Nutrition and Diagnosis-Related Care Flashcards
Cancer that starts in the glands
Adenocarcinoma
Benign growth that may or may not grow into cancer
Adenoma
Process of stopping a tumor from growing new blood vessels
Antiangiogenesis
Most common form of skin cancer - primary cause: sunlight exposure
Basal cell carcinoma
Treatment to stimulate or restore the immune system to fight infection and disease and lessen side effects that may be caused by some cancer treatments
Biotherapy (also known as biological therapy or immunotherapy)
Abnormal, uncontrolled growth of cells in a lump or mass that also destroys normal tissue
Cancer
Encompasses 80-90% of all cancers; involves epithelial tissue and coverings of internal and external surfaces; includes skin, lungs, colon, stomach, breast, uterus, and tongue cancers
Carcinoma
Use of medication to kill malignant cells
Chemotherapy
Permanent removal of cancer from the body
Curative therapy
GI carcinoid tumor, pancreatic islet cell carcinoma, parathyroid cancer, pituitary tumor, and thyroid cancer are all examples of what types of cancers?
Endocrine system cancers (aka: adrenocortical carcinomas)
Anal, bile duct, colon, esophageal, gallbladder, GI carcinoid tumor, liver, pancreatic, rectal, small intestine, and stomach cancers are all what type of cancer?
GI cancers
Cervical, endometrial, ovarian, vaginal, and vulvar are all what type of cancer?
Gynecological cancers
Cancer where bone marrow-produced abnormal WBCs crowd out normal WBCs, RBCs, and platelets
Leukemia
Penile, testicular, and prostate cancers all are what?
Male reproductive cancers
Tumors affecting the meninges
Meningiomas
Rare cancer affecting the lining of the chest, heart, and abdominal cavity from exposure to abestos
Mesothelioma
Transfer of disease from one organ to another that is not directly connected to it
Metastasis
Targeted therapy to locate and bind cancer cells; can be used to delivery drugs, toxins, or radioactive material directly to tumor cells.
Monoclonal antibodies
Tumor composed of nerve cells
Neuroma
Most common bone cancer, which develops in new tissue of growing bones, affecting young people
Osteosarcoma
Treatment with high-energy rays to kill or damage cancer cells
Radiation
Cancer arising from bone or connective tissue
Sarcoma
Key dietary message to prevent cancer: promote intake of 3 main things…
Fruits, vegetables, and whole grains
Type of fiber that increases stool bulk
Insoluble fiber
Type of fiber that has a cholesterol-lowering effect
Soluble fiber
Dietary factors and physical inactivity contributes to what fraction of cancer patients?
1/3rd
In cancer patients, PIF (proteolysis-inducting factor), TNF (tumor necrosis factor), and LMF (lipid metabolizing factor) all promote _______.
Catabolism
Supplementation with this has been shown to stabilize weight in some cancer patients on oral diets experiencing progressive, unintentional weight loss.
Omega-3 fatty acid
Cancer drugs (type): these drugs kill cancer cells by stopping their growth or by making it hard for cancer cells to repair damage (side effects: n/v/hyperuricemia)
Alkylating agents
Cancer drugs (type): prevents nutrients and oxygen from being delivered to the tumor by reducing the number of blood vessels, thus hindering its growth
Antiangiogenic agents
Cancer drugs (type): DNA substrate analogs that lead to incorrect DNA synthesis affecting cancer cells (side effects: n/v/d/stomatitis)
Antimetabolites
Cancer drugs (type): used to relieve n/v after chemotherapy (side effects n/d/increased gastric emptying/drowsiness)
Antiemetics
Corticosteriods can cause 4 nutrition-related side effects:
1) hyperglycemia, 2) weight gain, 3) sodium/fluid retention, 4) calcium losses
Methotrexate is a _____ antagonist - it may decrease the absorption of these 4 components in food.
Folate; 1) lactose, 2) fat, 3) vitamin B12, 4) folate
Cancer drugs (type): these drugs correct the abnormal enzyme that causes cancer cells to grow out of control
Monoclonal antibodies
Bone cancer that most often occurs in the long bones of young people … and it most often spreads to ______.
Osteosarcoma, the lungs
Bone cancer staging:
Stage 1:
Stage 2:
Stage 3:
1: low-grade, no spread
2: high-grade, no spread
3: cancer of any grade that has spread beyond the bone
Most common method of treatment of bone cancer
Radiation
Most common drug used to treat bone cancer - helps to reduce bone breakdown, the risk of fracture/hypercalcemia, and bone pain
Bisphosphonates
Hematopoietic stem-cell transplantation is _____ _____ transplantation.
Bone marrow
Leukemias, lymphomas, and multiple myeloma are all:
Hematological cancers
The preparative regimen for bone marrow transplantation includes: ______ and _______ in order to: ______
High-dose chemotherapy and may also include total-body radiation; suppress immune reactions post-transplant
Most common indication for stem-cell transplantation
Hematological cancers
Post stem-cell transplantation - what diet would be most appropriate and why?
Neutropenic diet (low-bacteria)because the immune system is compromised and would not want to expose to a high-bacteria diet in an effort to reduce the risk of food-borne illness.
Post stem-cell transplantation - Provide _ - _ kcal/kg
30-35
Post stem-cell transplantation - Provide _ - _ g/kg protein
1.5-2.0
Neutropenic diet after bone marrow transplantation - follow for __ months or until immunosuppressive therapies are complete.
3
Neutropenic diet guidelines - name 5 things it entails
Hand washing, safe food temperatures
Avoid unpasteurized milk and juices, raw or undercooked foods containing heme protein, yogurt with active cultures, hot dogs/bacon/sausage/lunch meat, soft or mold-containing cheeses, unwashed produce, picked fish, etc.
Most common symptom of a brain tumor:
Headache
Headaches are the most common symptom of brain tumors because they:
Produce inflammation in the brain, compressing other parts of the brain as the tumor grows, causing swelling and pressure inside the skull
Non-neuronal cells in the brain that support and protect neurons in the the brain
Glial cells
A _____ is a tumor of neurological origin which constitutes over 50% of all brain cancers.
Glioma
_________ is the most frequent and devastating primary malignant brain tumor in adults.
GBM (glioblastoma multiforme)
Standard of treatment for GBM patients includes:
Surgical intervention, followed by radiation with chemotheraphy
Type of brain tumor that may be classified as benign or malignant and surgical excision is curative for most patients
Meningioma
The meninges covers and protects ____ and ____.
the brain and spinal cord
Brain cancer protein needs: for surgery =s _ - _ g/kg and RTX =s _ - _g/kg
1.2-1.5; 1.0-1.2
Why may you want to limit sodium in brain tumor patients?
to correct cerebral edema
Which are more common: primary or secondary brain tumors?
Secondary
Diagnosis of cancer is done by:
Biopsy
The process of measuring the amount that the cancer has spread or grown using medical imaging techniques
Staging
Stages of colon cancer: Stage 1: Stage 2: Stage 3: Stage 4:
1: Cancer is small, localized, and limited
2: Local spreading occurs within the organ and lymph nodes
3: Cancer cells invade through the organ and lymph nodes
4: Mets of the tumor occurs in other tissues of the body
Patients with ulcerative colitis and Crohn’s disease are at a higher risk for this type of cancer.
Colon
Risk factors of ______ cancer include: age >50, excessive alcohol intake, overweight or obese, smoking, western-style diet (high in red meat & fat and low in vegetables), family history, and inflammatory cytokines (cyclooxygenase-2 (COX-2) and prostaglandin).
Colon
A fecal occult blood test and sigmoidoscopy are used to help in diagnosis of ______ cancer.
Colon
In cancer of the small intestine, malignancy is generally found in the lower ______ and _______ with a ____ rate of mortality and ___ early symptoms.
Duodenum, Ileum, high, few
Common symptoms of ______ cancer include bloody bowel movements, pain, and irregular bowel habits.
Rectal
In colon cancer, slow-growing malignancies are usually found in these 3 sections of the colon. Few early symptoms are found but the prognosis is optimistic.
Cecum, lower ascending colon, sigmoid colon
The ______ (_________) colon absorbs fluids and salts and the _______ (_________) colon stores feces. Which one tends to cause obstruction?
Right (ascending), Left (descending), Left (descending)
Category of cancers that affect esophageal, hypopharyngeal, laryngeal, lip and oral cavity; nasopharyngeal, oropharyngeal, paranasal sinus and nasal cavity; and parathyroid and salivary glands
Head and neck cancers
Head and neck cancers – the highest incidence rate is in this group of people…
Black males
85% of head and neck cancers is linked to _______.
Tobacco use
Damage from acid reflux may contribute to ________ cancer.
Esophageal
Odynophagia
Painful swallowing w/ or w/o dysphagia
Odynophagia, dysphagia, muscositis, esophagitis, xerostomia, dental caries, wt loss, taste changes, and decreased appetite are all side effects of ________ treatment.
Radiation
Treatment for localized thyroid cancer
Surgical removal of the thyroid gland
Thyroid cancer: MUST UNDERSTAND: pituitary gland produces ______ which causes the ________________ to produce thyroid hormones and release thyroidglobulin. Patients who undergo surgical resection of the thyroid gland must take Thyroxine medications to keep ________ low.
TSH (thyroid-stimulating hormone), thyroid gland, TSH
MNT for esophageal cancers:
1) Symptom control
2) Avoid refeeding syndrome
3) Diet high in energy (- kcal/kg) and protein (- g/kg)
4) Dysphagia/texture-modified diets as needed
5) ENS as needed via g- or j-tube for maintaining gut integrity
6) Increase fluid intake (dehydration is common)
7) MVI
30-35, 1.0-1.5
Medication: _____ can lower esophageal cancer risk by 90% by reducing prostaglandin production
Aspirin
Medication: What is Pilocarpine used for?
Saliva substitute for xerostomia
Gastric cancer is most commonly found in what part of the stomach?
Pylorus
Over 90% of gastric cancers begin in the ….
This type of gastric cancer is known as
Glandular cells; adenoma
A gastric lymphoma begins in the _______
Immune system
Gastric carcinoid syndrome starts in the _________
Hormonal system
Gastrointestinal stromal tumors (GIST) begin in the ________
Nervous system
H. pylori infection can commonly play a role in development of what kind of cancer?
Gastric cancer
Most common treatment method for gastric cancer
Surgery
Stage of gastric cancer limited to the inside of the lining of the stomach. Since the tumor is small, it can be removed via endoscopy.
Stage 1
Procedure where only the part of the stomach having the cancer is removed.
Subtotal gastrectomy
In stage 3 or 4 gastric cancer, it may be necessary to undergo this procedure and connect the _____ to the ______.
Total gastrectomy; esophagus; small intestine
Before or following surgical intervention for gastric cancer, ______ may be used to shrink the tumor or kill any remaining malignant cells respectively.
Radiation
After surgical resection of the stomach: review MNT
Small meals and snacks with fluids in between meals
Foods that are nutrient/energy/protein-dense
Manage symptoms of dumping syndrome (avoid concentrated carbohydrates, alcohol, and carbonated beverages)
MVI daily (to correct anemia/malabsorption issues plus supplementation specially with selenium, vit E, and beta-carotene has been shown to decrease mortality)
Prior to surgical resection of the stomach, what should be considered to help optimize nutrition status post-op?
J-tube placement
Cancer: HCC stands for:
Hepatocellular carcinoma
Alcohol abuse and Hep B/C causes chronic inflammation of the ______, increasing the risk of this type of cancer.
Liver, HCC
Patients with HCC may have problems with significant abdominal fluid retention, a condition known as ______.
Ascites
Renal cell cancer, Wilm’s tumor, and bladder cancer are all what type of cancer?
Urinary tract cancers
Blood in the urine and increased frequency of urination are common symptoms of this type of cancer.
Renal cell cancer
HTN, long-term dialysis, smoking, obesity, and occupational exposure to dyes, rubber, and leather products specifically increase the risk for this type of cancer.
Renal cell cancer
A highly malignant tumor occurring almost exclusively in children younger than 6 years of age; common treatment includes nephrectomy and chemotherapy.
Wilm’s tumor
The two main types of lung cancer
SCLC (small-cell lung cancer, 15%) and NSCLC (non-small cell lung cancer, 85%)
What specific cancer is the leading cause of cancer-related death in the U.S.?
NSCLC
3 major subtypes of NSCLC
Adenocarcinoma (40%), squamous carcinoma (30-35%, slow growing), large-cell carcinoma (5-15%)
Type of cancer that accounts for 15% of all lung cancer patients and is more aggressive but usually responds well to specific chemo protocols.
SCLC
1 cause of lung cancer (accounts for 85% of all cases)
Smoking (increases susceptibility by 25 times)
Lung cancer’s 5-year survival rate is only … ___ %
15
Cancer cells of the lung often spread to these four areas…
Brain, bone, skin, liver
Toxicity is far less when docetaxel is taken with these two supplements:
Vitamin B12 & folate
An infection of the common bile duct, the tube that carries bile from the liver to the gallbladder and intestines
Cholangitis
Nearly all pancreatic cancers are primary or secondary?
Primary
About 50-70% of pts with pancreatic cancer have it in the ____ region of the pancreas while about 50% have it in the ______ and ______ regions.
head; body and tail
Development of this cancer progresses over many years and common symptoms include: cholangitis, nausea, anorexia, weight loss, new-onset diabetes, light-colored stools, dark urine, steatorrhea, jaundice & pruritus (itching)
Pancreatic cancer
Thrombophlebitis (spontaneous blood clots in the portal blood vessels) may be associated with this type of cancer and is called…
Pancreatic cancer; the Trousseau sign
A diet high in ________ may mitigate pancreatic precancer by inhibition of cellular proliferation through induction of cell cycle arrest and apoptosis. However, the Academy does not recommend routine use of it in supplement form.
Omega-3 fatty acids
When pancreatic cancer has spread to the liver, common mode of treatment is ________.
Chemotherapy
The Whipple procedure often involves the surgical removal of:
The duodenum, the head of the pancreas, the gallbladder, and the spleen; it may also include the pylorus part of the stomach
After the Whipple procedure, the diet can be liberalized after __ -__ days, adding one new food at time
10-14
For pancreatic insufficiency: name 4 minerals that may become deficient unless supplemented … and what vitamins?
Calcium, zinc, selenium, and iron; ADEK (fat-soluble vitamins)
After the Whipple’s procedure: what kind of diet should be followed?
1) low fat (40-50g/day)
2) low lactose
3) omit fried foods; nut and seeds
4) small, frequent meals
5) avoid simple sugars/CCD to help manage hyperglycemia
Usual chemotherapy drug for pancreatic cancer is:
Gemcitabine
Pancrelipase and pancreatin are _________ used for _________ and should not be used if the patient has a _____ allergy (food).
Pancreatic enzymes, pancreatic insufficiency, pork
The most common cancer in the US
Skin cancer
Name the 3 types of skin cancers.
Basal cell carcinoma, squamous cell carcinoma, malignant melanoma
Excessive UVB light exposure in childhood promotes the development of what particular type of skin cancer?
Melonomas
This particular skin cancer starts as a small, shiny, firm nodule that enlarges slowly, bleeds and scabs, then heals and repeats; originates in the deepest layer of the epidermis
Basal cell carcinoma (BCC)
This particular skin cancer originates in the middle layer of the epidermis and begins as a reddened area with a scaly, crusted surface that does not heal.
Squamous cell carcinoma (SCC)
The deadliest form of skin cancer and originates in the melanocytes (cells that make melanin in the deepest layer of the epidermis). Most begin as black or brown.
Melanoma
Early warning signs of ______ are identified by this acronym: ABCDE which stands for _____.
Melanoma; Asymmetry, Border, Color, Diameter, Evolving
Type of breast cancer characterized by breast cancer cells having a high proportion of estrogen receptors in the nucleus
ER-positive breast cancer
Early exposure in early childhood/adolescence to phytoestrogens may be protective of _______.
Breast cancer
Stages of breast cancer: Stage 0: Stage 1: Stage 2: Stage 3: Stage 4:
0: in situ; limited to lining or duct; has not spread to surrounding fatty tissue
1: spread to surrounding fatty tissue but not to lymph nodes
2: spread to lymph nodes
3: spread extensively into the axillary (underarm) lymph nodes
4: highly metastasizing to other parts of the body
_________ is a highly malignant neoplasm of the placenta with a secretion of hCG which stands for:
Choriocarcinoma; human chorionic gonadotropin
Define a molar pregnancy.
Instead of a fetus developing during pregnancy, a tumor develops instead.
Choriocarcinoma can develop in molar pregnancies, miscarriages, or full term deliveries as well as in men, presenting as a _______ neoplasm.
testicular
This enzyme is found in all choriocarcinomas.
Fatty acid synthase
Prostate cancer stages Stage 1: Stage 2: Stage 3: Stage 4:
1: cancer located only in the prostate
2: locally-advanced cancer (larger) still within prostate
3: cancer has spread to outside the prostate but not to the lymph nodes
4: cancer has spread to lymph nodes/other regions of the body
Name the term: Internal radiation therapy in which small radioactive pellets are inserted or transplanted into the prostate gland
Brachytherapy
Red fruits/vegetables like grapes and red wine contain this antioxidant.
Resveratrol
Red/pink fruits/vegetables like tomatoes, pink grapefruit and watermelon contain this antioxidant.
Lycopene
Red/purple fruits/vegetables like pomegranates, grapes, plums, and berries contain this antioxidant.
Anthocyanins
Orange fruits/vegetables like carrots, mangoes, apricots, cantaloupes, pumpkin, and sweet potato contain this antioxidant.
Alpha and beta carotenes
Orange/yellow fruits/vegetables like oranges, peaches, papaya, and nectarines contain this antioxidant.
Beta-cryptoxanthin
Yellow/green fruits/vegetables like spinach, collard greens, yellow corn, green peas, avocado and honeydew contain these antioxidants.
Lutein and zeaxanthin
Green fruits/vegetables like broccoli, Brussels sprouts, cabbage, bok coy and kale contain these antioxidants.
Sulforaphane, isothiocyantes, indoles
White/green fruits/vegetables like garlic, onion, asparagus, leeks, shallots, and chives contain this antioxidant.
Allyl sulfides
Cancer that involves the uncontrolled proliferation of leukocytes and their precursors in blood-forming organs, with infiltration into other organs. The blood has a grayish-white appearance.
Leukemia
This type of leukemia progresses rapidly, with an accumulation of immature, fractionless cells in the marrow and blood so that the bone marrow stops producing enough normal red blood cells, white blood cells, and platelets and anemia develops.
Acute leukemia
This type of leukemia progresses slowly.
Chronic leukemia
The most common childhood cancer.
Leukemia
ALL stands for what type of cancer? Obesity is a well-known problem with children with this. It accounts for ___ percent of all childhood leukemias.
Acute lymphocytic leukemia; 50%
Insulin-like growth factor I (IGF-1) and insulin act to promote cell proliferation (associated with high birth weight) and inhibit cell apoptosis, increasing risk of this type of cancer.
Childhood leukemia
Limiting exposure to cured/smoked meats/fish, nitrites, and nitrosamines can decrease the risk of childhood/adolescent _______.
Leukemia
Primary treatment of leukemia is ________ to kill attacking abnormal RBCs.
Chemotherapy
Stages of medical treatment of acute leukemia:
Stage 1 called _______ : destroy as many cancer cells as quickly as possible to bring about a remission
Stage 2 called _______: the goal is to get rid of leukemia cells where they reside
Stage 3 called _______: lower doses of chemotherapy are given over __ years
Induction; Consolidation; Maintenance; 2
ALL affects ____ and _____. It often spreads to _____ and _____.
Bone marrow and lymph nodes; the covering of the brain and spinal cord
AML stands for? It starts in the ______ but moves into the blood and to the lymph nodes, liver, spleen, central nervous system, and testes. It consists of the proliferation of myeloblasts , which are immature polynuclear _______.
Acute myelogenous leukemia; bone marrow; leukocytes
CLL stands for? It involves the crowding out of normal leukocytes in the ______, interfering with the body’s ability to produce other blood cells. It is common more in adults or children? It is more or less common than CML?
Chronic lymphocytic leukemia; lymph glands; adults; more (twice)
CML stands for? It mainly affects children or adults?
Chronic myelogenous leukemia; adults
T-cell prolymphocytic leukemia (T-PLL) is characterized by overproduction of ________ in the _______. It is ____ common than other types and is _____ to treat and does not respond well to _________.
WBCs; bone marrow; less; difficult; chemotherapy
Name two types of lymphoma. Which one is more common?
Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL); NHL
Treatment of HL involves ______ and _______ and the survival rate is _____ (high/low).
Radiation and chemotherapy; high
Burkitt’s lymphoma is associated with a prior infection with ________.
the Epstein-Barr virus
The distinction between Hodgkin’s disease and non-Hodgkin’s lymphoma is made upon examination of the cancerous material (from a biopsy or aspiration of the tumor tissue). The type of _______ identified in the sample determines whether a lymphoma is classified as Hodgkin’s disease or non-Hodgkin’s lymphoma.
abnormal cells
This type of cancer is a rare form of high-grade, T-cell NHL of the upper small intestine. It is specifically associated with this disease.
Enteropathy-associated T-cell lymphoma (EATL)
Most common type of treatment for NHL
Radiation
Multiple myeloma is a malignant cancer in which ________ proliferate and invade bone marrow.
Plasma cells
