Chapter 20: Nutrition Management of GI Cancers Flashcards
Nutrients absorbed in the ileum
Vitamin C Folate Vitamin B-12 Vitamin D and K Magnesium Bile salts and acids
Nutrients absorbed in the duodenum
Ca Phos Mg iron Copper selenium, thiamin, riboflavin, biotin, folate, Vit A, D, E, K
Nutrients absorbed in the jejunum
Thiamin, riboflavin, niacin, biotin, folate, B6, C, A, D, E, K, Ca, Phos, mg, iron, zinc, chromium, manganese, lipids, monosaccharides, amino acids, small peptides
Nutrients absorbed in the stomach
Eater, alcohol, copper, iodine, fluoride
Nutrients absorbed in the large intestine
Water, vitamin K, biotin, Na, Chloride, potassium, short chain fatty acids
_____ is the 7th leading cause of death in the US
gastric cancer
Survival rates of gastric cancer in the US
5 year >70% at stage 1
5 year 4% at stage IV
Overall 5 year 28% worsening with age >60 and tumors>5 cm or poorly differentiated
The majority of gastric cancers are ____
adenocarcinomas
Leading cause of gastric cancers, especially in the distal stomach
H. pylori
Risk factors for cancer in cardia/GEJ
Being overweight or obese
GERD
Risk factors for cancer in both cardia/non-cardia
Heavy alcohol intake
Smoking or other tobacco products
Lack of physical activity
Risk factors for cancer in non-cardia
chronic H. pylori infection Hypochlorhydria Atrophic gastritis autoimmune disorders Prior stomach surgeries Hx of childhood malnutrition salted and smoked foods (meats, fish, and pickled vegetables) Low intake of fruits and vegetables (particularly beta-carotene and vitamin C)
Frequent metastasis of gastric cancer
liver, lung, bone
Signs and symptoms of gastric cancer
Early satiety, heartburn, abd pain or discomfort, anorexia, unintended wt loss, anemia related to impaired iron absorption
Percent of individuals with malnutrition and wt loss with gastric cancer
> 70%
Diagnostic workup for gastric cancer
Upper endoscopy with biopsy, HER2/neu testing, EUS, CT scan, PET scan
Tx for gastric cancer
chemotherapy, biotherapy, radiation, surgery
NIS associated with gastric cancer tx
anorexia, N,V, gastric pain, wt loss
Surgeries for gastric cancer
Billroth I (gastroduodenostomy), Billroth II (gastrojejunostomy), partial gastric resection, and Rouex-en-Y
Chemos used for gastric cancer
Capecitabine (Xeloda), N,V,D Carboplatin (Paraplatin) N,V, Cisplatin (Platinol), N,V,D, taste Docetaxel (taxotere), N, V, D, mucositis Doxorubicin (Adriamycin) N,V,D, anorexia, mucositis Epirubicin (Ellence) N,V,D, mucositis Fluorouracil (5-FU) N,V,D, mucositis Irinotecan (Camptosar) anorexia, N,V,D Mitomycin (Mytamycin) anorexia, N,V,D, mucositis Oxaliplatin (Eloxatin)V,D,N, mucositis Paclitaxel (taxol), N,V,D,mucositis
Chemos used for colon cancer
Capecitabine (Xeloda), N,V,D Cisplatin (Platinol), N,V,D, taste Fluorouracil (5-FU) N,V,D, mucositis Irinotecan (Camptosar) anorexia, N,V,D Oxaliplatin (Eloxatin)V,D,N, mucositis Ziv-albercept (Zaltrap) anorexia, D, mucositis
Chemos used for gallbladder cancer
Capecitabine (Xeloda), N,V,D Cisplatin (Platinol), N,V,D, taste Fluorouracil (5-FU) N,V,D, mucositis Gemcitabine (Gemzar) D, mucositis Oxaliplatin (Eloxatin)V,D,N, mucositis
Chemos used for hepatocellular cancer
Cisplatin (Platinol), N,V,D, taste
Doxorubicin (Adriamycin) N,V,D, anorexia, mucositis
Fluorouracil (5-FU) N,V,D, mucositis
Chemos used for anal cancer
Cisplatin (Platinol), N,V,D, taste
Fluorouracil (5-FU) N,V,D, mucositis
Mitomycin (Mytamycin) anorexia, N,V,D, mucositis
NIS of radiation therapy to stomach, liver, and gallbladder
abd pain, N,V, urinary and bladder changes, D, changes in appetite, anorexia, fatigue
NIS of radiation therapy to small intestine, colon, and rectum
D, gas, bloating, urinary and bladder changes, proctitis, changes in appetite, anorexia, and fatigue
Biotherapies used for colon cancer
Bevacizumab (Avastin) anorexia, N,V,D,C,M
Cetuximab (Erbitux) A,N,V,D
Panitumumab (Vectibix) A, N,V,D,M
Regorafenib (Stivarga), A, N,V,D, M
Biotherapies used for gallbladder cancer
Bevacizumab (Avastin) anorexia, N,V,D,C,M
Cetuximab (Erbitux) A,N,V,D
Trastuzumab (herceptin) N,V,D
Biotherapies used for hepatocelluar cancer
Sorafenib (Nexavar) A,V,N,D
Biotherapies used for gastric cancer
Trastuzumab (herceptin) N,V,D