Nutritional Care in Oncology

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Nutritional Care in Oncology

• Presented by
• Susan Villaroman
• Dr. Kelly Salvador

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Agenda/Overview

• V. Think Positive
• Teach Yourself a Lesson
• Interrupt Your Negative Thoughts
• Set Realistic Goals
• Be Good to Yourself
• Be Glad It's Not Worse
• Look for the Silver Lining
• VI. Chemotherapy Side Effects and their
  Nutritional/Personal Management

• I. Your diet as an important part of your
  treatment for cancer.
• II. Ways to get ready
• Eat a Healthy Diet
• Plan Ahead
• Think Positive
• III. Eating a Healthy Diet
• IV. Planning Ahead
• Do not binge
• Dont diet
• Keep exercising (or start walking)
• Drink lots of water
• Read
• Sleep

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Ways to get ready

• Preparing Yourself for Cancer Treatment
• Until your treatment actually starts, you will
  not know exactly what, if any, side effects you
  may have or how you will feel. One way to prepare
  is to think of your treatment as a time for you
  to concentrate on yourself and on getting well.
• Here are some other ways to get ready
• Eat a Healthy Diet
• Plan Ahead
• Think positive

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Eat a Healthy Diet

• A healthy diet is vital for every person's body
  to work its best. This is even more important for
  cancer patients.
• You'll go into treatment with reserves to help
  keep up your strength, prevent body tissue from
  breaking down, rebuild tissue, and maintain your
  defenses against infection.
• People who eat well are better able to cope with
  side effects. You may even be able to handle
  higher doses of certain treatments. For example,
  we know that some cancer treatments are actually
  much more effective if the patient is
  well-nourished and getting enough calories and
  protein in his or her diet.
• Don't be afraid to try new foods. Some things you
  may never have liked before may taste good to you
  during treatment.

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Planning Ahead

• How to Prepare for Cancer Chemotherapy and
  Radiotherapy
• Get Healthy Before Treatment
• Do not binge
• Dont diet
• Keep exercising (or start walking)
• Drink lots of water
• Read
• Sleep

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What To Do During Treatments

• Know what youre getting
• Know your terminologies
• Some examples
• Oncologist doctor who prescribes and monitors
  the course of your chemotherapy.
• Adjuvant therapy chemotherapy treatment that
  follows surgery or radiation therapy to prevent
  cancer reoccurrence.
• Antiemetic medicine that controls nausea
• Systemic therapy describes how chemotherapy
  works. The drugs affect the whole body by flowing
  through the bloodstream. The purpose is to
  destroy cancer cells that may have spread from
  the original site.
• Metastasis describes the condition where cancer
  cells have spread beyond the original site, such
  as from breast to liver. This occurrence may call
  for more strenuous drugs, larger doses and more
  rounds.
• Lymph node rounded masses of lymphatic tissue
  through which cancer spreads throughout the body.
  A telling sign of metastasis is when one or more
  of the lymph nodes have enlarged.

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What To Do During Treatments

• Expect weight gain
• Prepare as much as possible
• Try to keep busy
• Bring a pal and a sucker
• Be super clean
• Drink plenty of water
• Avoid risky foods
• These include
• Inorganic salad greens some retain dirt even
  when washed (instead eat cooked organic greens)
• Raw or lightly cooked eggs
• Shellfish
• Soft cheeses
• Sushi and sashimi
• Look your best

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What To Do During Treatments

• What happens after chemotherapy?
• Chemotherapy can treat most cancers effectively.
  But theres no way to predict its effect on your
  tumor until you go through it. Medical tests will
  determine if chemotherapy is working. Possible
  results are
• Absolute remission or response. Patient is
  monitored for reoccurrence.
• Partial remission or response. This means your
  tumor shrank but did not disappear. You doctors
  will most likely recommend more chemotherapy,
  possibly with different drugs.
• Stabilization. Theres been no increase or
  decrease in the size of your tumor. Other therapy
  possibilities will be offered.
• Progression. You tumor continues to grow. More
  aggressive therapy might be recommended.
• Secondary malignancy. This means cancer has
  spread to another area, which may require
  additional surgery, chemotherapy and/or radiation

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What To Do During Treatments

• Radiotherapy
• This treatment uses radiation to kill cancer
  cells and shrink tumors at a specific site. It is
  considered the least invasive of cancer treatment
  options. This is often the last step in your
  regiment, if its needed at all. If and when you
  should have radiotherapy depends on a myriad of
  factors. For example, in treating breast cancer,
  you and your doctors may have opted for a
  lumpectomy (removing the cancerous lump only)
  instead of a full mastectomy. Because the
  remaining breast tissue might have cancer cells,
  the treatment of radiotherapy would allow doctors
  to target that specific area of concern.
• Radiotherapy does not usually cause nausea or to
  greatly weaken the immune system. But in cases
  where radiation is applied to the entire body,
  thereby soaking into the bone marrow, the counts
  of your white blood cell counts will decrease.
  You should be on high alert to prevent getting
  sick. Follow the same clean habits as during
  chemotherapy.

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What To Do During Treatments

• You can ask your radiation oncologist if you
  experience irritation on the treated area so
  he/she can prescribe a relief or you can apply
  clear plain aloe vera gel after every treatment
  to help regenerate damaged skin but not before.
• All the methods of treating cancer - surgery,
  radiation therapy, chemotherapy, hormone therapy,
  and biological therapy (immunotherapy) - are very
  powerful. Although these treatments target the
  fast-growing cancer cells in your body, healthy
  cells can also be damaged. Healthy cells that
  normally grow and divide rapidly, such as those
  in the mouth, digestive tract, and hair, are
  often affected by cancer treatments. The damage
  to healthy cells is what produces the unpleasant
  side effects that cause eating problems.

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What To Do During Treatments

• The good news is there are many things a patient
  can do about them and that not everyone has side
  effects during treatment, and most side effects
  go away when treatment ends. Side effects can
  also be well-controlled with new drugs. Talk to
  your doctor about possible side effects from your
  treatment and what can be done about them.
• Some eating problems are caused by the treatment
  itself. Other times, because they are upset,
  worried, or afraid. Losing your appetite and
  nausea are two normal responses to feeling
  nervous or fearful. Once you get into your
  treatment period and have a better sense of what
  to expect and how you will react, these
  anxiety-related eating problems should get
  better.

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What To Do During Treatments

• While you are in the hospital or undergoing
  treatment, talk to your doctor, nurse, or a
  registered dietitian. They can answer your
  questions and give you suggestions for specific
  meals, snacks, and foods, and for dealing with
  any eating problems you may have. They can also
  help with dietary preferences that reflect
  various cultural and ethnic backgrounds. Feel
  free to talk to them if problems arise during
  your recovery as well. Ask them what has worked
  for other patients.
• Remember, there aren't any hard and fast
  nutrition rules during cancer treatment. Some
  patients may continue to enjoy eating and have a
  normal appetite throughout most of their cancer
  treatment. Others may have days when they don't
  feel like eating at all even the thought of food
  may make them feel sick.
• There is much that you can do to help yourself, a
  friend or loved one through the period of cancer
  treatment.

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Side effects associated with chemotherapy may
  vary from person to person. Some patients may
  experience significant side effects while others
  may experience very minimal side effects. It is
  not possible to predict who is going to have more
  severe side effects.
• All the side effects described here will not
  affect everyone. Most patients will have the
  common side effects like hair loss, while some
  other side effects may affect few patients, and
  may not trouble some others. Here we will show
  you the most common side effects of chemotherapy.

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Chemotherapy Drug - Nutritional/Personal
  Management
• Doxorubicin (Adriamycin)
  
• Cyclophosphamide (Cytoxan)
• Methotrexate (Amethopterin)
• Bone marrow suppression and lowering of blood
  counts----eat plenty of dark green, leafy
  vegetables
• Hair loss----wear fashionable turbans and wigs
• Nausea and vomiting----cold fresh ginger tea with
  a bit of honey
• Mouth ulcers--cold compress ganoderma
  toothpaste (used to relieve gum sores too)
  
  
• Tiredness and a general feeling of weakness
  ----allow plenty of time for rest
  and sleep while
  on
  treatment
• Diarrhea----drink plenty of water, buko juice to
  replace electrolytes, reduce fiber intake
• Muscle pain----eat foods high in alkaline ash
  like fresh fruits and vegetables

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Paclitaxel (Taxol)
• Docetaxel (Taxotere)
• Nausea and vomiting----cold fresh ginger tea with
  a bit of honey
• Loss of appetite, Change in taste----eat food
  that appeals to palate in small amounts several
  times a day
• Mouth blistering----cold compress ganoderma
  toothpaste (used to relieve gum sores too)
• Fatigue----allow plenty of time for rest and
  sleep while on treatment.
• Soreness and redness of palms/soles of
  feet----Vitamin B6 pyridoxine (ask your doctor)
• Bone marrow suppression and lowering of blood
  counts----eat plenty of dark green, leafy
  vegetables

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Speak to your doctor if either of these symptoms
  is severe or lasts for several hours
• Pain in the joints of the arms or legs lasting
  2-3 days,
• Changes in the color of the nails,
• Tingling in the hands or toes
• If you experience any of the following symptoms,
  call your doctor immediately
• Unusual bruising or bleeding,
• Pain, redness, or swelling at the injection site,
  
• Change in normal bowel habits for more than 2
  days,
• Fever, chills,
• Cough, sore throat, difficulty swallowing,
• Dizziness, shortness of breath, severe
  exhaustion,
• Skin rash,
• Chest pain

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Fluorouracil (5FU)
• Sore mouth and taste change----eat food that
  appeals to palate in small amounts several times
  a day
• Diarrhea ----drink plenty of water, buko juice to
  replace electrolytes, reduce fiber intake
• Lowered resistance to infection----avoid raw and
  easily contaminated food as this time (ex. sushi,
  oysters, mussels,
  and
  the like) ----eat plenty of dark green, leafy
  vegetables
• Soreness and redness of palms/soles of
  feet----Vitamin B6 pyridoxine (ask your doctor)
  
• Speak to your doctor regarding these symptoms
• Gritty eyes and blurred vision,
• Your temperature goes above 38C (100.5F),
• Bruising or bleeding, rashes, severe anemia

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Capecitabine (Xeloda)
• Nausea and vomiting----cold fresh ginger tea with
  a bit of honey
• Sore mouth and taste change----eat food that
  appeals to palate in small amounts several times
  a day
• Diarrhea----drink plenty of water, buko juice to
  replace electrolytes, reduce fiber intake
• Abdominal pain and constipation----considering
  adding a fiber supplement to your diet (ask your
  doctor or a nutritionist)
• Loss of appetite, Change in taste----eat food
  that appeals to palate in small amounts several
  times a day
• Speak to your doctor regarding these symptoms
• Skin changes,
• Severe diarrhea,
• Very high fever

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Breast Cancer Chemotherapy Side Effects and their
Nutritional/Personal Management

• Eating problems
• Apart from a poor appetite and loss of weight,
  some people with cancer have other difficulties
  with eating.
• Some of these problems may be related to the
  cancer itself, while others may be temporary side
  effects of treatment.
• We suggest that you discuss the matter with your
  oncologist and/or nutritionist to assist you to
  plan a healthy diet that can help you handle the
  treatment better.
• PETALS OF HOPE CANCER SUPPORT GROUP/NUTRITION
  RESEARCH
• /shv.2005

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Recovery

• Six months to a year after diagnosis, you will
  most likely be finished with treatments. Its
  time to celebrate. Go on a trip, start a dream
  project a garden, watercolor, kayaking. Your
  body will recover to its full speed and you will
  get your life back.
• Two months after the last chemotherapy session,
  fuzz will appear, if youve lost hair at all. By
  now you should able to resume your exercise and
  work routines. Six months after the last
  treatment, you will be seeing your oncologist and
  other doctors only once or twice a year.
• A year after treatment, you might be so engrossed
  into your normal life that you forget you had
  cancer. Well, not completely forget, but half of
  your day might be without a thought of illness.
• Three years after treatment, you might only
  remember when you happen to look at your scar or
  breast reconstruction.
• Five years after treatment, you might be declared
  cancer free.

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Think Positive

• Seven Ideas That Really Work
• Think Positive
• Teach Yourself a Lesson
• Interrupt Your Negative Thoughts
• Set Realistic Goals
• Be Good To Yourself
• Be Glad It's Not Worse
• Look For the Silver Lining

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Closing

• After cancer treatment ends and you're feeling
  better, you may want to think again about the
  traditional guidelines for healthy eating. Just
  as you wanted to go into treatment with all the
  reserves that such a diet could give you, you'll
  want to do the best for yourself at this
  important time. There's no current research that
  suggests that the foods you eat will prevent your
  cancer from recurring. But, we do know that
  eating right will help you regain your strength,
  rebuild tissue, and help you feel and live well
  with cancer.

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THANK YOU!