Chapter 16: Primary Brain Tumors Flashcards
Malignancies of the brain are called ________ rather than “cancer” because benign growths can be just as disabling/life threating
Tumors
There are over ______ different types of Primary brain tumors
120
What type of classification system do PBT use?
Histology (type of cell) and grade (how differentiated the cell is)
i.e. G4 tumors reproduce rapidly
T/F: Brain tumors rarely metastasize to other parts of the body
True
_______ is the largest risk factor for PBT development, however most have no apparent cause
Radiation exposure
T/F: There is a positive association w/ brain tumor incidence and diet quality
True
___________ is the most aggressive type of brain cancer
Glioblastomas
These are the 2 most common types of brain cancer in adults
Astrocytomas and glioblastomas
Treatment for brain cancers
Surgery low grade
Adjuvant chemoRT for higher grade
Most common side effects of brain radiation
Loss of appetite, N/V, hypogeusia, fatigue
Why are anti-epileptic drugs often ordered w/ PBTs?
Seizure activity
*Best to avoid those that do not interfere with chemo
________ ______ fields are low-intensity, electric fields are newly used for treatment of glioblastoma. Minimal side effects.
Tumor Treatment
Most common NIS for malnourished pts with brain tumors
N/V, dysphagia, headache, weight loss, fatigueh
What is the Prognostic Nutritional Index (PNI)
Derived from albumin & lymphocyte counts
(not a validated screening or assessment tool but has shown some interesting relationships)
Why is hyperglycemia common with PBTs
Steroids (dexamethasone) is often used to decrease peritumoral edema & reduce radiation side effects
*Hyperglycemia management usually isnt a goal d/t poor prognosis
_________ is often used as an adjuvant therapy to chemoRT but it isn’t the standard of care
Ketogenic Diets
(Promising results in animals but more studies needed in humans)
90, 8, 2
80,15, 5
When does the KD diet show most promise
When started during radiation for PBT
What are 2 contraindications for KD?
- Malnutrition
- Metabolic conditions (i.e. carnitine deficiency)
*steroids are not contraindicated but ketone levels may be lower w/ steroids)
KG diet equation
Fat grams: [grams pro + grams CHO]
Ratios usually used to achieve ketosis
4:1 or 3:1 (~90 energy from fat)
*must use food scale for accuracy
T/F: The Keto Diet is usually started inpatient
True, the modified atkins diet is usually started outpatient though
Ratios normally used for modified Atkins
2:1 or 1:1
(10-20 g CHO/day)
Websites used for Keto recipes & Modified Atkins
KetoDietCalculator through the Charlie Foundation
ruled.me & Cronometer mobile app & Modified Keto Cookbook
Many side effects from treatment for brain cancer is similar to those who experience ___________________
Traumatic Brain Injuries
T/F: Depression, fatigue, and impaired memory/reasoning are common with PBTs and may impact intake
True
_________ often assume burden for patients of PBT d/t impairments and this should be addressed
Caregivers
Take breaks, have a backup person, have people bring food, serve foods that are easy to eat with a spoon/hands, keep a notebook/log, use a pill organizer
Tips for memory
Using all 5 senses (touching, smelling foods), using word play, limiting overstimulation
An MCT supplement may be beneficial for managing _________ (side effect) of KD
Constipation
You may wish to decrease the KD ratio if
Experiencing N/V, losing too much wt
