NUTRITION AND CANCER

WHAT IS CANCER

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Cancer can start almost anywhere in the human body, which is made up of trillion of cells.

MOST COMMON TYPES OF CANCER IN MALES AND FEMALES

WHAT IS CARCINOGENESIS

Cells become cancer cells because of damage to DNA. The genetic material of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens cells do not die when they should and new cells from when the body does not need them. Hence the process is not controlled and the extra cells may form a mass of tissue called a TUMOR. This process is called CARCINOGENESIS.

Any substance that has the potential to cause cancer in living tissues is called CARCINOGEN.

3 PHASES OF CARCINOGENESIS

INITIATION- The carcinogen when exposed, enters the cell. This carcinogen then alters the cells.

PROMOTION- Initiated cells start to get multiply.

PROGRESSION- Tumor cells aggregate and grow into a fully grown tumor.

WHAT ARE TUMORS

An abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should.

Types of tumors

Main categories of cancer

Carcinoma- cancer that begins in the skin or in the tissues that line or cover internal organs.

Sarcoma- cancer that begins in bone, cartilage, fat, muscle, blood vessels or other connective or supportive tissue.

Leukemia- cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

Lymphoma and myeloma- cancer that begin in the cells of the immune system.

Central nervous system cancer- cancer that begins in the tissue of the brain and spinal cord.

Nutrition and carcinogenesis

•Nutrition may modify the carcinogenic process at any stage.

•Gene expression can be promoted or altered by nutrients during- infancy, childhood or pregnancy.

Here are some phytochemicals of vegetables and fruits that may have cancer protective properties.

COLOURPHYTOCHEMICALSVEGETABLES AND FRUITS
RedLycopeneTomatoes, pink guava, watermelon etc.
Red, purple and orangeAnthocyanins, polyphenols, alpha-beta carotenePlums, grapes, carrots, mango etc
Orange and yellowFlavonoidspeaches, papayas
Yellow and greenLutein, zeaxanthinSoinach, avocado, turnip
GreenIndolesCabbage, cauliflower
White and greensulfidesOnion, garlic etc

Chemoprevention

•Chemoprevention is defined as the use of drugs, vitamins or other agents to reduce the risk of or delay the development of cancer.

Examples- Non-steroidal anti-inflammatory drugs (that may protect against colon cancer).

Metformin tablets (commonly used for diabetes are currently being exposed as cancer prevention and treatment agents).

Phenolic acid, flavnoids and lignans are the most abundant polyphenols: and they are chemopreventives.

Chemotherapy agents and their common nutrition impact symptoms

Akylating agents- Anorexia, nausea, fatigue, renal toxicity.

Antitumor agents- Anorexia, nausea, vomits, fatigue, diarrhoea.

Antimetabolities- Anorexia, nausea, fatigue, diarrohea.

Nutritional impacts of cancer treatments

vCHEMOTHERAPY- Chemotherpy is a systemic therpy that affects the malignant tissue and normal cells as well. In bloodstream these agents are carried through the body to reach as many cancer cells as possible.

•Routes for chemotherpy includes-

1. oral (capsules, pills or liquid)

2. Intravenous

3. Intraperitoneal– medication directly intp abdominal cavity.

4. Intravesicular medications delivery into bladder.

5. Intrathecal- medicatin delivery in CNS.

Common side effects of chemotherapy

1. Diarrhoea-

2. Nausea –

3. Food drug interaction- individual of certain types of lung cancers require vit B12 and folic acid supplement throughout the treatment, to avoid anaemia.

•Brain cancer patients- Require Tyramine rich foods and beverages. (eg- processed meats, dried or overripe fruits, fermented foods,yeast, beverages with caffiene etc).

ØNote- Tyramine is a trace amine derived from amino acid and tyrosine

•Colon cancer patients- should not drink, eat or handle cold drinks for upto 5 days

4. Oral changes- people withaltered taste activity may benefit from increased use of flavourings and seasonings during food preparations

5. Mucositis

vBIOTHERPY- it is also known as immunotherapy

•A group of cancer treatment drugs prescribed to stimulate the body’s own immune system is used to treat cancer.

•Biotherapy is often given in combination with chemotherapy drugs biotherapy drugs are groups of protein that cause blood cells to grow and mature.

•Effects of biotherapy are- fatigue, chills, fever and flu like symptoms.

vHORMONE THERAPY- This therapy adds, blocks or removes hormone to slow or stop the growth of hormone sensitive breast or prostate cancer.

•Side effects- hot flashes, decresed sexual drive and bone pain.

vRADIATION THERAPY- Radiation is used to cure control or palliate cancer. radiation therapy an be delivered externally into the body from megavoltage machine. radiation therapy affects only the tumor and the surrounding area.

•chemotherapy is also given in the combination of radiation therapy to give enhancing effect.

•common side effects- fatigue, loss of appetite, skin changes, hair loss in the area being treated.

NUTRITIONAL REQUIREMENTS

Energy– calorie requirements are-

20-25 kcal/kg- (non-ambulatory or sedentary patients)

30-35 kcal/kg- (slightly hypermetabolic; forweight gain)

40-45 kcal/kg- (severely stressed pateints)

Protein– Additional protein is required to provide essential amino acids and nitrogen necessary for tissue regeneration and healing.

Vitamins and minerals– Optimal intake of vitamins and minerals are recommended. In addition dietary supplements are given to improve the nutritional status.

Fluids– Fluids are increased to compensate losses from gastrointestinal problems as well as  any additional loss caused by infection and fever.

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