nutrition for patients with cancer
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#120 Bonifacio St. Baguio City, 26000928 392 2878 / 0916 785 3046
[email protected] ; [email protected];[email protected]
TOUCHSTONE INTENSIVE TRAINING & RESEARCH CENTER
TI T RC2007TOU
CHS
TONE
INTENS
IVETRAINING
&R
ESEARC
HCENTER
Nutrition for Patients With
Cancer or HIV/AIDS
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Cancer and HIV
Without early and aggressivenutritional interventions, cancer and
HIV/AIDS can have profound anddevastating effects on nutritionalstatus, often resulting in wasting and
malnutrition
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Cancer
Cancer alters metabolism by
increasing energy expenditure
increasing protein catabolism
increasing fat catabolism
increasing the use of fat for energy
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Cachexia
causes 20 to 40% of cancer deaths characterized by early satiety, anorexia,
anemia, loss of immunocompetence, and
severe weight loss defined as an unintentional loss of 10% or more of
body weight within 6 months
diminishes quality of life
impairs wound healing increases the risk of infection increases the risk of mortality
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Cachexia (contd)
neither the incidence nor the severity ofcachexia can be related directly to calorieintake or tumor weight
can develop in people who appear to beconsuming adequate calories and protein, butbecause of the altered metabolism of thedisease, are malabsorbing nutrients
unlike simple starvation, to which the bodyadapts by lowering metabolic rate, themetabolic rate in cachexia is not adaptive andmay increase, decrease, or be normal
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Nutrition therapy
cannot cure cancer or HIV/AIDS
may improve tolerance to therapies
may promote quality of life
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Nutrition therapy for cancer
and for HIV/AIDS is similar:
minimize side effects that interferewith nutrient intake
use and increase protein and calorie
intake
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Chemotherapy
For most people undergoingchemotherapy, fatigue and nausea
and vomiting are among the mostdistressing side effects
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Tips to help manage
anorexia
is best in the Overeat during gooddays
Eat a high-protein, high-calorie,nutrient-dense breakfast if appetitemorning
Eat small, frequent meals (e.g., every 2
hours by the clock) Limit low-calorie and empty-calorie
items such as carbonated beverages
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Tips to help manage
anorexia (contd)
Increase nutrient density of foods by addingbutter, skim milk powder, peanut butter,cheese, honey, or brown sugar
Limit liquids with meals to avoid early satietyand bloating at mealtime
Use liquid supplements in place of mealswhen appetite deteriorates or the client is tootired toeat
Enhance appetite with light exercise, a glassof wine or beer if not contraindicated, and theuse of appetite stimulants
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Tips to help manage
anorexia (contd)
Make eating a pleasant experience byeating in a bright, cheerful environment,playing soft music, and enjoying thecompany of friends or family
Experiment with recipes, flavorings,spices, and the consistency of foods
Avoid strong food odors if theycontribute to anorexia--serve cold foods Use appropriate medications to control
pain, nausea, and depression
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Calorie and protein densities vs. volume
Increasing the calorie and proteindensities of the diet is generally
more acceptable than increasing thevolume of food served
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Malnutrition
Malnutrition may speed theprogression from HIV disease to
AIDS
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HIV/AIDS
Nutrient requirements for peoplewith HIV/AIDS have not been
determined
It appears that calorie and proteinneeds are increased
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Nutritional cures
Clients with cancer or HIV/AIDS aresusceptible to nutritional cures and
may use unorthodox diets orsupplements that may bedetrimental to their health
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Think beyond nutritional
value of food:
Allow client and family to verbalize feelings
Emphasize a positive, supportive, team-effortapproach
Encourage the client to be an activeparticipant in his or her nutritional care
As long as the client does not lose more
weight than was agreed on, the client is incharge of his or her own nutritional care
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Force-feeding:
No benefit is derived from force-feeding a client whose cancer is not
being aggressively treated
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Supportive measures for
palliative nutrition therapy
Controlling unpleasant side effects suchas pain, constipation, nausea, vomiting,
and heartburn, with medication Respecting the clients wishes
regarding the level of nutritional supportdesired
Providing adequate mouth care tocontrol dryness and thirst
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Supportive measures for palliative
nutrition therapy (contd)
Respecting the clients personal tastesand preferences
Ensuring a pleasant eating environmentand serving attractive food
Serving food of appropriate textures
Using a team approach that includesphysician, dietitian, and nurse
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Nurses provide nutrition
counseling:
How to cope with side effects such asanorexia, nausea, and vomiting
Guidelines for evaluating nutritionalsupplements and products
Benefits of using high protein supplements
Benefits of comfort foods
Information on food and drug interactions Information about home-delivered meals