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Nutritional Issues in Cancer Care

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Contents

Preface....................................................................................................................................... xv
   
Acknowledgments....................................................................................................................... xvii
   
Chapter 1. Cancer Prevention.................................................................................................... 1
Overview..................................................................................................................................... 1
Diet’s Protective Influence..................................................................................................................................... 2
Physical Activity’s Protective Influence..................................................................................................................................... 6
Diet as Promoter of Carcinogenesis........................................................................................... 7
The Promotion of Prevention...................................................................................................... 10
Summary.................................................................................................................................... 11
   
Chapter 2. Breast Cancer........................................................................................................... 15
Overview..................................................................................................................................... 15
Incidence.................................................................................................................................... 16
Risk Factors and Prevention...................................................................................................... 16
Treatment Modalities.................................................................................................................. 19
Nutritional Implications................................................................................................................ 21
Assessment Guidelines.............................................................................................................. 21
Special Considerations for Nutrition............................................................................................ 22
Care Planning and Expected Outcomes of Therapy................................................................... 23
   
Chapter 3. Colorectal Cancer..................................................................................................... 29
Overview..................................................................................................................................... 29
Incidence.................................................................................................................................... 29
Risk Factors and Prevention...................................................................................................... 30
Treatment Modalities.................................................................................................................. 30
Assessment Guidelines.............................................................................................................. 32
Special Considerations for Nutrition............................................................................................ 33
Nutrition Care Planning............................................................................................................... 39
Expected Outcomes of Therapy................................................................................................. 40
   
Chapter 4. Esophageal and Gastric Cancers............................................................................. 45
Esophageal Cancer.................................................................................................................... 45
Nutritional Implications and Treatment........................................................................................ 50
Gastric Cancer........................................................................................................................... 53
Nutritional Implications and Treatment........................................................................................ 56
Summary.................................................................................................................................... 59
   
Chapter 5. Genitourinary Cancers............................................................................................. 65
Overview.................................................................................................................................... 65
Renal Cell Carcinoma................................................................................................................. 65
Bladder Cancer.......................................................................................................................... 71
Testicular Cancer....................................................................................................................... 73
Assessment Guidelines.............................................................................................................. 75
Care Planning............................................................................................................................ 75
Summary.................................................................................................................................... 75
   
Chapter 6. Gynecologic Cancers................................................................................................ 79
Overview..................................................................................................................................... 79
Ovarian Cancer.......................................................................................................................... 79
Cervical Cancer.......................................................................................................................... 85
Endometrial Cancer.................................................................................................................... 87
Nutritional Implications................................................................................................................ 90
Treatment-Related Nutritional Implications................................................................................. 93
Assessment Guidelines.............................................................................................................. 96
Special Considerations for Nutrition............................................................................................ 98
Summary.................................................................................................................................... 100
   
Chapter 7. Head and Neck Cancers........................................................................................... 103
Overview..................................................................................................................................... 103
Incidence.................................................................................................................................... 103
Risk Factors and Prevention...................................................................................................... 104
Treatment Modalities.................................................................................................................. 105
Nutritional Implications................................................................................................................ 107
Assessment Guidelines.............................................................................................................. 112
Special Considerations for Nutrition........................................................................................... 112
Care Planning and Expected Outcomes of Therapy................................................................... 114
   
Chapter 8. Hepatobiliary Cance................................................................................................. 117
Overview.................................................................................................................................... 117
Incidence.................................................................................................................................... 117
Risk Factors and Prevention...................................................................................................... 118
Treatment Modalities.................................................................................................................. 119
Nutritional Implications................................................................................................................ 121
Assessment Guidelines.............................................................................................................. 122
Special Considerations for Nutrition............................................................................................ 122
   
Chapter 9. Lung Cancer............................................................................................................. 127
Overview..................................................................................................................................... 127
Incidence.................................................................................................................................... 127
Risk and Prevention................................................................................................................... 128
Treatment Modalities.................................................................................................................. 132
Nutritional Implications................................................................................................................ 133
Special Considerations for Nutrition........................................................................................... 136
Care Planning............................................................................................................................ 136
Expected Outcomes of Therapy................................................................................................. 137
Summary.................................................................................................................................... 137
   
Chapter 10. Pancreatic Cancer.................................................................................................. 139
Overview..................................................................................................................................... 139
Incidence.................................................................................................................................... 139
Risk Factors and Prevention...................................................................................................... 140
Treatment Modalities.................................................................................................................. 141
Nutritional Implications................................................................................................................ 143
Special Considerations for Nutrition............................................................................................ 145
Expected Outcomes of Therapy................................................................................................. 148
   
Chapter 11. Prostate Cancer...................................................................................................... 153
Overview..................................................................................................................................... 153
Incidence.................................................................................................................................... 154
Risk Factors and Prevention...................................................................................................... 154
Treatment Modalities.................................................................................................................. 156
Nutritional Implications................................................................................................................ 158
Assessment Guidelines.............................................................................................................. 169
Special Considerations for Nutrition............................................................................................ 169
Antioxidant Supplements............................................................................................................ 170
Hormone Therapy....................................................................................................................... 171
Expected Outcomes of Therapy................................................................................................. 172
   
Chapter 12. Adult Leukemia....................................................................................................... 187
Overview..................................................................................................................................... 187
Definition and Pathology of Leukemia........................................................................................ 187
Types and Classification of Leukemia........................................................................................ 187
Diagnosis.................................................................................................................................... 189
Risk Factors and Prevention...................................................................................................... 190
Treatment Modalities.................................................................................................................. 190
Nutritional Implications................................................................................................................ 191
Assessment Guidelines.............................................................................................................. 191
Special Considerations for Nutrition........................................................................................... 192
Care Planning............................................................................................................................. 199
Expected Outcomes of Therapy................................................................................................. 199
   
Chapter 13. Lymphoma.............................................................................................................. 201
Overview..................................................................................................................................... 201
Incidence.................................................................................................................................... 202
Risk Factors and Prevention...................................................................................................... 202
Diagnosis.................................................................................................................................... 203
Treatment Modalities.................................................................................................................. 205
Nutritional Implications................................................................................................................ 207
Assessment Guidelines.............................................................................................................. 211
Summary.................................................................................................................................... 216
   
Chapter 14. Multiple Myeloma, Melanoma, and Sarcoma........................................................... 219
Multiple Myeloma........................................................................................................................ 219
Nutritional Implications............................................................................................................... 221
Melanoma.................................................................................................................................. 224
Nutritional Implications................................................................................................................ 226
Sarcoma..................................................................................................................................... 229
Nutritional Implications................................................................................................................ 231
   
Chapter 15. Pediatric Cancers................................................................................................... 235
Incidence of Childhood Cancer.................................................................................................. 235
Causes of Childhood Cancer...................................................................................................... 235
Types of Cancer and Treatment Modalities................................................................................ 236
Patterns of Care......................................................................................................................... 243
Nutritional Management of the Pediatric Patient With Cancer.................................................... 244
Assessment Guidelines.............................................................................................................. 245
Nutritional Intervention................................................................................................................ 248
Obesity....................................................................................................................................... 248
Late Effects................................................................................................................................ 249
   
Chapter 16. Hematopoietic Stem Cell Transplantation............................................................... 253
Introduction................................................................................................................................ 253
Overview..................................................................................................................................... 253
Types of Hematopoietic Stem Cell Transplantation.................................................................... 254
Process...................................................................................................................................... 255
Toxicities..................................................................................................................................... 256
Assessment Guidelines.............................................................................................................. 257
Nutritional Support...................................................................................................................... 259
   
Chapter 17. Complementary and Alternative
Medicine in Cancer Care............................................................................................................		 265
Introduction................................................................................................................................ 265
Overview..................................................................................................................................... 265
Health Paradigms Shift............................................................................................................... 266
Seven Modifiable Factors for Cancer Inhibition.......................................................................... 267
Supplements for Cancer Inhibition.............................................................................................. 268
Complementary and Alternative Medicine Diets.......................................................................... 269
Using Complementary and Alternative Medicine Knowledge With Patients................................. 282
Summary.................................................................................................................................... 283
   
Chapter 18. Immunonutrition: The Role of Specialized
Nutritional Support for Patients With Cancer..............................................................................		 291
Overview..................................................................................................................................... 291
Weight Loss in the Patient With Cancer: Reversible Anorexia or
Tumor-Induced Cachexia?..........................................................................................................		 292
Nutritional Interventions for Weight Loss in Cancer.................................................................... 296
Enhancement of Immune Function in the Patient With Cancer................................................... 301
Nutritional Interventions in the Surgical Patient With Cancer...................................................... 305
Consensus Recommendations on Immune-Enhancing Diets...................................................... 308
Summary.................................................................................................................................... 209
   
Chapter 19. Palliative Care and Hospice.................................................................................... 319
Overview..................................................................................................................................... 319
Palliative Care and Hospice Definitions...................................................................................... 319
What is the Medicare Hospice Benefit?...................................................................................... 320
Treatment Modalities and Nutrition Assessment......................................................................... 321
Issues Affecting Nutritional Status............................................................................................... 321
Counseling Suggestions............................................................................................................. 322
Hydration and Enteral and Parenteral Nutrition.......................................................................... 323
Complementary Therapies in Palliative Care and Hospice......................................................... 326
Ethical Issues Related to End-of-Life Care................................................................................. 326
Summary.................................................................................................................................... 327
   
Chapter 20. Resources and References.................................................................................... 331
Evaluations of Internet Health Information.................................................................................. 331
   
Appendices 343
Appendix A. Scored Patient-Generated Subjective Global
Assessment (PG-SGA)...............................................................................................................		 344
Appendix B. Body Mass Index (also known as Quetelet’s Index)................................................. 347
Appendix C. Nutrition Impact Symptoms and Interventions......................................................... 347
Appendix D. Nutrition Sequelae of Radiation Therapy and Suggested
Nutritional Interventions.............................................................................................................. 		350
Appendix E. Components of a Comprehensive Nutrition Assessment......................................... 352
Appendix F. Harris-Benedict Equation Used for Estimating Energy
Expenditure................................................................................................................................		 353
Appendix G. Protein Requirements for Adults............................................................................. 353
Appendix H. Hamwi Method for Determining Desirable Body Weight
in Adults .....................................................................................................................................		 353
Appendix I. Guidelines for Assessing Calorie, Protein, and
Fluid Needs for the Adult Patient With Cancer............................................................................		 354
Appendix J. Nutritional Risk Index............................................................................................... 354
Appendix K. Food Safety Guidelines for Patients With Low Immune Function or Who Are Neutropenic................................................................................................................................ 355
   
Index........................................................................................................................................... 359