Chapter 40 Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery

Cancer When cells divide and reproduce abnormally and have the potential to spread throughout the body, crowding out normal cells and tissues One third of the cancer deaths in the United States each year can be attributed to nutrition and other lifestyle factors.

Cancer—Cause Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.

Cancer—Pathophysiology Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.

Cancer—Medical and Nutritional Management Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.

Prevention Factors Energy balance and exercise Fat Protein Fiber Fruits and vegetables Chemoprevention

Prevention Factors—cont’d Alcohol Coffee and tea Artificial sweeteners Nitrates, nitrites, and nitrosamines Method of food preparation

Fruits and Vegetables Appear to have a protective effect against cancer Thought to be due to the phytoestrogen and phytochemical content of the plant- based diet

Fat Research, although controversial, has shown evidence that high-fat diets are linked to an increased risk of cancer of the breast, colon, lung, and prostate

American Cancer Society’s Dietary Recommendations for Cancer Prevention 1. Eat a variety of healthful foods, with an emphasis on plant sources. 2. Adopt a physically active lifestyle. 3. Achieve and maintain a healthy body weight throughout life. 4. Limit consumption of alcoholic beverages.

Metabolic agents and cytokine blockers Prokinetic drugs Pharmacological Agents for Anorexia-Cachexia Syndrome and Weight Loss Management Appetite stimulants Metabolic agents and cytokine blockers Prokinetic drugs Anabolic agents

Factors That Affect Appetite Reference: American Institute for Cancer Research: Food, nutrition, and the prevention of cancer: a global perspective, Washington, DC, 1997, AICR.

Nutritional Implications of Cancer Therapy Chemotherapy —Taste abnormalities, diarrhea, constipation Radiation therapy —Fatigue, loss of appetite, skin changes Surgery —Fatigue, pain, loss of appetite Immunotherapy —Flulike symptoms, decreased food intake

Nutritional Implications of Cancer Therapy—cont’d Bone marrow transplant —Nausea, vomiting, diarrhea, mucositis, xerostomia, dysgeusia Severe oral muscositis Graft versus host disease (GVHD) Veno-occlusive disease (VOD)

Marrow Transplantation—Cause Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.

Marrow Transplantation—Pathophysiology Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.

Marrow Transplantation— Medical and Nutritional Management Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.

Severe Oral Mucositis Following Marrow Transplantation

Guidelines for Oral Feeding During Antitumor Therapy

Guidelines for Oral Feeding During Antitumor Therapy —cont’d

Commonly Used Complementary and Alternative Therapies Macrobiotic diet Vegetarian diet Gerson therapy Kelley/Gonzales regimen Juice therapies Shark cartilage DHEA Enzymes Oxymedicine Coenzyme Q10

Commonly Used Complementary and Alternative Therapies—cont’d Black cohosh Echinacea Flaxseed Ginger Iscador Milk thistle PC-SPECS Saw palmetto Soy and soy foods Teas

Nutrition in the Etiology of Cancer Epidemiologic research has evaluated the role of diet in the etiology of cancer in different population groups. Diets contain inhibitors and enhancers of carcinogenesis. Laboratory studies have served as models to test the effect of food and nutrition on cancer development.