Cancer

• Cancer


  Growth of malignant tissue, the second most common cause of death in the United States
• Cancer is not a single disorder, there are many kinds of malignant growths
• Types of cancer


  • They have different characteristics, occur in different locations in the body, take different courses, and require different treatments
• Isolated, nonspreading type of skin cancer may be removed in a physician's office with no effect on nutrition status, advanced cancers-especially those of the gastrointestinal (GI) tract and pancreas-can seriously impair nutrition status
• The most common cancers in the United States are breast cancer (in women), prostate cancer (in men), lung cancer, and colorectal cancers
• How Cancer Develops


  1. Genetic mutations alter gene expression in a single cell

  2. The affected cell loses its built-in capacity for halting cell division and produces daughter cells with the same genetic defects

  3. The abnormal mass of cells called a tumor (or neoplasm) grows

  4. A network of blood vessels forms to supply the tumor with nutrients

  5. The tumor can disrupt the functioning of normal tissue

  6. Tumor cells may metastasize, spreading to other regions in the body
• Reasons why cancers develop

  • Inherited genetic defects
  • Metabolic processes that promote carcinogenesis
  • Interaction between a person's genes and the environment
  • Exposure to carcinogenic substances
• Nutrition and Cancer Risk

  Diet and lifestyle strongly influence cancer risk
• Nutrition-related factors that may increase cancer risk

  • Obesity
  • Red meat
  • Processed meats
  • Saturated and salt preserved foods
  • High-calcium diets over 1500 mg daily
  • Low level of physical activity
• Nutrition-related factors that may decrease cancer risk

  • Fruits and nonstarchy vegetables
  • Carotenoid containing foods
  • Tomato products
  • Cruciferous vegetables
  • Vitamin C-containing foods
  • Folate-containing foods
  • Selenium-containing foods
  • Milk products and calcium supplements
  • High level of physical activity
• Obesity increases cancer risk, in part by altering the levels of hormones that influence cell growth, such as insulin, the sex hormones, and several kinds of growth factors
• About 1 in 30 cancer deaths can be attributed to alcohol consumption, which correlates strongly with cancers of the head and neck, liver, stomach, colon, mouth, and breast
• Cooking meat, poultry, and fish at high temperatures (by frying or charbroiling for example) may cause carcinogens to form in these foods
• Consumption of meat carcinogens has been linked to cancers of the colon, rectum, pancreas, and kidney
• Consuming fruits and vegetables may decrease the risks of some cancers, possibly due to nutrients and phytochemicals with antioxidant activity
• Inadequate folate intakes may allow DNA damage to accumulate
• Dietary fiber may help to protect against colon and rectal cancer by diluting potential carcinogens in fecal matter and accelerating their removal from the GI tract
• Guidelines for reducing cancer risk

  • Maintain a healthy body weight
  • Be physically active daily
  • Choose a healthy diet that emphasizes plant foods
  • Limit consumption of energy-dense foods and sugary drinks
  • Consume whole grains, vegetables, and fruits daily
  • Limit consumption of red meat, processed meats, and salty/preserved foods
  • Limit alcohol consumption
• Nonspecific effects of cancer

  • Anorexia, fatigue, unexplained weight loss, night sweats, skin lesions, and hyperpigmented (darkened) skin
• Factors that contribute to anorexia or otherwise reduce food intake in cancer patients

  • Mental distress, anxiety, and depression
  • Nausea and early satiety
  • Fatigue
  • Pain
  • Gastrointestinal obstructions
  • Side effects of cancer therapies
• Metabolic changes in cancer

  • Increased protein turnover but reduced muscle protein synthesis
  • Increased triglyceride breakdown, elevating serum lipids
  • Insulin resistance
• Cancer cachexia


  Characterized by anorexia, weight loss, muscle wasting, anemia, and fatigue, develops in 50 to 80 percent of cancer patients and is responsible for as many as 20 percent of cancer deaths
• Primary medical treatments for cancer

  • Surgery
  • Chemotherapy
  • Radiation therapy
• The likelihood of effective cancer treatment is highest with early detection and intervention
• Nutrition-related side effects of cancer surgeries

  • Aspiration
  • Dry or sore mouth
  • Reduced chewing or swallowing ability
  • Reduced sense of taste or smell
  • Esophageal strictures
• Cachexia

  Involuntary weight loss of more than 5 percent of body weight over the preceding 6 months
• Nutrition intervention alone is unable to reverse cachexia
• Treatments for Cancer


  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Any combination of the three
• Surgery


  Performed to remove tumors, determine the extent of cancer, and treat nearby tissues
• Nutrition-Related Side Effects of Cancer Surgeries

  • Aspiration
  • Dry or sore mouth
  • Reduced chewing or swallowing ability
  • Reduced sense of taste or smell
  • Altered gastric motility
  • Reduced swallowing ability
  • Dumping syndrome
  • Early satiety
  • Inadequate gastric acid secretion
  • Malabsorption of iron, folate, and vitamin B12
  • Fluid and electrolyte imbalances
  • General malabsorption
  • Diabetes mellitus
• Chemotherapy


  Uses drugs to inhibit tumor growth, shrink tumors before surgery, and prevent or treat metastasis
• Nutrition-Related Side Effects of Chemotherapy

  • Abdominal pain
  • Anorexia
  • Nausea and vomiting
  • Oral mucositis
  • Reduced taste sensation
• Radiation Therapy


  Treats cancer by bombarding cancer cells with X-rays, gamma rays, or various atomic particles
• Nutrition-Related Side Effects of Radiation Therapy

  • Anorexia
  • Damage to teeth, gums, or salivary glands
  • Dysphagia
  • Esophagitis
  • Nausea and vomiting
• Increased Nutrient Losses from Cancer Treatments

  • Diarrhea
  • Gastrointestinal inflammation
  • Malabsorption
  • Blood loss from intestine and bladder
• Altered Metabolism from Cancer Treatments

  • Anemia, neutropenia
  • Fluid and electrolyte imbalances
  • Hyperglycemia
  • Interference with vitamins or body compounds
  • Negative nitrogen and micronutrient balances
• Hematopoietic Stem Cell Transplantation

  Replaces blood-forming stem cells destroyed by high-dose chemotherapy or radiation therapy
• Graft-versus-host disease often damages tissues of the GI tract, leading to severe intestinal inflammation, profuse diarrhea, and malabsorption
• Cancer Immunotherapy


  Treatments that enable a person's own immune system to fight their cancer
• Potential Side Effects of Cancer Immunotherapy

  • Fever
  • Nausea
  • Vomiting
  • GI symptoms
  • Headache
  • Fatigue