Week 9 Oncology Flashcards
How many Canadians are diagnosed with Cancer during this 3 hour lecture?
66
What is the leading cause of death in Canada?
Cancer (followed by heart disease)
how many Canadians will develop cancer during their lifetime?
40% - 2 in 5
How costly is cancer in canada?
$4.4 billion
Cancer is the 7th most costly illness in Cnada
1 in ____ men will develop cancer
1 in ____ women will develop cancer
1 in 2.2. for men (45%)
1 in 2.4 for women (42%)
what are the most common cancers in men? women?
men:
- lung
- colorectal
- prostate
women:
- lung
- colorectal
- breast
what are 2 common characteristics of all cancers?
- uncontrolled cellular proliferation
- ability of cells to metastasize or migrate from IG site to distant site
what are the 10 risk factors for cancer?
- age
- tobacco
- sun exposure
- carcinogen exposure
- family history
- bacteria
- alcohol
- dietary factors
- lack of physical activity
- excess weight
what are 5 direct causes of cancer?
- genetics
- error in cell division
- carcinogens
- radiation
- UV
what are 6 nutrition risk factors for cancer?
- lots of red meat (sausage, bacon, and then pork, beef, lamb)
- smoking, salting, pickling
- high temp cooking
- high total fat intake
- low fruit and veggie intake
- high alcohol consumption
what are 4 nutrition protective factors for cancer?
- fruits and veggies
- whole grains
- fibre
- vitamin D - ALL spfs block vitamin D
what are the 2 types of cancer genes?
- oncogenes (control cell division)
- tumor suppressor genes (cause apoptosis)
Cancers are characterized by 3 things:
- unregulated cell growth
- tissue invasion
- metastasis
How would you define cancer?
- it is a genetic disease that causes cells to divide abnormally and spread into surrounding areas
- a disorder of cell growth and regulation
- abnormal cells divide without control and are able to invade other tissues
- a group of >100 multifactorial diseases in which abnormal cells reproduce in an uncontrolled manner
According to the WHO, which food group (and 3 foods in it) cause cancer
processed meats:
- sausages/hotdogs
- bacon
- salami
According to the WHO, which food group (and 3 foods in it) probably cause cancer
red meats
- pork
- beef
- lamb
How many Canadian deaths are due to behavioural and dietary risk factors?
1/3
the original cancer, with the original specific area, is called the:
primary cancer
Cancer screening tests include 3 general types of tests:
- lab tests
- imaging tests
- biopsy tests
calcitonin and CA-125 are ____
tumor markers - substances produced by cancer cells or by other cells in response to cancer
What are 7 examples of possible imaging scans for cancer?
- CT scan
- MRI
- nuclear scan
- bone scan
- ultrasound
- x-ray
- PET scan
What type of imaging scan uses radioactive material attached to glucose
Pet scan
radioactive material travels through the body, collecting in cells that us a lot of energy (cancer cells)
____ works because radioactive material travels to the area where there is more energy concentration becauce cancer cells produce the most energy
PET Scan
In most cases, a ____ test is required to diagnose cancer
biopsy test
In a biopsy test, how do you obtain a sample of the tissue? there are 3 ways
- needle
- endoscopy
- surgery
Tumors are classified and assigned a stage using 1 of 2 methods
- the tumor node metastases staging system (TNM)
- overall staging group
What are the 7 main treatment modalities for cancer?
- chemotherapy
- radiation
- immunotherapy
- target therapy
- hormone therapy
- stem cell therapy
- surgery
Depends on tumor location, size, and health of person
what are the 2 types of surgery used to treat cancer?
- open surgery
- minimally invasive surgery
What are the 6 different routes to administer chemotherapy?
- oral
- IV
- injection
- intraperitoneal
- intra-arterial
- topical
What is adjuvant chemotherapy?
chemo administered after surgery to remove any chance cells that were missed
what is neoadjuvant chemotherapy?
cheo administered to shrink the tumor so it can be more easily treated by radiation or surgery
Why does chemo have so many side effects?
toxicity due to rapidly dividing cells
What are 9 common medical side effects of chemo?
- neutropenia - low neutrophil count
- thrombocytopenia - low blood platelet count
- anemia
- diarrhea
- mucositis - inflammation of digestive tract
- alopecia - hair loss
- cardiotoxicity - adverse effects on structure and function
- neurotoxicity
- nephrotoxicity
what are common nutrition side effects of chemo?
- anorexia
- nausea
- mucosititis - all through digestive tract
- diarrhea
- constipation
- weight loss
- ageusia - no taste
- hypogeusia - little taste
- dysgeusia - distorted taste
- xerostomia - dry mouth, lack of saliva
- lactose intolerance
- thrush
Cistaplin and Dacarbazine are the only 2 chemo drugs that
have taste alterations (metallic taste
____ leads to alteration in cellular and nuclear DNA from eletrcomagnetic rays and charged particles
radiation
What are 6 of the most common side effects of all of the chemo agents?
- nausea and vomiting
- diarrhea
- xerostomia
- stomatitis
- anorexia
- taste alterations
Which cells are most susceptible to radiation?
continuously proliferating cells
is toxicity or radiation localized or generalized?
it is localized to the region that is being irradiated
what are the 2 types of radiation?
- internal beam (seeds placed in the body)
- external beam (comes from a machine)
How does radiation work?
it damages the cancer cell’s dna
What are the main nutrition side effects of radiation?
- fatigue
- anorexia
3.. nausea - oropharyngeal
- taste alterations
- mucositis
- dysphasia - painful swallowing
- xerostomia (dry mouth
- esophagitis
- abdomen/pelvis -
- steatorrhea - fat in stool
Malnutrition is VERY common in oncology, and impact ____ % of cancer patients. it is the biggest cause of cancer death
30-70%
OR
40-80%
what is the biggest cause of cancer death?
malnutrition
what is the primary goal of oncology nutrition therapy?
what are the secondary and tertiary goals?
primary goal: prevent malnutrition
secondary goal: optimize nutritional status during treatment
what % of cancer deaths are attributed to malnutrition rather than tumor/malignancy itself?
10-20%
Cancer is associated with rapid and extensive weight loss. Muscle loss or sarcopenia is seen in ____ %
15-50%
by age 80, what % of your muscle is gone?
30%
What is cancer cachexia?
it is a type of malnutrition
it is a muscle wasting disease of cancer
can occur with our without fat loss - you are losing muscle without losign fat
chances can be irreversible with traditional nutrition
what are the 5 mechanisms in volved in cancer cachexia?
- systematic inflammation - the main hallmark for cancer cachexia) - production of acute phase proteins
- anorexia
- decreased physical activity
- decreased secretion of host anabolic hormones
- altered protein, lipid and carb metabolism
What are 4 different types of cancer malnutrition?
- cancer cachexia
- tumor mediated malnutrition
- starvation-related malnutrition
- sarcopenia
What happens in tumor related malnutrition?
- tumor signals CNS signals anorexia
- inflammation leads to muscle wasting, liver metabolism changes, and fat use and depletion
what is starvation-related malnutrition?
chronic starvation WITHOUT inflammation
characterized by REDUCED ENERGY INTAKE, OR malabsorption when intake is normal
Can be fully reversed with proper nutrition