Cancer Case Study PresentationKatrina Beining and Katie Koller2/8/14FN 4360

What is Cancer?

Over 100 diseases1

Cancer can cause almost any sign or symptom depending on size/location of tumor & how it effects organs and tissues1

Etiology

In general1: Normally: cell restoration or death occurs if DNA

damaged Cancer: continual cell growth with DNA damage

Environmental factors or errors in multiplication lead to damage

Overgrowth of cells can lead to a tumor Benign vs. malignant tumors Cells also intrude into other areas of body

Etiology Cont.

How does cancer spread?:1

Cells move to other parts of body through blood or lymph vessels

Cancer cells take over Process known as metastasis

Etiology Cont.

Factors:2

Overweight and obesity: Inflammation Immune system activity Hormones amounts and metabolism (estradiol and

insulin) Cell multiplication components Hormone accessibility from proteins (IGF-binding

proteins)

Etiology Cont.

Factors:2

Red and Processed Meats: Mutagens and carcinogensfrom high temperatures

and/or grilling Salt & nitrates/nitrites in luncheon/processed meats Iron in myoglobin can speed up production of

nitrosamine Amount of fatproduction of bile acids

Etiology Cont.

Factors2: Alcohol Consumption:

Less Understood Production of acetaldehyde damages DNA Raise levels of hormones (breast cancer)

Other note-worthy contributors: Food contaminants Pesticides and herbicides Salting and Pickling

Diagnostic Tests and Treatment General Tests:

Computed tomography (CT)3

Magnetic resonance imaging (MRI)3

Position emission tomography (PET)-CT3

Ultrasound4

Biopsy4

Specific Tests: Colonoscopy5

Mammogram4

Treatment options

How Cancer Affects Nutrition Status

High risk population5

Hypermetabolic state ->increased energy needs ->Cachexia5

Treatment side effects: anorexia, changes in taste and smell (tissue damage), GI dysfunction, nausea, vomiting, mouth sores, chewing problems, fatigue, food aversions5

Weight loss factors study results

Treatment and Prevention Treatment for cancer:

Small and frequent meals (2-3 hours), drink more water, nutritional supplements, high-protein snacks5

Foods not normally considered “healthy” consumed to maintain caloric intake/make easier to eat, ex. milkshake6

Prevention of Cancer:2

Physical Activity: Can inhibit cancer due to control over hormones and assisting immune

system Decreased risk of breast, colon, advanced prostate cancer (even if start

physical activity later in life) Fruits and Vegetables:

Contain fiber, carotenoids, sterols, phenols, vitamins, mineralsantioxidants Better to eat whole foods, versus supplements Water and fiber content can lead to weight loss

Fiber and Soy: More research needs to be done; may help reduce risk

Colorectal Cancer

Colorectal cancer:7

More prevalent with older age and males One of the more widespread cancers in developed

nations

Etiology: Genetic factors:2

History of benign polyps or colorectal cancer Environmental factors:7

Increased risk from diabetes, obesity, smoking, chronic inflammation, alcohol, and physical inactivity

Nutrition factors: fruit, vegetable, fiber2, red meat, calcium, and vitamin D intake

Case Studies:

Katie’s Patient: 63 yo Caucasian female Before Diagnosis:

Fairly healthy regarding diet and physical activity Smoked up until cancer diagnosis

Diagnosed after surgery, and had colostomy Met with oncology Dietitian

Started chemolactose intolerant, diarrhea, decreased muscle mass, white count down, crave sugar, no raw vegetables

After chemoEating more fresh fruit and vegetables, less nitrites/nitrates

Diagnosed againable to eat fruit/vegetables, constipated

Case Studies Cont.: Katrina’s Patient: 74 y.o. caucasian female

-Before Diagnosis: Healthy, varied diet, active lifestyle, non-smoker Strong Family Hx: mother, sister, brother, nephew

Diagnosed in ‘07 after routine colonoscopy and immediate surgery Started chemo shortly after

Became severely sick 5m. later= extreme wt. loss Food aversions: fruit & meat Nutritional advice from nurse b/c of wt. loss; 3m. break in treatment w/

routine scans during Cancer metastasized to lungs, lung punctured during biopsy= pain &

loss of appetite Put back on chemo since Persistent cough treated by radiation to throat= swallowing problems Original GI symptoms returned, lung tumor remains same size Currently, no food aversions

References 1. What is cancer? [Internet] [updated 2012 Mar 21; cited 2014 Feb 1]. Available from:

http://www.cancer.org/cancer/cancerbasics/what-is-cancer

2. Kushi LH, Doyle, C, McCullough M, Rock CL, Denmark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T, The American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Committee. American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing activity of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012; 62: 30-67.

3. Deng SX, An W, Gao J, Yin J, Cai QC, Yang M, Hong SY, Fu XX, Yu ED, Xu XD, Zhu W, Li ZS. Factors influencing diagnosis of colorectal cancer: a hospital-based survey in China. J Dig Dis. 2012 Oct; 13(10):517-524.

4. Diagnostic tests for breast conditions [Internet] [updated 2012 Jul 13; cited 2014 Feb 1]. Available from: http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/forwomenfacingabreastbiopsy/breast-biopsy-diagnostic-tests-used

5. Smith JL, Malinauskas BM, Garner KJ, Barber-Heidal K. Factors contributing to weight loss, nutrition-related concerns and advice received by adults undergoing cancer treatment. Adv Med Sci. 2008; 53(2):198-204.

6. Nutrition for the person with cancer during treatment: a guide for patients and families. American Cancer Society. 2012 Mar.

7. Huhn S, Bevier M, Rudolph A, Pardini B, Naccarati A, Hein R, Hoffmeister M, Vodickova L, Novotny, Brenner H, Chang-Claude J, Hemminki K, Vodiska P, Forsti A. Shared ancestral susceptibility to colorectal cancer and other nutrition related diseases. BMC Med Genet. 2012; 13(1): 94-105.

Cover Photograph: http://doitandhow.com/2011/07/14/cancer-ribbon-color-chart/