What is Cancer?

Normal body cells grow, divide and die in an orderly fashion. Cancer cells are different because they do not die, just continue to divide and grow. Cancer cells form as a result of damaged DNA.

The Phases of Cancer Survival

Phase 1: Active Treatment involves Surgery, chemotherapy and radiation therapy Phase 2: Recovery from Treatment Phase 3: Preventing Cancer Recurrence,Second Primary Cancers. Phase 4: Living with Advanced Cancer Dietary management

Cancer cachexia

Nutritional stages of cancer cachexia

Pre cachexia Cachexia syndrome Advanced Cachexia

Weight loss Metabolic changes

Weight loss Reduced food intake Severe muscle wasting Fat loss

Nutrition
Nutrition


The nourishment of the body with food The processes by which food is used to provide energy, maintenance and growth The sum of the processes involved in taking in nutrients and then incorporating and using them

Purpose of Nutrition Care

To restore or maintain nutritional status, body composition and functional status before, during and after treatment To reduce food related discomfort connected with cancer and/or its treatment To improve strength, well being and quality of life

Good Nutrition is Important

Good nutrition can help people to:
Feel better Fight fatigue Maintain body weight and nutrient stores Improve strength and energy Reduce risk of infection Manage side effects Improve quality of life

Cancer deaths: Up to half are malnourished1 and 20% die from malnutrition rather than cancer

What Dietitians Look at

Tumor and treatment issues Weight Status Current Food Intake Energy and Protein Requirements Laboratory Analysis

Diet Therapy
Ample of liquids to prevent dehydration High caloric foods High protein foods

AIM
To assess the nutritional status of the cancer patients under treatment undergoing surgery, chemotherapy and radiation therapy.

OBJECTIVES
To do the nutritional assessment in comparision to Harris benedicts equation and anthropometric measurements To Estimate the Nutrient intake of patients undergoing treatment of cancer therapy including surgery, chemotherapy and radiation. To observe the dietary pattern and diet quality of the subjects. To estimate the percentage of subjects that are malnourished.

MATERIALS AND METHODS

Selection of Subjects Assessment of Nutrient intake and diet quality Diet survey and food frequency chart Anthropometrical assessment Height (cm) Weight (kg) Body Mass Index (BMI) Waist circumference (cm) Waist and Hip ratio Statistical analysis

RESULTS AND DISCUSSION

The dietary quality is a major cause of malnutrition and many studies have been done to assess the type of foods consumed and nutrient intake of cancer patients under treatment. The present study aims to assess the dietary quality through types of foods consumed, nutrient intake w and anthropometry of adult men and women under treatment of cancer.

General Information

Total population

Female 46% male 54%

Out of the total population 69 (54%) were male and 58 (46%) were female.

Based on food habits

0%

veg 17%

Non veg 83%

A total of 127 young adult women were included in the study out of which 22 (17%) were Vegetarians and 105 (83%) were nonvegetarians.

Out of the total population, 3(2%) fall under age group of less than 20yrs, 25(20%) fall under group of 20-40 yrs, 53(42%) fall under the group of 40 60 yrs, 46(36%) fall under the group of geriatrics

Based on BMI
G2 Obese 3% G1 Obese 7% Over weight 21% G2 UW 3% G1 UW 9%

Normal 57%

Changes in appetite
70 60 50 40 30 20 10 0 62

20

18

Severe loss of appetite

Moderate loss of appetite

no loss of appetite

Weight changes in the last 3 months

70 60 50 40 30 20 10 0 21 0 Weight loss > 5kg Weight loss > 3kg No wt loss 15 64

Mobility

40 30 40 20 24 10 0 Bed ridden Able to move Goes out 36

Nure psychological problems

No psychological problems Mild dementia

21

20

Severe dementia 0 10 20

59

30

40

50

60

Protein supplements

Not aware 37%

Yes 40%

No 23%

Nutrient intake
The calorie intake was calculated with the harris benedicts eqn Avg Ht: 160 cm Avg Wt : 60kg According to Harris benedicts equation, Calorie requirement:=665+(9.6xWt in kg)+1.7xHt in cm)-4.7xAge in yrs = 665+(9.6x60)+(1.7x160)-(4.7x53) =(665+(576+272-249) x Activity factor x Stress factor =1265x1.2x1.5 =2277kcal Protein Requirement:-1.2gm/Kg body wt = 72gm

Mean energy intake of population

Energy intake(kcal)
2500 2000 1500 1000 500 0 Acc to harris benedict's eqn Sugery chemo radiation 2277 1829 1574 1510

Mean protein intake of Population

Protein Gm 80 70 60 50 40 30 20 10 0 Recommended Surgery Chemo Radiation 72 57 48 47

Mean fat intake of the population

Fat Gm 63 62 61 60 60 58. 59 58 57 Recommended Surgery Chemo Radiation 59 62

Mean calcium intake of population

Calcium Mg 800 700 600 500 400 300 200 100 0 Recommended Surgery Chemo Radiation 400 757

704 622

Mean iron intake of the population

Iron Mg 37 36 35 34 33 32 31 30 29 28 27 35 34

31 30

Recommended

Surgery

Chemo

Radiation

conclusions
Out of the total population, 20% of the subjects suffered from oral cancers and 24% from GI Tract cancers, 31% from lymphomas and rest 25 %from other cancers such as Breast, Cervix, Prostrate, etc An attempt was made to evaluate the nutrient intake of the adult women and men of ages 15-75y 15rs under the treatment of cancer. In case of nutrient intake Energy, Protein, fat, calcium and Iron are the nutrients assessed in the present study. The nutrient intake was assessed from grouped data based based on Stages of treatment (Surgery, chemotherapy, radiation therapy) in which there was found to be much significant difference in Nutrient intake particularly calorie and protein. In the groups based on grades of BMI i.e, Normal, G1 overweight, G1 underweight, G2 underweight, G3 underweight, the nutrient intake and body fat components were assessed and compared. No significant difference was found in Energy, Protein, fat, Vitamin A, Calcium and Iron intake of the subjects. In the groups based on food habits i.e, vegetarians and non-vegetarians the nutrient intake nonwas assessed and compared. A significant difference was found in Energy, Protein, fat, Calcium and Iron intake of the subjects. From the present study it is revealed that all the subjects undergoing chemo and radiation had low energy intake which may be due less food intake, skipping of meals, and loss of appetite and there was very low intake of iron, may be because of disinterest towards Green leafy vegetables. On the other hand, fat intake was very much high which could be because of consumption of junk foods.. Low intake of iron may result in Anemia. Hence, there is an urgent requirement to educate these age groups particularly about the importance of balanced diet, rudent lifestyle, meal timings also healthy eating habits and sufficient physical activity and necessity of protein supplements. So, if the patients of all age groups are made conscious of their diet and dietary habits, certainly there is a decrease in further health complications . The calorie and protein intake among the population was found to be statistically significant.