Oncology Flashcards
Neo-adjuvant
Therapeutic agent administered before main treatment
Adjuvant
Treatment in addition to main/primary treatment
Allotransplantation
Transplantation to recipient from genetically non-identical donor
Surgery
Remove or debulk the tumour
ERAS (enhance recovery after surgery)
- optimise nutritional status before + after surgery
Chemotherapy
Use of variety of drugs
Interfere with ability of cancer cells to divide + reproduce
Undesirable damage to normal cells can occur as drugs not selective
Given in combo w/ other drugs (targeting different aspects)
Cycles of treatment (good/bad days)
Side effects dependent type, dose, other medications
Radiotherapy
More targeted than chemo High energy radiation to shrink tumours + kill cancer cells DNA damage X-rays, gamma rays, charged particles Causes localised problems
Biological therapy
Use body’s immune system to fight cancer or lessen side effects
Multi-modality treatment may increase risk malnutrition
Allogenic stem cell transplant
Relapsed ALL/AML
10-20% mortality risk
56% matched to unrelated donors
Length stay - 3-6wk may have decreased appetite
Rejection - immune response, graft verses host disease
Cachexia
Complex metabolic process
Significant negative effect on prognosis + survival
Experienced by 40%
Increased complications of treatment
Symptoms - abdo pain, taste changes, malabsorption, muscle wasting, rapid weight loss
Possible nutritional consequences (10)
Cachexia N+V Weight gain Dysphagia Taste changes Pain Altered bowel habits Oral mucositis Oropharangeal candidiasis Social isolation
Weight gain
Medications and/or chemo
Seen in - breast, prostate, ovarian
Could be change eating pattern due to stress or low P.A
Dysphagia
Infection/inflammation can affect oral phase swallowing
Taste changes
Dysgeusia, hypogeusia, ageusia
Due to - chemo, infections, dry mouth
Advice - marinade, herbs/spices
Pain
Symptom/marker recurrence
May be related to tissue destruction
May be tumour damaging or travelling along nerves
Fatigue
Acute or chronic
Depends site, stage, treatment (4-96%pt)
Impacts appetite, cook, shop
Altered bowel habits
Fats may be hard to digest
Constipation
Diarrhoea
Lactase production may be impaired
N+V
Caused by treatments
Immediately or days later (understand pattern to maximise nutritional status)
Risk increased with radiation dose
Triggers - anxiety, pain, motion, poor blood flow, irritation, gas in stomach, taste, smell
Oral mucositis
Inflammation of mucosal membranes lining GI tract Ulceration may occur Can be exacerbated by infections Drug treatment Self limiting
Oropharangeal candidiasis
White coating on tongue
Foul smelling breath
Often decreased oral intake
Promoting appetite
Short term success with drugs
Not suitable for all
Social isolation
Can develop as interest in food declines
Social/religious events revolve around food
Don’t want people to see them struggling
Family conflict
Pressure to eat
Wastage
Express love through food so tension if refused
Dietary advice
Find right time
Reminders
Tailored literature
Neutropenic diet
Controversial as restriction when vulnerable
Avoid - raw meat, egg, unpasteurised milk, buffets, pate
Survivorship
May have unmet needs
May struggle with consequences of treatment
Lifestyle changes
Long term follow up
