CSO Study Guide Flashcards
Alimta (pemetrexed) drug class
Anti-cancer drug (“antimetabolite)
Alimta (pemetrexed) treats
- met nonsquamous nonsmall cell lung cancer
- malignant mesothelioma
complications and side effects of pemetrexed can be reduced by using _____ and _______ supplementation
folic acid and vitamin B12 supplementation.
Abraxane
(Paclitaxel protein bound) type
Anti-cancer drug (Cytotoxic /
Antineoplastic)
Avoid __________ with Abraxane
(Paclitaxel protein bound)
grapefruit
Avoid _______ with Arsenic Trioxide (Trisenox)
Avoid/limit seafood and homeopathic remedies as these may contain arsenic
Avastin (bevacizumab) type
Monoclonal Antibody
Bleomycin (Blenoxane) type
anti-cancer (antineoplastic/
cytotoxic)
Carboplatin type
Anti-cancer drug (Cytotoxic /
Antineoplastic)
Carbozantinib (Oral Pill) type
Targeted Therapy
things to avoid / considerations with Carbozantinib (Oral Pill) type
- Avoid grapefruits
- don’t eat 2hrs before or 1hr after
- take with 8oz H2O
Cisplatin type
Anti-cancer drug (Cytotoxic /
Antineoplastic)
Cytoxan
(Cyclophosphamide/Neosar) type
Anti-cancer drug (Cytotoxic /
Antineoplastic)
Avoid _______ , _______, and __________with Cytoxan
(Cyclophosphamide/Neosar)
Avoid grapefruit, starfruit, Seville oranges
Etoposide (VP-16, Etoposide phosphate, Toposar, VePesid, Etopophos) is an _____________, ____________, and _________________.
antineoplastic / cytotoxic. Plant alkaloid and topoisomerase II inhibitor
Avoid _________ with Etoposide (VP-16, Etoposide phosphate, Toposar, VePesid, Etopophos)
- AVOID pomegranate, seville oranges, grapefruit and star fruit
Fluorouracil (Adrucil) AKA 5-FU type
Anti-cancer drug (Cytotoxic /
Antineoplastic)
“Antineoplastic”
Gemzar (Gemcitabine) type
Anti-cancer / antineoplastic / cytotoxic drug
Avoid _______, ______, ______, ______, and ________ with Gleevec (Imatinib) * Oral Chemo
AVOID
St. John’s Wort, grapefruit, pomegranate, seville oranges and star fruit
Herceptin (Trastuzumab) type
Monoclonal antibody
Ifosfamide type
Antineoplastic
Avoid _________ with Methotrexate (Otrexup, Rasuvo, Rheumatrex, Traxall)
Do not take folic acid or B-vitamins w/in 24 hours of tx
Pembrolizumab (Keytruda) type
Monoclonal Antibody
Rituxan type
Monoclonal Antibody
Velcade (Bortezomib) * An injection * is a __________ therapy. More specifically, a ___________ ___________.
Targeted therapy. Proteasome inhibitor
Avoid _______, _______, _______, _______, and ________with Velcade (Bortezomib) * An injection *
- AVOID
green tea, grapefruit, pomegranate, star fruit, seville oranges
Velcade (Bortezomib) * An injection * is used to treat
MM
Xeloda (Capecitabine) * Pill taken by mouth type
Anti-cancer drug
Supplement _______________ with Xgeva
calcium and vitamin D
FOLFOX =
Fluorouracil (5FU), Leucovorin (folinic acid), Oxaliplatin
Black cohosh claims to __________ but may cause ______________
- Suppresses symptoms (hot flashes) associated with menopause and breast cancer
- Cause severe liver toxicity
Black cohosh may interfere with ________, __________, or __________
Tamoxifen, Doxorubicin, Docetaxel
CoQ10 may reduce toxicity of _______ and ______ but can also interact with ____________.
Doxorubicin and carboplatin; warfarin
____________ may sensitize cisplatin resistant tumors to cisplatin
turmeric
- DIM and I3c is a ___________
naturally occurring plant alkaloid metabolite ; found in cruciferous veggies
This metabolite found in cruciferous vegetables may interfere with hormone treatment
DIM and I3c
_____________ may enhance Tamoxifen through weak estrogenic activity
flaxseed
___________ may interference with prescription drug saquinavor and antiplatelet meds
garlic
___________ may help with nausea, heartburn, anorexia, diarrhea, and gas— however, it may also interfere with anticoagulant drugs
Ginger
___________ is one of the oldest living tree species. People use it reduce chemo-related toxicity; however, it may interfere with anticoagulant and anti-seizure meds
Ginkgo
Discourage use of _________ with alkylating agents, antitumor antibiotics and platinum analogues
Ginkgo
_______________ may reduce inflammatory side effect of cancer treatment ie. may reduce degree of mucositis, stomatitis, esophagitis, and diarrhea
glutamine
____________ may interact with seizure meds, be converted to ammonia, and may decrease effect of lactulose
glutamine
_________ may inhibit drug metabolizing enzymes (like Bortezomib in myeloma)
green tea
___________ is a Pacific island plant made into a beverage and holds concern for liver damage
Kava
__________ may enhance immune system but can also enhance tumor response
Reishi Mushroom
It is recommended to consume ____________ with caution in those taking tamoxifen, as this flavonolignan May interact with it.
silymarin
_______________ induces chromosome CYP3A4 resulting in lower plasma levels of drugs that are CYp3A4 substrates
St. Johns Wort
what should Regorafenib (Stivarga) be taken with and when?
a low fat meal and at the time each day
grapefruit juice and St Johns wort can interact with _________________, which should be taken with a low fat meal and at the same time each day.
Regorafenib (Stivarga)
What drugs are in folfox?
folinic acid (leucovorin), fluorouracil/5FU, and oxaliplatin
What drugs are in folfiri?
leucovorin calcium (calcium folinate), fluorouracil/5FU, and irinotecan
What drugs are in folfirinox?
leucovorin calcium, fluorouracil/5FU, irinotecan hydrochloride, and oxaliplatin
_____________ is a topoisomerase I inhibitor that can cause severe diarrhea
Irinotecan
____________ is an alkalizing agent used to treat colorectal and pancreatic cancers, and its primary side effect is cold-induced peripheral neuropathy
Oxaliplatin
__________ is a vinca alkaloid used to treat ALL, AML, sarcoma, brain, and thyroid cancers. Grape fruit and St. Johns Wort should be avoided with this medication.
Vincristine
Erlotinib/Tarceva type
Tyrosine Kinase Inhibitor
SIADH is a common side effect with __________ and ____________
(Hint: TV - SIADH)
vincristine and Erlotinib/Tarceva
Turmeric should be avoided with this alkylating agent because it inhibits chemo-induced cell apoptosis
cyclophosphamide
5FU is an ___________________, meaning that it sabotages a cancer cell’s genetic code so that it can’t replicate and make more cancer cells
antimetabolite
_____________ is a tyrosine kinase inhibitor used to treat GIST, leukemia, and MDS, and may interact with grapefruit
Gleevac (imatinib)
Herceptin is a monoclonal antibody targeting ___________ and ________ genes
HER2+ and ERBB2
________________ is a monoclonal antibody that treats breast and gastric cancer, but can also cause cardiotoxicity
Herceptin (trastuzumab)
_____________, which is an antimetabolite, requires B12 and folic acid supplementation to minimize its side effects
Pemetrexed
_____________ is a taxane that requires low fiber diet education for symptom management
Paclitaxel (Taxol)
______________ is an epipodophyllotoxin that can cause a metal taste during infusion and hypersensitivity reactions
etopiside
Bortezumib (Velcade) is protein targeted agent that is used to treat __________ and _____________.
MM and mantle cell lymphoma
No green tea is recommended with ______________ because some flavonoids and vitamin C presenting in green tea leaves and teas can neutralize it in the blood by direct interaction
Bortezumib (Velcade)
_____________ is a vegetarian diet promoting natural, unrefined foods; eating 8x daily from allowed foods, combined with breathing exercises and enemas if tolerated
Budwig Diet
____________ is a natural diet and metabolic therapy promoting organic vegetarian diet with no sodium or fat except flaxseed oil including daily raw juices and strict adherence to meal schedule and prep
Gerson Therapy
________________ is a metabolic treatment developed in 1970s combing vegetarian diet, mega doses of vitamins/minerals/digestive enzymes, and includes a vaccine made from a persons own urine or blood
Livingston Wheeler Diet
this diet claims that modern diets cause acidosis, which then causes disease by destroying minerals in cells and also claims cancer grows in acidic environments
alkaline diet
this diet is based on Budwig diet claiming cancer is caused by lack of oxygen in cells, weak immune system, excess acidity and toxicity mostly related to smoking, alcohol, and asbestos
Bill Henderson Protocol
This diet claims that toxins from processed foods, pesticides, preservatives, and pollutants cause cancer so following diet modification which includes supplements, extracts of animal organs (pancreatic enzymes), and detox practices will cure cancer
Gonzalez Program
This diet is an adaptation of traditional Japanese diet and consists of an organic locally grown primarily vegetarian diet with whole foods
Macrobiotic diet
Health is promoted via balance in ying and yang for this diet
Macrobiotic diet
This diet claims that unprocessed foods preserve enzymes in food and provide health
Raw Food Plan
The goal of _______________ is to lessen or ease symptoms of disease independent of curative efforts, and to improve QOL of patients and families facing problems associated with life threatening illnesses
palliative care
The goal of ________________ is to help someone live with a terminal illness as well as possible for as long as possible
hospice
_____________ may increase risk for bleeding by way of omega 3 fatty acids role in decrease clotting and platelet aggregation
flaxseed
____________ is an antidepressant medication that works in the brain to treat major depressive disorder, but is sometimes prescribed for nausea/vomiting, low appetite and underweight
Remeron
T= reflects the size and extend of the tumor — explain T0 to T4
TX is tumor cannot be evaluated ; T0 is no evidence of tumor ; Tis is carcinoma in situ which means abnormal cells are present with no spread; T1 is tumor is not palpable or visible by imaging ; T2 confined to primary cancer site; T3 extends to neighbor tissue; T4 is metastatic disease
N= reflects extent of spread to local lymph nodes — explain each stage of N
a. NX regional nodes cannt be evaluated and N0 is no regional lymph node involved
b. N1 involvement of regional nodes
c. N2 etc. indicates # of nodes
_______, ________, and _________ are impacted during alcohol liver disease
Vitamin A, B-Vitamins (including B6), and folate
_______, ________, and ________ are affected with renal failure
Vitamin B6, Vitamin C, folate
On this religious diet, individuals follow plant based diet that excludes most animal products, alcohol, and caffeine
Seventh Day Adventist
____________ is described as metabolic disturbances that occur when large number of cancer cells are killed quickly leading to release of intracellular ions and metabolic byproducts into systemic circulation
Tumor Lysis Syndrome
Labs in Tumor Lysis Syndrome
Will see elevated potassium (>6), Phosphorus (>4.5), uric acid, and higher than normal BUN levels and LOW Calcium
How do we treat Tumor Lysis Syndrome?
i. Hydrate and recommend a low potassium, phosphorus, and purine diet
ii. Recommend insulin therapy, calcium carbonate, loop diuretic, and medication to clear uric acid (Rasburicase)
______________ will present as water retention, less urine production, low Na levels, and lyte imbalances
SIADH
____________ is a side effect of Alkylating agents: Cisplatin, Cyclophosphamide, Ifosfamide, and vincristine
SIADH
What is the treatment for SIADH?
Fluid restrictions, hypertonic saline, medications that promote solute free water excretion by kidneys
_____________ ____________ refers to a condition that secretes bioactive hormones, amines, and peptides. Specifically, they result in a secretion of excess serotonin
Functional NET
___________ is a tumor marker for those diagnosed with NET
Chromogranin A
___________ is a corticosteroid to help treat anorexia and early satiety
decadron
______________ is an antihistamine prescribed to children to help treat anorexia and early satiety
Periactin
___________ is a pro kinetic agent used to treat anorexia and early satiety
Reglan
Miralax, lactulose, Milk of Magnesia, and Magnesium Citrate are examples of ______________ laxatives
osmotic
two examples of stimulant laxatives are
dulcolax and senna
________, _________, ________, and ________ are serotonin antagonists used to treat acute nausea (24 hours after chemo)
Zofran, Anzemet, Kytril, Aloxi
__________ or _____________ are prescribed for prevention of nausea; ________ may be considered too.
Decadron or Zofran WITH neurokinin-1 receptor; reglan
_______ , _________, _______, or ______ are prescribed for either anticipatory (before treatment) or delayed nausea and vomiting (1 to 7 days after chemo)
i. Dopamine antagonists= Compazine
ii. Benzemides= reglan
iii. Cannaboids= marinol
iv. Benezodiazapines= Ativan
**ATIVAN
Describe the progression of the GVHD diet (just the phases)
- bowel rest –> 2. intro to oral –> 3. intro to solids –> 4. expansion of diet –> 5. Regular
What are the symptoms of phase 1 of the GVHD diet? What is the diet intervention?
GI cramping, large volume diarrhea, low albumin, very short transit time, limited bowel sounds ; NPO, IV fluids, and meet protein/energy with nutrition support
What are the symptoms of phase 2 of the GVHD diet? That is the diet intervention?
Minimal GI symptoms and <500mL diarrhea ; Isotonic, low residue, low lactose fluids
What are the symptoms of phase 3 of the GVHD diet? That is the diet intervention?
Minimal to no GI symptoms with formed stool ; low lactose, fat, fiber, acid diet with no gastric irritants
What are the symptoms of phase 4 of the GVHD diet? That is the diet intervention?
Same as phase 3 ; Shift from low to minimal and if fat malabsorption add low fat
What are the symptoms of phase 5 of the GVHD diet? That is the diet intervention?
No cramping, normal stool, normal albumin ; Progress to reg with gradually adding lactose and fiber
____________ is an Inpatient and outpatient screening tool and includes screening and assessment criteria
Patient Generated-Subjective Global Assessment (PG-SGA)
_________ is purely a screening tool for inpatient and outpatient
Malnutrition Screening tool (MST)
___________ is a screening tool which includes ECOG score for inpatient population only
Malnutrition Screening Tool for Cancer Patients (MSTC)
______________ is a screening tool that contains screening and assessment (upper arm circumference measurement) and is for inpatient population only
Malnutrition Universal Screening Tool (MUST)
https://www.bapen.org.uk/pdfs/must/must_full.pdf
Loss of subcutaneous fat can be identified by looking at …
orbitals, triceps, and fat over ribs
Loss of muscle mass can be identified in …
temples, clavicles, shoulders, scapula, thigh, calf
Malnutrition in CHRONIC ILLNESS non-severe
a. Energy intake- <75% for >/=1 month
b. Weight loss- 5% in 1 month, 7.5% in 3 month, 10% in 6 month, and 20% in 1 year
c. Physical finding- body fat, muscle mass, and fluid accumulation is mild, and reduced grip strength is N/A
Malnutrition in CHRONIC ILLNESS severe
a. Energy intake- </= 75% for >/= 1 month
b. Weight loss- >5% in 1 month, >7.5% in 3 month, >10% in 6 month, and >20% in 1 year
c. Physical finding- body fat, muscle mass, and fluid accumulation severe, and grip strength measurable reduced
Criteria for diagnosing cachexia
i. Weight loss of more than 5% over 6 months in absence of starvation
ii. BMI <20 with any degree of weight loss greater than 2%
iii. Skeletal muscle reflective of sarcopenia
Protein needs in acutely or chronically ill older adult
@ least 1.0 to 1.2
Adult with cancer protein needs
1.0 - 1.5
Protein needs for an adult undergoing HCT
1.5
Low Tyramine Diet
Avoid aged cheese, smoked/fermented/cured meats or fish, nuts,
___________ or ________ can be prescribed to help treat dumping syndrome
octeotide or acarbose
__________ does NOT increase as body fat increases
Nuclear factor-kappa beta (NFkB)
A patient with Colon Cancer on Xeloda reports trialing the Budwig Diet to help fight the cancer. What supplement recommendation are you most likely to make?
Vitamin B6
__________ is a chemotherapy used to treat hepatocellular cancer can cause anorexia
Doxorubicin (adriamycin)
You are counseling a patient on Tarceva (Erlotinib), a tyrosine kinase inhibitor, who wishes to discuss the potential food / drug interactions. You recommend avoiding ________________
grapefruit and grapefruit juice
The PG-SGA assesses _______, _______, and __________.
Percent weight change, dietary recall, and edema
A patient on Cisplatin may experience ________, _______, and/or _______ side effects.
Dysesthesia (abnormal physical touch sensation without outside cause), SIADH, and/or dysgeusia
A semi-elemental formula is a partially hydrolyzed formula used for individuals with _______________ that may be preventing standard enteral formulas to be digested or tolerated.
individuals with dysfunction in the GI tract
Pernicious anemia is evaluated by looking at which lab values?
B12 and Folate
__________, __________, and ________ are latent side effects of radiation therapy (RT).
osteoradionecrosis, hot flashes, and esophageal fibrosis
Which botanical supplement was found to alter the pharmacokinectics the chemo drug Imatinib (Glivec)?
St Johns Wort
A dietitian would best analyze a patient with hemolytic anemia with which lab(s) values?
RBC
An isotonic, fiber-free formula is ideal for patients at high risk for ________________ or if they have _______________.
intestinal ischemia ; a high GFR
______________ is a supplement originating from native Americans claimed to relieve pain and inflammation; however, in cancer care, it is also known to cause hepatotoxicity
Chaparral
A patient starting on CHOP should increase ___________ intake
fiber
___________ is the best tool to measure dysphagia
DIGEST
A patient receiving Erbitux (cetuximab) will likely benefit from consuming foods that are good sources of _____________
magnesium
Bisacodyl is a type of __________ ___________
stimulant laxative
What is the soonest a G-tube can be removed when the patient has not used it for nutrition, hydration or medication and their weight has been stable?
4 weeks
_____________ is used to control and relieve the symptoms of acute diarrhea
Loperamide
_________________ is used to lower high cholesterol levels in the blood
Cholestyramine
______________ is a brand of diphenoxylate and atropine. It’s a medication that treats diarrhea.
Lomotil
Glutathione S-transferase is known as the _________ _________.
detoxifying enzyme
Selenium is beneficial in reducing risk for which type of cancer?
Prostate
Thrombocytopenia is characterized by a platelet count of <_____________________.
100,000
You might suggest ____________ for someone on cisplatin
selenium
What might the dietitian recommend be given with Cisplatin to reduce renal toxicity?
Mannitol
At what creatinine level would Cisplatin be held?
1.5mg/dL
Irinotecan is often provided with _______________for metastatic colon cancer.
Cetuximab (erbitux)
Adriamycin (Doxorubicin) is often given with_______________for breast cancer.
Cytoxan (cyclophosphamide)
__________ is a monoclonal antibody used as a treatment for breast cancer with side effects including thrombocytopenia.
Avastin (Bevacizumab)
A common side effect of Mitomycin, an antibiotic used as a chemotherapy drug, is _______________.
renal and lung toxicity
Cytarabine (Ara C or cytosine arabinoside) is a treatment for _________ __________ and is toxic to the ___________ and __________.
acute leukemias ; kidneys and liver
GI perforation, hypertension, and CHF are common side effects of this anti-angiogenic treatment
Avastin (Bevacizumab)
Xeloda is often given in replacement of ______________ for metastatic breast or colon cancers.
5FU (Leucovorin)
It is recommended to not take ______________, a theopurine and antimetabolite, with dairy-containing foods.
Mercaptopurine (purinethol)
_____________ may be given alongside FOLFIRI for colorectal cancer.
Cetuximab (Erbitux)
__________________ is the most common side effect of Femara (Letrozole), a hormone therapy drug.
Nausea/Vomiting
A person with Hodgkin’s Lymphoma is starting ABVD. What treatments comprise this regimen?
Adriamycin, Bleomycin, Velban, Dacarbazine
Carboplatin (Paraplatin), Paclitaxel (Taxol), and/or Cisplatin (cis-platinum) may be offered alongside ________________ for non-small cell or small cell lymphomas.
Gemcitabine (Gemzar)
Bone pain is a common symptom of this hormone receptor antagonist.
Lupron (Eligard)
_____________ topoisomerase inhibitor (Top 1), is known to cause diarrhea, especially when paired with 5FU for the treatment of metastatic colon cancer.
Irinotecan
FOLFOX is a first line treatment for which cancer?
Colon Cancer
____________ has been studied to potentially enhance the benefits and reduced toxicity of Doxorubicin (Adriamycin)
Theanine
This “chemotherapy protectant” is a derivative of folic acid and is often given alongside other treatments.
Leucovorin (5-FU)
_____________ is a protein-targeted therapy and kinase inhibitor for renal cell cancer may cause fluid retention and decreased appetite.
Torisel
Increasing evidence suggests at least ______ minutes per week of moderate exercise may prolong survival in those with a breast cancer diagnosis.
180
The registered dietitian should monitor a patient’s _____________ to attain information on ongoing systemic inflammation.
CRP
The dose of Warfarin a patient receives can be best determined by what lab value?
International Normalization Ratio (INR)
In severe deficiency, each 1000IU dose increment of Vitamin D3 should increase 25-hydroxyvitamin D levels by:
10 ng/mL
___________ and __________ have been found to assist in absorption of curcumin
black pepper and fatty foods
______________ mushroom is not an immune modulating mushroom
Maitake
As a dietary supplement, ________________ may exacerbate diarrhea due its laxative effect.
Aloe Vera
Known otherwise as lockjaw, this is a possible late side effect of head and neck radiation therapy.
Trismus
a patient may benefit from sucking on an ice pop or ice chips during infusion with 5FU or _________________.
Doxorubicin (Adriamycin)
Caphosol is used to treat __________________
dry mouth and throat
________________ is a medication that increases the saliva in your mouth to treat dry mouth as a result of Sjögren’s syndrome
Pilocarpine (Salagen)
Questran (cholestyramine) is a medication used to …
lower high levels of cholesterol in the blood, especially low-density lipoprotein (LDL)
________, ________, and _________ cancer survivors make up the majority of cancer survivors.
Prostate, colon, and breast
Li-Fraumeni Syndrome is associated with an inherited defect in the _________ gene.
TP53
Point mutations in genes which cause loss-of-function are termed ____________ genes
tumor suppressor
What are two ways by which diet impacts epigenetics?
- Host somatic cell mitosis
- Germ cell trans generational inheritance
____________ and ____________ are two types of epigenetic changes.
methylation and acetylation
___________ ____________ is the scientific investigation of the composite interactions between nutrients, bioactive food components, and the genome as they impact host health and disease.
Nutritional genomics
______________ are chemicals found in an organism, but not produced by it, such as drugs or pollutants.
Xenobiotics
________________ are typically minor variations in nucleotide sequence that may impact the function of corresponding protein to varying degrees and thereby modify cancer risk.
Polymorphisms
The ___________________ is a multisite randomized controlled trial that showed ~50% reduction in mortality rate for those who ate >5 servings of fruits and vegetables per day and exercised 30 minutes (moderate) 5-6 days / week.
Women’s Healthy Eating and Living (WHEL) Study
Results from the initial _________________ suggested that a lifestyle intervention targeting dietary fat intake and weight loss could improve overall survival in breast cancer patients.
WINS study
__________ describes muscle aches and pain
Myalgia
_____________ describes joint stiffness
Arthralgia
Evidence-based and concensus-driven cancer treatment standards of care are sanctioned by __________________
National Comprehensive Cancer Network (NCCN)
What are the 6 subclasses of chemotherapy?
(hint: you want your patients to EAAAT V_ery much on chemotherapy)
1. Alkylating agents (like Cisplatin)
2. Antimetabolites (like Xeloda / capecitabine)
3. Antitumor antibiotics (like Adriamycin / doxorubicin)
4. Epiodophyllo-toxins (like etopiside)
5. Taxanes (like Taxol / paclitaxel)
6. Vinca alkaloids (like Vincristine / oncovorin)
The 5 subclasses of biotherapy include:
(you skipped bio class to go party with MC PAC)
1. Monoclonal antibodies (like Rituxan / rituxumab)
2. Protein targeted therapies (like an mTOR inhibitor like affinitor)
3. Angiogenesis inhibitors (like Avastin / Bevacizumab)
4. Cytokines (like interleukin-2)
5. Cancer vaccine therapy (like Gardasil to protect again HPV)
What are the 5 subclasses of hormone therapies?
(_S_argent PAAL is undergoing hormone therapy)
1. Selective Estrogen Modulators (SERMS) (like Tamoxifen)
2. Aromatase inhibitors (like aromasin)
3. Progesterone (like Megace)
4. Antiandrogens (like casodex)
5. Leutenizing hormone releasing hormone agonists (like Lupron)
___________ ,________, __________, and ___________ are the 4 major cancer therapies.
chemotherapy, biotherapy, hormone, and radiation.
frying, broiling, or grilling meats at high temperatures creates __________ and __________, who may increase cancer risk.
heterocyclic amines and polycyclic aromatic hydrocarbons
when initiating PN, start is a goal of ______________% dextrose and titrate up as tolerated
25-50%
_____________ is a chemotherapy that should also include increased fluid needs.
cisplatin
What are 6 main indications for TPN?
- nonfunctional GI tract
- severe N/V
- severe diarrhea or malabsorption
- GI fistula
- severe acute necrotizing pancreatitis and unable to tolerate EN
- GVHD and intolerance to EN support
what are 5 possible long-term complications of TPN?
- steatosis
- biliary sludge
- catheter sepsis
- venous thrombosis
- hypertriglyceridemia
_________________ may allow bacterial and fungi overgrowth, which can cause pain when eating.
achlorhydria
__________________, ________________, __________________, ___________, and ______________ are the most 5 most prevalent childhood cancers
- Brain and nervous system
- Lymphoma
- Leukemia
- Neuroblastoma
- Wilms Tumor
Long-term side effects of childhood cancer include ___________, ________, ___________, and _______________.
- slow or stunted growth
- compromised bone health and development
- Altered eating behaviors
- Altered quality of life
____________ and _____________ are the two vitamins/minerals of concern for childhood cancer survivors and can/should be supplemented.
Calcium and Vitamin D
The 2 types of HCT are ____________ and ____________.
myeloblative and nonmyeloblative
__________________ HCT involves high dose chemotherapy and radiation to ablate bone marrow
myeloblative
_______________ HCT involves lower dose chemotherapy and radiation
nonmyeloblative
What follows myeloblative or nonmyeloblative HCT?
an IV infusion of autologous (pt’s own), syngeneic (from an identical twin), or allogenic (from another human related or unrelated) stem cells.
IV infusions of stem cells following myloblative or nonmyeloblative HCT preparations can come from __________, _________, or ___________.
bone marrow, peripheral blood, or umbilical cord blood
A neutropenic diet should be followed for __________ months following HCT
3 months
Symptoms of GI GVHD include __________, ___________, and ___________.
N/V, secretory diarrhea, and GI bleeding
MNT for GI GVHD
low lactose, fiber, acid, fat, and then possibly ading PERT if nutritional interventions are not sufficient
Chronic GVHD develops beyond ____________ days post-transplant.
80-100
________________ therapy along with vitamin D and calcium supplementation with regular weight bearing exercise can reverse bone loss.
Bisphosphonate
Eliminate _________ and _________ from TPN for persistent bilirubinemia
Copper and manganese
ER+ and PR+ Breast cancer is treated with _________, _________, _________, and _________.
SERMs (tamoxifen), aromatase inhibitor (aromasin), ERDs (faslodex), and LHRHs (Lupron)
_________, _________, ________, and __________ are the main risk factors for SCC of the esophagus, which usually is in the upper 2/3 of the esophagus.
smoking, ETOH, H Pylori, and HPV
Risk factors for AE esophageal cancer, which usually occur in the lower 1/3 of esophagus, are __________ and ____________
GERD and Barrett’s esophagus
_________ tubes are preferred to G-tubes in patients with esophageal cancer
J-tubes
A right colectomy will resect the _______________ colon.
ascending colon
___________, ______________, and ________________ are unique risk factors to salivary cancer
older age, radiation exposure, and asbestos exposure
____________ is the most common lung cancer
NSCLC
cigarette smoking, second hand smoke, gas exposure, ETOH, arsenic, chromium, and/or nickel exposure are risk factors for _______________
SCLC
____________, ___________, and ____________ are gene mutations that increase ones risk of developing ovarian cancer
BRACA1, BRACA2, and RAD51C
__________________ is the main chemotherapy classification for treatment of ovarian cancer
alkylating agents (like carboplatin)
_________________ tumors represent 95% of pancreatic tumors
exocrine
what is the overall survival rate of pancreatic cancer?
4% ; 5-10% if caught early and surgical resection is achieved
Healthy eating patterns and physical activity can reduce _______% of the most common cancers
33
According to AICR, people who consume red meat should consume no more than ______oz per week
16oz
What nutrient may be used to enhance 5FU, as 5FU is targets enzyme that use this nutrient as a cofactor
Folate
__________, _________, and _________ are allium veggies and protect against stomach cancer
garlic, onions, and leeks
