Nutrition and Cancer

Question 1

What part of the environmental part of cancer is determined by diet

Answer 1

30-35% (don’t memorise)

Question 2

Why are red and processed meats carcinogenic

Answer 2

Nitrates + Amino Acids make nitrosamines which are known to be mostly carcinogenic

Question 3

Which fats are carcinogenic

Answer 3

Saturated and Animal Fats

Question 4

What drink is carcinogenic

Answer 4

Alcohol

Question 5

Why are many healthy foods ‘anti’ carcinogenic

Answer 5

They have products that increase the elimation/metabolism of the carcinogenic nitrosamines

Question 6

Are cancer patients generally over, under or well-nourished

Answer 6

Approximately 75% of cancer patients are undernourished

Question 7

Which cancers cause the highest weight loss

Answer 7

Oesophogeal, Stomach and Laryngeal

Question 8

Cachexia

Answer 8

Chronic hypermetabolic state characterised by rapid weight loss and anorexia

Question 9

When might cachexia me seen

Answer 9

Patients with cancer, certain infectious diseases (malaria, TB, HIV, Cystic Fibrosis) & chronic alcholics

Question 10

Cancer cachexia vs starvation

Answer 10

Basal metabolic rate and total energy expenditure are decreased in starvation but increased in cachexia

Cachexia also causes inflammation while starvation does not

Question 11

Pathogenesis of Cancer Cachexia

Answer 11

Tumour induced inflammation causes the release of cytokines
These lead to the induction of the hepatic acute phase response, decreased protein synthesis/increased breakdown, anorexia, increased metabolism etc

Thus

Body fat/Muscle Mass are lost, the body is fatigued, immunity is impaired and the physical function & quality of life are impaired

Question 12

Goal of Nutrition Therapy for cancer patients

Answer 12

Increase likelihood of treatment completion & improvement of quality of life through supporting adequate energy/nutrient intake

This reverses past malnutrition, prevents weight loss/promotes weight gain, enhances immune function and reduces both physical & mental fatigue

Question 13

Describe nutrition therapy for cancer patients

Answer 13

Provide sufficient protein

Carbs should be primary energy source

Fat should represent ~25% energy intake

Adequate dietary fibre/fluid intake

Question 14

Enteral vs Parenteral Nutrition Support

Answer 14

Enteral refers to methods of nutrition that use the GI tract like a normal oral diet, liquid supplments or feeding tube

Parenteral is used when the GI tract is not functional/accessible/safe to use, e.g. colon cancer
Nutrients are delivered directly to the blood stream