Chapter 20: MNT for GI Cancers Flashcards
What nutrients are absorbed in the stomach?
water alcohol copper iodide fluoride molybdenum
What nutrients are absorbed in the Duodenum?
Ca Phos Mg Fe Copper Selenium Thiamin Riboflavin Niacin Biotin Folate Vit A Vit D Vit E Vit K
What nutrients are absorbed in the Ileum?
Vit C Folate B12 Vit D Vit K Mg
bile salts/acids
What nutrients are absorbed in the Large Intestine?
water Vit K Biotin Sodium Chloride K+ SCFAs
What nutrients are absorbed in the Jejunum?
Thiamin Riboflavin Niacin Pantothenate Biotin Folate Vit B6 Vit C Vit A Vit D Vit E Vit K Ca Phos Mg Fe Zinc Chromium Manganese Molybdenum
Lipids
Monsaccharides
AAs
Small peptides
Name the two sections of the stomach
Upper - proximal (contains cardia [closest to esophagus], fundus and body)
lower - distal (antrum and pylorus)
What is believed to be the leading cause of gastric CA?
H pylori infections, particularly with distal stomach CA
Where do gastric CAs most frequently metastasize to?
liver, lung and bone
What are risk factors for gastric CA?
GERD Obesity Etoh/smoking lack of physical activity chronic H pylori infections hx of gastric surgeries salted/smoked foods high heme iron intake from meats high intake of grilled/processed meats low intake F/V, particularly betacarotene ones and Vit C
Name the common chemos for GI CA?
Xeloda Paraplatin (Carbo) Cisplatin Taxotere (Docetaxel) Adriamycin Epirubicin (Ellence) 5-FU Gemzar (Gemcitabine) Camptosar (Irinotecan) Mitomycin Oxaliplatin (Eloxatin) Taxol Zaltrap
What are common side effects from XRT to the abd (stomach/liver/gallbladder)?
abd pain/discomfort N/V Urinary/bladder changes D decreased appetite anorexia fatigue
What are common side effects from XRT to the pelvis (Sm Intestine, colon, rectum)?
D bowel gas (and anus) bloating urinary/bladder changes proctitis decreased appetite anorexia fatigue
What are the common biotherapies used for GI CA?
Avastin Erbitux Vectibix Nexavar Stivarga Herceptin
What are some sign/symptoms of gastric CA?
early satiety (full/bloating) heartburn/indigestion abd pain N/V (with or wout blood) anorexia and unintended wt loss
Also unexplained anemia (from GERD)
Name the possible nutrition related complications from Gastric CA surgery?
Surgery itself - partial/total gastrectomy
GERD
Dumping Syndrome
Osteoporosis risk
Vit/Min malabsorption - Fe, B12, folic acid
MNT for Gastrectomy
Pre-op - small/freq meals, soft/easy-to-digest foods and fluids
post-op - small/freq meals, soft/easy-to-digest foods and fluids
initially limit refined CHO and lactose
avoid greasy/fried foods and initially limit total fat foods
include protein at east meal
seperate solids from fluids, wait 30-60 min before/after eating solids to consume liquids
What are the risk factors for colon CA?
over 50 presence of adenoma polyps in colon inherited syndromes race/ethnicity - AAs, Ashkenazi jews DM II obesity, particularly abd obesity smoking/etoh physical inactivity UC or Crohn's diet high in red/processed meats/grilled meats low serum Vit D and low Ca intake
What are signs/symptoms of Colon CA?
change in bowel habits (having D or C, narrowing of stool) also, heme+ stools or unexplained anemia abd pain/bloating N/V blood in stool unintended wt loss fatigue
Name the common surgeries for colon CA?
left colectomy - portion of colon taken (transverse or desending colon)
right colectomy - portion of colon taken closest to small intestine (cecum or ascending colon)
sigmoid colectomy - portion of colon taken at the end of colon/near rectum (sigmoid)
Low anterior resection - sigmoid colon/rectum removed, reconnected right to anus
abd perineal resection - portion of desending, all of sigmoid/rectum/anus taken - stoma created (permanent)
segmental resection - transverse colon taken
What is the diet recommendation for Colon CA survivors?
reduce red/processed meats limit etoh increase F/V/fiber maintain healthy wt add physical activity adequate Vit D levels
MNT for bowel resections/ostomies
small/frequent meals
fluids/electrolytes in small/frequent amounts as well - recommended to consume 1 L more than ostomy output
May need sports drinks to help with losses of electrolytes
Initially a low fiber, low fat, soft diet needed for 6-8 weeks, after that gradual introduction to other foods as able. most can eat majority of foods further out from surgery
ostomies have foods to watch for blockage/odor/consistency concerns
Risk factors for HCC?
Male Hep B or C Etoh Aflatoxin Hemochromatosis inherited metabolic diseases cirrhosis obesity DM II anabolic steroids
What are the most common causes for HCC in the US specifically?
Cirrhosis from chronic Hep C
Etoh abuse
NAFLD
What are the common treatment options for HCC?
Surgery - resection, or partial/total transplant (rare-most don’t qualify due to underlying risk factors)
Ablation - directly into the tumor, usually
