Chapter 16: MNT for PBT Flashcards
Cancers that originate in the brain are called?
Primary brain tumors
True or False: Benign tumors can be disabling or life threatening to due pressure on and destruction of normal brain tissue
True
True or False: Benign brain tumors are treated with the same modalities as malignant ones?
True
What are the 3 common treatment methods for PBT?
Chemo, RT, surgery
How many types of PBT are there?
120
How are PBT classified?
By histology. Grades 1-4, I-IV, or G1-G4
True or False: G4 tumors are high grade tumors that reproduce rapidly, often invading normal brain tissue, developing new blood vessels, and resulting in areas of necrosis, but rarely spread to other parts of the body.
True
What is secondary brain tumor?
Secondary (metastatic) tumors have spread to the brain from other types of cancer. Treatment options are different than PBT as they are based on where the cancer originated.
Most common types of PBT
Anaplastic astrocytoma and glioblastoma (38% of PBT)
Meningiomas (27% of PBT)
What is the largest risk factor for developing PBT?
Radiation exposure is the largest risk factor for PBT
Common side effects of treatment for PBT
Fatigue
Loss of appetite
Nausea
Vomiting
Alopecia
Loss of taste
Seizures
Why is hyperglycemia common with PBT?
Patients frequently receive dexamethasone to decrease peritumoral edema and radiation side effects.
Increased serum glucose is a/w insulin resistance, promotion of hepatic glucose production, and decreased insulin secretion from islet cells.
True or False - glucose management is a common goal for PBT population
FALSE
Patients are unlikely to have long-term diabetic complications and intense management of BG may decrease QoL
Common Chemos
Temozolomide (Temodar) - nausea, vomiting, constipation, fatigue
Procarbizine (Matulane) - nausea, vomiting, anorexia, stomatitis; avoid alcohol; AVOID TYRAMINE RICH FOODS
Lomustine (CNCU, CeeNu) - nausea, vomiting, anorexia, stomatitis; avoid alcohol
Vincristine (Oncovin) - constipation, wt loss, nausea, vomiting; avoid alcohol
Irinotecan (Camptosar) - diarrhea, anorexia, nausea, vomiting
Carmustine (Gliadel) - nausea, vomiting
Targeted Therapy
Bevacizumab (Avatin) - anorexia, stomatitis, nausea, vomiting, constipation, diarrhea
Anti-epileptics
Keppra, Vimpar, Lamictal, Depakote
Two treatment modalities being explored for PBT?
Ketogenic diet and Short-term Starvation (STS)
What is the largest challenge with the ketogenic diet?
Compliance
Modified Keto
Most people doing keto are doing “modified keto.” Daily carbohydrate intake is 10-20 grams. Ketogenic ratios of 1:1 or 2:1 are achieved. Instead of weighing foods, patients can read food labels
Classic Keto
Developed in 1950s
NOT a standard of care
4:1 ratio (90% of diet is fat) or 3:1 ratio (87% of diet is fat) to achieve ketosis
Negative side effects of ketogenic diets
Inadequate oral intake
Constipation
Nausea and vomiting
Weight loss
Acidosis
Hyperlipidemia
Vitamin and mineral deficiencies
Carnitine deficiency
Osteoporosis
Kidney stones
Decreased QoL
The side effects of PBT are comparable to ____
traumatic brain injuries
True or False: Brain tumors are considered low nutrition-risk cancers.
True
True or False: Headache is the most common presenting symptom of brain cancer.
True
Brain Stem cancers frequently cause ___ and ___?
Nausea, Vomiting
What is SIADH?
Syndrome of Inappropriate Antidiuretic Hormone secretion. It is occasionally caused by primary and metastatic brain tumors.
Nutrition impact symptoms a/w PBT
Dysphagia, constipation, fatigue, low or increased appetite, xerostomia, hyperglycemia, dysgeusia, ageusia
Goal of nutrition in PBT
Controlling physical symptoms that contribute to nutritional decline from the tumor itself, treatment and NIS
Caregiver support
End of life care
