Nutrition & Cancer

What dietary factors are linked to cancer?

Obesity/weight gain, red & processed meat (nitrosamines), saturated & animal fats, alcohol

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How many cancer patients are undernourished at diagnosis? What diet related affect does cancer have?

75% are undernourished with a significantly lower fat-free mass. Patients can experience anorexia, taste changes, dysphagia, nausea, vomiting, diarrhoea & other disease/treatment related factors

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What is cachexia?

Chronic hypermetabolic state characterised by rapid weight loss & anorexia. Generally seen in cancer patients, some infectious diseases (malaria, TB, HIV, CF) & chronic alcoholics. Prevalence depends on type of malignancy

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How is cachexia different to starvation or ageing?

Increased BMR, TEE & inflammation (BMR/TEE decreased & no change in inflammation for wasting and sarcopenia)

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What is enteral nutritional support?

Provided when patients are expect to (or have) not received adequate nutrition for 7 days. Small bowel feeding administered with pump over 8-20 hours

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What factors should be considered when deciding on a nutritional support dose?

Resting energy expenditure, physical activity level, stress factor, ref-eeding factor. Monitor nutrition status, tolerance, electrolytes etc.

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What is parenteral nutritional support?

Used when GI tract is not functional, accessible or safe to use e.g. colon caner

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In what form are protein/fat/CHO/fluids supplied in parenteral nutritional support?

Protein: non-essential amino acids & EAAs to maintain nitrogen balance/lean body mass. Fat: triglyceride emulson for essential fatty acids/energy. CHO: dextrose to prevent protein breakdown. Fluid/electrolytes administered according to fluid balance

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