Chapter 22: Lung cancer

Question 1

T/F: Lung is both the most common and deadliest form of cancer in the USA

Answer 1

True

Question 2

8 risk factors for lung cancer

Answer 2

Smoking (80% cases attributed)

Secondhand smoke

Exposure to asbestos

Exposure to radon (found from soil)

Inhalation of chemicals (air pollution, workplace)

hx of radiation to the thoracic region

Family hx

HIV

Question 3

_______ is a surprising risk factor for lung cancer

Answer 3

HIV

Question 4

Link between carotenoids & lung cancer

Answer 4

Decreased risk w/ food-containing carotenoids while B-carotene supplements increased risk

Question 5

A _______ diet may lower the risk for lung cancer in heavy smokers

Answer 5

Mediterranean

Question 6

3 types of non-small cell lung cancer (80-85% of cases)

Answer 6

1. Squamous cell
2. Adenocarcinoma
3. Large cell

Question 7

_________(type of lung cancer) begins in the bronchi and is most closely related to smoking

Answer 7

Squamous cell

Question 8

______ (type of lung cancer) can occur in any part of the lung but is usually asymptomatic & metastasizes rapidly

Answer 8

Small cell

Question 9

______ (type of lung cancer) occurs in any part of the lung and tends to metastasize rapidly, but not as quickly as small cell

Answer 9

Large cell

Question 10

___________ is the slowest growing of lung cancers and associated with an improved prognosis

Answer 10

Adenocarcinoma (occurs on the very outside of the lungs in the mucous-producing cells)

Question 11

T/F: Surgery is often used to treat small cell lung cancer

Answer 11

FALSE d/t high risk for mets, usually already spread once found

Preferred treatment option for most NSCLC

Question 12

Nutritional consequences for lung cancer surgery are typically low as the GI tract isn’t involved, however ________ has been associated with a higher complication rate

Answer 12

Malnutrition

Question 13

_______ is the primary treatment for small cell lung cancer

Answer 13

Chemotherapy

Question 14

8 common types of chemotherapy used with lung cancer

Answer 14

Carboplatin
Cisplatin
Paclitaxel
Docetaxel
Vinblastine
Gemcitabine
Etoposide
Pemetrexed

Question 15

T/F: Targeted therapies may be used to treat advanced NSCLC

Answer 15

True

Question 16

__________ is the preferred treatment option for stage 3 NSCLC

Answer 16

Concurrent chemoRT

Question 17

T/F: Concurrent chemoRT is associated with higher risks of acute esophagitis for lung cancer pts when compared to sequential options

Answer 17

True

Question 18

________ may be used to treat stage 4 NSCLC

Answer 18

Monoclonal antibodies (immunotherapy)

blocks proteins on the cancer cells that prevent the immune system from recognizing them as cancerous

Question 19

Kcal & protein recommendations for lung cancer

Answer 19

Normal kcal/kg equations
At least 1 g/kg protein, up to 1.5 g/kg if possible

Question 20

Macronutrient intake for lung cancer

Answer 20

Standard - increase fat and decrease CHO if needed for hyperglycemia

Question 21

There is some evidence that _______ supplementation in lung cancer may help to preserve lean body mass, specifically those w/ advanced disease receiving chemotherapy

Answer 21

Omega-3

Question 22

Nutrition goals during lung cancer treatment

Answer 22

Maintain body wt/minimize unintended wt loss & maintain muscle mass

Question 23

2 situations to consider EN with lung cancer

Answer 23

No food for > 1 week

<60% energy requirements for > 2 weeks

Question 24

Is the prevalence for malnutrition with lung cancer high or low?

Answer 24

High, ~50%

Question 25

3 situations associated with increase risk for unintended wt loss with lung cancer. Should receive automatic nutrition referrals.

Answer 25

1. Concurrent chemoRT
2. Stage 3 or higher
3. Esophagus regarding a large portion of radiation (dose > 40 Gy)

Question 26

How to help identify sarcopenia despite the BMI category

Answer 26

Incorporate strength and muscle mass assessments (BIA, handgrip, skinfold)

Question 27

A weight loss of ________% body wt before lung cancer resection was an independent risk factor for 1 year mortality in older pts (>/= 70)

Answer 27

5%