screening methods and give examples

Answer 24

physical examination: breast/testicle self exams, skin exam looking for pigmentation

blood tests: PSA

imaging: mammograms, colonoscopies

molecular tests: genotyping

Question 25

Explain the different grades of the Tumor part of TNM

Answer 25

``` Tx=cannot be evaluated T0=no evidence of tumor Tis=in situ, abnormal cells that have not spread, possibly precancerous T1=not palpable or visible by imaging T2=confined to primary cancer site T3=extends to neighboring tissue T4=metastatic disease ```

Question 26

Explain the different grades of the Lymph Nodes part of TNM

Answer 26

Nx=regional lymph nodes cannot be evaluated N0=no regional lymph node involvement N1, 2, 3=involvement of regional lymph nodes (number/extent of spread)

Question 27

Explain the different grades of the Metastasis part of TNM

Answer 27

Mx=distant metastasis cannot be evaluated M0=no distant metastasis M1=distant metastasis present

Question 28

Explain the Histological Cancer Tumor Grading System

Answer 28

``` Gx - undetermined/can't be assessed G1 - well-differentiated (low grade) G2 - moderately differentiated (intermediate grade) G3 - poorly differentiated (high grade) G4 - undifferentiated (high grade) ```

Question 29

Potential Nutrition Issues - Cancer Prevention

Answer 29

``` Obesity, body fatness Energy-dense food intake Excessive micro nutrient intake from dietary supplements food contaminants (toxins, chemicals) ```

Question 30

Potential Nutrition Issues - Initial Treatment

Answer 30

``` Side Effects of Treatment Fatigue Pain Anorexia Treatment-related cachexia Immuno-suppression Weight/body composition changes Drug-nutrition interactions ```

Question 31

Potential Nutrition Issues - Early Post Treatment

Answer 31

``` Fatigue Pain Endocrine disorders Weight / body composition changes cognitive deficits dental caries/complications ```

Question 32

Potential Nutrition Issues - Long term Cancer Survivorship

Answer 32

``` weight changes osteoporosis endocrine disorders cardiovascular complications cognitive deficits dental caries/complications ```