nutritional care in oncology.ppt

Agenda/Overview

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 – Don’t diet – Keep exercising (or start

walking) – Drink lots of water – Read – Sleep

V. Think Positive1. Teach Yourself a Lesson 2. Interrupt Your Negative

Thoughts 3. Set Realistic Goals 4. Be Good to Yourself 5. Be Glad It's Not Worse 6. Look for the Silver Lining

VI. Chemotherapy Side Effects and their Nutritional/Personal Management

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

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.

Planning Ahead

• How to Prepare for Cancer Chemotherapy and Radiotherapy

– Get Healthy Before Treatment1. Do not binge 2. Don’t diet 3. Keep exercising (or start walking) 4. Drink lots of water 5. Read 6. Sleep

What To Do During Treatments

1. Know what you’re getting 2. 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.


3. Expect weight gain 4. Prepare as much as possible 5. Try to keep busy 6. Bring a pal and a sucker 7. Be super clean 8. Drink plenty of water 9. 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

10. Look your best


What happens after chemotherapy?• Chemotherapy can treat most cancers effectively. But there’s 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. There’s 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


• 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 it’s 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.


– 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.


– 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.


– 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.

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.


Chemotherapy Drug - Nutritional/Personal Management• Doxorubicin (Adriamycin) • Cyclophosphamide (Cytoxan)• Methotrexate (Amethopterin)

1. Bone marrow suppression and lowering of blood counts----eat plenty of dark green, leafy vegetables

2. Hair loss----wear fashionable turbans and wigs3. Nausea and vomiting----cold fresh ginger tea with a bit of honey4. Mouth ulcers--cold compress & ganoderma toothpaste (used to relieve gum

sores too) 5. Tiredness and a general feeling of weakness ----allow plenty

of time for rest and sleep while on treatment

6. Diarrhea----drink plenty of water, buko juice to replace electrolytes, reduce fiber intake

7. Muscle pain----eat foods high in alkaline ash like fresh fruits and vegetables


• Paclitaxel (Taxol)• Docetaxel (Taxotere)

1. Nausea and vomiting----cold fresh ginger tea with a bit of honey

2. Loss of appetite, Change in taste----eat food that appeals to palate in small amounts several times a day

3. Mouth blistering----cold compress & ganoderma toothpaste (used to relieve gum sores too)

4. Fatigue----allow plenty of time for rest and sleep while on treatment.

5. Soreness and redness of palms/soles of feet----Vitamin B6 [pyridoxine] (ask your doctor)

6. Bone marrow suppression and lowering of blood counts----eat plenty of dark green, leafy vegetables


• 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


• Fluorouracil (5FU)

1. Sore mouth and taste change----eat food that appeals to palate in small amounts several times a day

2. Diarrhea ----drink plenty of water, buko juice to replace electrolytes, reduce fiber intake

3. 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

4. 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


• Capecitabine (Xeloda)

1. Nausea and vomiting----cold fresh ginger tea with a bit of honey2. Sore mouth and taste change----eat food that appeals to palate in small

amounts several times a day3. Diarrhea----drink plenty of water, buko juice to replace electrolytes, reduce

fiber intake 4. Abdominal pain and constipation----considering adding a fiber supplement

to your diet (ask your doctor or a nutritionist)5. 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


• 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

Recovery

• Six months to a year after diagnosis, you will most likely be finished with treatments. It’s 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 you’ve 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.

Think Positive

Seven Ideas That Really Work1. Think Positive2. Teach Yourself a Lesson3. Interrupt Your Negative Thoughts4. Set Realistic Goals5. Be Good To Yourself6. Be Glad It's Not Worse7. Look For the Silver Lining

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.

THANK YOU!

nutritional care in oncology.ppt

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