Lung Cancer and Nutrition Symptom Management (Week 8 Lecture 1)

Question 1

Important physiology of respiratory system

Answer 1

Question 2

Prevalence of lung cancer

Answer 2

• Average age of diagnosis is 70
• More common in men
• Most cases caused by smoking and quitting improves outcomes
• Most common cancer in the world

Question 3

How easily does lung cancer metastasize?

Answer 3

This cancer does metastases easily particular to the brain also lymph nodes adrenal glands and liver

Question 4

Types of lung cancer

Answer 4

• Non-Small Cell Lung Cancer (NSCLC): most common ~85% diagnosed
• Small Cell Lung Cancer (SCLC): About 15% and usually develop in higher regions which are more aggressive
• Mesothelioma: Cancer of lining of lung but diagnosis is poor (asbestos lung cancer)

Question 5

Treatment options for lung cancer

Answer 5

• Surgery – for earlier stages, can be curative.
• Systemic Treatment (Chemotherapy, immunotherapy)
• Radiation
• Targeted therapy

Question 6

What are side effects of lung cancer treatment

Answer 6

Question 7

nutrition intervention for weight loss

Answer 7

Extremely common in lung cancer, but overall a major problem in almost all types of cancer
* High calorie high protein diet
* Nutrition supplements

Question 8

Nutrition intervention for decreased appetite

Answer 8

• Eat small, frequent meals
• Eat more when your appetite is good
• Keep favorite healthy food within easy reach
• Stimulate appetite
• Drink adequate fluids
• Distract yourself
• Eat with others

Question 9

Nutrition intervention for nausea

Answer 9

• Take anti-nausea medications as prescribed
• Eat slowly
• Eat more during times when your appetite is best
• Choose foods with little smell and eat in an open area
• Avoid foods that are too greasy, sweet or spicy

Question 10

Nutrition intervention for constipation

Answer 10

• Drink plenty of fluids
• Slowly increase fibre while also increasing fluids
• Exercise and movement
• Meds (PEG 3350, Senokot)

Question 11

Nutrition intervention for diarrhea

Answer 11

• Drink at least 2 L (8 cups) daily
• REPLACE lost electrolytes
• Limit foods that can increase diarrhea
• Choose small, frequent meals

Question 12

How to replace lost electrolytes

Answer 12

• Drink about half your fluids as oral rehydration solution (ORS) like Gatorade G2TM
• For sodium: soup broths, tomato/ClamatoTM/vegetable juices
• For potassium: fruit juices, soft fruits such as bananas and vegetables, as tolerated
• May require an oral rehydration solution

Question 13

What foods might increase diarrhea

Answer 13

Caffeine, spicy foods, greasy or fatty foods, sugary drinks, and insoluble fibre

Question 14

What are soluble fibre foods to choose to help with diarrhea?

Answer 14

• Oats
• Barley
• Potato & other vegetables (no peels)
• Legumes (Soluble & insoluble)
• psyllium
• Banana & other fruits (no peels or seeds)

Question 15

Nutrition intervention to deal with fatigue

Answer 15

• Keep pre-made meals or convenience foods at home
• Ask family and friends to shop and cook
• Cook more when you have good energy and freeze extras
• Use community supports
• Grocery and meal service delivery
• Meal prep kits

Question 16

Nutrition intervention to deal with dry mouth & thick saliva

Answer 16

• Practice good oral hygiene. With thickened saliva, use a SLS (Sodium Lauryl Sulphate)-free toothpaste such as Pro-enamelTM Children’s toothpaste.
• Rinse your mouth before and after meals
• Try rinsing with Club Soda or 1⁄4 tsp baking soda or salt in 1 cup water
• Stay hydrated by drinking at least 8 cups (2 L) of fluid each day
• You may be able to make more saliva by chewing sugar-free gum or mints ice chips, or having citrus fruit
• Sip fluids with each mouthful of food
• Avoid mouth wash made with alcohol. Try brands like BioteneTM.
• Keep lips moist with lip balm. Water-based, wax-based, or oil-based lip balms are good. Lanolin-based products are the best, whereas petroleum-based lip balms like VaselineTM should be avoided as can worsen dry mouth.
• Talk to your pharmacist about using gels, sprays or artificial saliva
• Choose soft, moist foods

Question 17

Nutrition intervention for taste changes

Answer 17

• Bland: Add extra seasoning and eat a mixture of textures; smell your food before taking a bite.
• Bitter: Add tart or acidic flavors or foods (such as lemon)
• Metallic: Use plastic cutlery and glass cookware, add marinades to meats or use meat in mixed dishes. Tart flavors are helpful for masking metallic tastes, ex. Dill pickles, relish, cranberry sauce, chutneys, or barbeque sauce.
• Salty: cook without adding salt, avoid processed foods, use herbs and spices, add a pinch of sugar to foods
• Sweet: Add salt, add sour or acidic flavors, use herbs or spices, dilute sweet drinks with milk, water or ice, try eating foods at room temperature or cold.
• Always clean your mouth with a Club Soda rinse before eating.
• Play around with fats, acids, salt and sweet flavors to help alter the way the food is tasting to you, example:

Question 18

Nutrition intervention for smell changes

Answer 18

• Choose what smells and looks appealing
• Eat foods that are cold or room temperature
• Cook with a fan or by an open window
• Use covered pots and pans
• Ask friends and family to help with cooking or drop off prepared meals so that the cooking smells aren’t in your house
• Use a straw or cup with a lid for drinks that have a strong smell
• Eat away from where food was prepared
• Try using essential oils, like citrus, to mask unpleasant smells