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1
Q

What is cancer?

A

A group of neoplastic diseases characterized by uncontrollable growth and spread of abnormal cells

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2
Q

What are the most common types of cancer in the US for men?

A
  • Prostate
  • Lung and Bronchus
  • Colorectal
  • Urinary
  • Melanoma
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3
Q

What are the most common types of cancer in the US for women?

A
  • Breast
  • Lung and Bronchus
  • Colorectal
  • Uterine
  • Thyroid
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4
Q

What is the TNM classification system used for?

A

To classify tumors based on Tumor size, Lymph Node involvement, and presence of Metastasis

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5
Q

What are the different grades in the tumor grading system?

A
  • Gx: Grade cannot be assessed
  • G1: Well differentiated (low grade)
  • G2: Moderately differentiated (intermediate grade)
  • G3: Poorly differentiated (high grade)
  • G4: Undifferentiated (high grade)
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6
Q

What are the 3 stages of carcinogenesis?

A
  • Initiation: normal cells develop some DNA damage
  • Promotion: initiated cells are stimulated to grow
  • Progression: tumor grows rapidly and invades neighboring tissues
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7
Q

What are the risk factors for cancer?

A

Smoking, overweight/obesity, physical inactivity, and diet

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8
Q

What is the role of nutrition in cancer treatment?

A

Nutrients can play different roles in different stages of carcinogenesis. Ex: Folate is important for preventing many types of cancer. However, once carcinogenesis has been initiated, folate can lead to proliferation and expansion of the tumor.

Methotrexate, an anti-folate chemotherapeutic agent, targets this metabolic process by inhibiting folate-mediated DNA synthesis.

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9
Q

What are some biological processes that protect the cell and prevent cancer initiation and progression?

A
  • Detoxification of carcinogens
  • Protection of DNA from oxidation
  • DNA repair
  • Cell cycle regulation
  • Promotion of cell differentiation
  • Induction of apoptosis in initiated cells
  • Prevention of angiogenesis
  • Suppression of inflammation
  • Regulation of hormonal signals
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10
Q

What are some examples of nutrients shown to support the biological processes that protect the cell?

A
  • Detoxification of carcinogens: Isothiocyanates, flavonoids
  • Protection of DNA from oxidation: Vitamins A, C, D, and E, selenium
  • DNA repair: Folate, selenium, lycopene, retinoids
  • Cell cycle regulation: Polyphenols, retinoids, folate, selenium
  • Promotion of cell differentiation: Long chain omega 3 fatty acids, Vitamin D, retinoic acid
  • Induction of apoptosis in initiated cells: Curcumin, polyphenols, sulforaphane, isothiocyanates, quercetin, lycopene
  • Prevention of angiogenesis: Indol-3-carbinol
  • Suppression of inflammation: Omega 3 fatty acids, indol-3-carbinol
  • Regulation of hormonal signals: Soy isoflavones, Vitamin D, carotenoids
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11
Q

What are some key strategies for cancer prevention?

A
  • Healthful dietary patterns
  • Regular physical activity
  • Maintaining a healthy weight
  • Avoiding tobacco and excess sun exposure
  • Getting certain vaccines and regular screenings
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12
Q

What foods have direct antioxidant activity to reduce development of reactive oxygen species that lead to inflammation?

A

Vitamins C and E, carotenoids

Polyphenols in tea, berries, onions, grapes, turmeric, ginger

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13
Q

What do gut bacteria produce from fermentable dietary fiber and B glucons?

A

Butyrate

Butyrate shows potential anti-inflammatory and tumor-suppressive properties

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14
Q

What are the potential anti-inflammatory effects of gut bacteria?

A

Producing butyrate

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15
Q

What are the sources of omega 3 fatty acids?

A

Fish, flaxseed, chia seeds, walnuts

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16
Q

What is the evidence regarding soy consumption and cancer risk?

A

Soy foods do not increase cancer risk and may lower it

Soy isoflavens may slow the growth of cancer cells

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17
Q

What is considered moderate soy food consumption?

Study These Flashcards
A

1-2 standard servings daily of whole soy foods

One serving averages 7g protein and 25mg isoflavens

18
Q

What is the potential benefit of consuming ground flaxseed?

Study These Flashcards
A

Lower risk of breast and uterine cancer

ALA in flaxseed can be converted to long chain omega 3 fatty acids

19
Q

What is the recommended level of physical activity to lower cancer risk?

Study These Flashcards
A

At least 150 minutes of moderate activity or 75 minutes of vigorous activity per week for adults

60 minutes of moderate or vigorous activity per day for children

20
Q

What are the recommended levels of physical activity during treatment and survivorship?

Study These Flashcards
A

Individualized during treatment, survivors with severe anemia should delay exercise

Survivors with severe fatigue are encouraged 10 minutes of physical activity every day

21
Q

What is a poor reflection of body composition?

Study These Flashcards
A

BMI

Waist circumference, hip circumference, waist to hip ratio are better indicators

22
Q

What is the main tissue implicated in cancer cachexia?

Study These Flashcards
A

Muscle

Visceral, subcutaneous, and intermuscular fat are also involved

23
Q

What are the key biological mechanisms relating to energetics and cancer?

Study These Flashcards
A

Visceral adipose tissue, insulin and IGF-1, leptin and adiponectin, estrogen

These factors contribute to insulin resistance, inflammation, and cancer development

24
Q

What is cachexia?

Study These Flashcards
A

A metabolic syndrome characterized by loss of muscle and sometimes fat mass

It leads to functional impairment and is difficult to reverse with nutrition support alone

25
What are the criteria for diagnosing cancer cachexia?
Weight loss, low BMI, low skeletal mass, low dietary intake, inflammation ## Footnote Different combinations of these criteria can indicate cachexia
26
What are the stages of cancer cachexia?
Pre-cachexia, cachexia, refractory cachexia ## Footnote Each stage has different characteristics and levels of severity
27
What is sarcopenic obesity?
The combination of low muscle mass and high adipose tissue
28
What is intermittent fasting?
A modality of calorie restriction involving 16-48 hours of little or no energy intake with periods of normal intake
29
Which chemotherapeutic treatments have been shown to be improved by short-term fasting?
Etopside, mitoxantone, oxaliplatin, cisplatin, cyclophosphamide, and doxorubicin
30
What are the recommended physical activity guidelines for cancer survivors?
150 minutes of physical activity per week with 2 sessions of resistance training
31
What percentage of cancer patients with GI, pancreatic, head and neck, and colorectal cancer experience signs of nutritional impairment at the time of diagnosis?
40-80%
32
What percentage of weight loss predicts a reduced response to oncology treatment, decreased survival, and decreased quality of life?
6%
33
When should nutrition screening be completed for all cancer patients?
On admission to oncology services and repeated throughout treatment
34
What are some nutrition impact symptoms experienced by cancer patients?
Anorexia, cachexia, muscle wasting, dysphagia, xerostomia, taste/smell changes, mucositis/stomatitis, N/V, esophagitis, diarrhea, early satiety, gastroparesis, malabsorption, constipation, SOB, dehydration
35
What are some examples of nutrition-focused physical findings?
Dermatologic findings, head and neck assessment, intra-oral cavity assessment, abdominal assessment, client history
36
What clinical characteristics support a diagnosis of malnutrition?
A minimum of 2 out of 6 characteristic criteria for malnutrition
37
What are the criteria for moderate malnutrition in acute illness or injury?
* Energy intake: <75% of estimated energy requirements for >7 days * Weight loss: 1-2% x 1 week, 5% x 1 month, 7.5% x 3 months * Physical findings: mild body fat loss, mild muscle mass loss, mild fluid accumulation
38
What are the criteria for severe malnutrition in acute illness or injury?
* Energy intake: <50% of estimated energy requirements for >5 days * Weight loss: >2% x 1 week, >5% x 1 month, <7.5% x 3 months * Physical findings: moderate loss of body fat and muscle mass, moderate to severe fluid accumulation, decreased grip strength
39
What are the criteria for moderate malnutrition in chronic illness?
* Energy intake: <75% of estimated energy requirements for >1 month * Weight loss: 5% x 1 month, 7.5% x 3 months, 10% x 6 months, 20% x 1 year * Physical findings: mild body fat loss, muscle loss, fluid accumulation
40
What are the criteria for severe malnutrition in chronic illness?
* Energy intake: <75% of estimated energy requirements for >1 month * Weight loss: >5% x 1 month, >7.5% x 1 month, >10% x 6 months, >20% x 1 year * Physical findings: severe loss of fat and muscle, severe fluid accumulation, reduced grip strength
41
What is the maximum rate of weight loss recommended for cancer survivors who are overweight or obese?
2 pounds per week

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