NHM 465 Cancer and HIV/AIDS – Flashcards
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carcinogenesis
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cancer development
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neoplasm
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any abnormal growth of new tissue, benign or malignant
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benign neoplasm
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a localized tumor that has a fibrous capsule, limited potential for growth, a regular shape, and cells that are well differentiated. Does not invade surrounding tissue or metastasize to distant sites
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malignant neoplasm
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a tumor that characteristically invades surrounding tissue, metastasizes to distant sites, and contains anaplastic cells
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anaplastic cells
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cells that are not very well differentiated
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metastasis (mets)
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the spread of malignant neoplasm to other sites
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grilled/broiled/fried/smoked/preserved foods
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nitrates can be converted to N-nitroso compounds are associated with increased cancer risk
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heterocyclic amines
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"muscle meats" cooked at high temperatures form cancer-causing heterocyclic amines
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polycyclic aromatic hydrocarbons
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fat dripping down from cooking meats causes smoke and flare-ups depositing polycyclic aromatic hydrocarbons
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excess energy intake (carcinogen generation)
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stimulates production of IGF-1 which can promote the growth of prostate, breast, lung, and colon cancer
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vitamin D
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increased serum 25-hydroxyvitamin D associated with decreased most forms of cancer
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folate
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essential for appropriate synthesis and repair of DNA, helps to prevent and repair DNA mutations
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coffee and tea
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increase in phenolic and antioxidant compounds
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soy
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increased whole food soy intake associated with decreased breast cancer incidence those who have increase estrogen-receptor should limit soy intake
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phytochemicals, protease inhibitors, phytoestrogens
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onions, garlic, grapes
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red
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lycopene: tomatoes, grapefruit, watermelon
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red/purple
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anthocyanins, polyphenols (resveratrol): berries, red grapes, red wine, prunes
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orange
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alpha and beta-carotene: carrots, mangoes, pumpkin
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orange/yellow
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beta-cryptoxanthin, flavonoids: cantaloupe, peaches, oranges, papaya, nectarines
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yellow/green
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lutein, zeaxanthin: spinach, avocado, honeydew, collard and turnip greens
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green
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sulforaphanes, indoles: cabbage, broccoli, brussels sprouts, cauliflower
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white/green
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allyl sulphides: leeks, onion, garlic, chives
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fiber
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associated with reduced risk of colon cancer
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cancer cachexia
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wasting syndrome of unknown etiology cytokines produce metabolic changes similar to stress response
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cancer-associated metabolism: energy
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REE can be increased, decreased, or normal increased serum levels of inflammatory mediators and acute phase proteins associated with hypermetabolism
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substrate alterations (cancer)
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tumors prefer glucose as fuel, increasing demand for energy substrate
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substrate metabolism (cancer)
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increased gluconeogenesis as tunor tissue uses glucose
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chemotherapy
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cancer treatment that attacks malignant as well as healthy cells; mostly admistered IV
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radiation therapy
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focused on a very targeted tissue area, and effects vary depending on location
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neutropenic diet
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limits exposure to bacterial and parasitic contamination, recommended for patients with weakened immune system
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neutropenic diet guidelines
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avoid all fresh fruit and vegetables avoid raw/rare cooked meat (cook to "well done") eggs should be thoroughly cooked avoid salad bars, deli counters, freshly sliced meats avoid raw nuts only pasteurized dairy products avoid yogurt/foods with live cultures wash hands thoroughly drink filtered/treated water
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chylorus fistula
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complication of radical next surgery/radiation injury to thoracic duct where it enters subclavian vein (chyle leaks into blood stream) treat with MCT
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gastric cancer
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surgical partial or total gastrectomy side effects similar to weight loss surgery
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pancreatic cancer
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only cure is surgery exogenous replacement of pancreatic enzymes
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colorectal cancer
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GI bleeding, anemia treat anemia and monitor hydration colon resection
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megestrol acetate (Megace)
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appetite stimulant, not appropriate for patients with prostate cancer or hyperglycemia
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dronabinol (marinol)
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cannabinoid, may increase appetite by decreasing N/V
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complementary medicine
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up to 90% cancer patients use at least 1 form
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common CAM
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diet and metabolic therapies vitamin/mineral supplementation herbal/botanic therapies
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human immunodeficiency virus (HIV)
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retrovirus that invades CD4 cells resulting in decreased cell-mediated immune response
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acquired immune deficiency syndrome (AIDS)
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condition of advanced HIV infection , with accompanying rise is opportunistic infections and/or CD4 count <200 cells/mm3 of blood
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acute HIV infection
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immediately follows infection 2-4 weeks flu-like symptoms
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asymptomatic, chronic HIV infection
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a few months to 10 years no symptoms of HIV infection
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symptomatic HIV infection
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fever, night sweats, dermatitis, fatigue, decline in nutrition status or body composition
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AIDS
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final stage of HIV infection (advanced HIV) presence of HIV infection AND CD4<200 or occurrence of well-defined opportunistic infection
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HIV/AIDS MNT Goals
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1. optimize nutrition status, immunity, and well-being 2. prevent total body weight loss 3. prevent development of specific nutrient deficiencies (vit A, copper, zinc, iron, vit E, vit C, selenium, Bvitaimins esp 6 and folate) 4. prevent loss of visceral and somatic proteins
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HIV/AIDS cachexia
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major contributor to decreased quality of life, increased morbidity and mortality decreased weight, cell body mass, TSF, MAC, serum albumin
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HIV/AIDS wasting syndrome
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involuntary weight loss >10% of baseline body weight and either chronic diarrhea or chronic weakness and documented fever
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HIV-related lipodystrophy
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depletion of subcutaneous adipose tissue and peripheral fat with accumulation of visceral, dorsovisceral, and mammary adipose can trigger insulin-resistance
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HIV/AIDS nutrient intake
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often have decreased intake: GI tract major site of infection (maldigestion, malabsorption, diarrhea) lesions of oral cavity and esophagus side effects of drugs
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HIV/AIDS energy needs
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BEE x 1.3 (weight maintenance) 1.5 (weight gain)
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HIV/AIDS protein needs
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1.0-1.4 g/kg maintenance 1.5-2.0 g/kg repletion
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HIV/AIDS growth hormone and anabolic steroids
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in clinical trials accessing their ability to promote gain of LBM and +N balance
