DIET AND CANCER

MS. Tahreem Nisar

Senior Lecturer
University of Lahore
Cancer

 It is a disease characterized by abnormal cell growth and

can occur in any organ. In some way the genes lose
control of cell growth, and reproduction becomes
unstructured and excessive.
 The developing mass caused by the abnormal growth is
called a tumor, or neoplasm.
 Cancerous tumors are malignant, affecting the structure
and consequently the function of organs.
 When cancer cells break away from their original site,
move through the blood, and spread to a new site, they are
said to metastasize.
 The mortality rate for cancer clients is high, but cancer
does not always cause death. When it is found early in its
development, prompt treatment can eradicate it.
 Oncology is the study of cancer, and a physician who
specializes in cancer cases is called an oncologist.
THE CAUSES OF CANCER

 The precise etiology of cancer is not known, but it is

thought that heredity, viruses, environmental carcinogens,
and possibly emotional stress contribute to its
development.
 Cancer is not inherited, but some families appear to have a
genetic predisposition for it.
 When such seems to be the case, environmental
carcinogens should be carefully avoided and medical
checkups made regularly.
 Environmental carcinogens include radiation (whether
from X-rays, sun, or nuclear wastes), certain chemicals
ingested in food or water, some chemicals that touch the
skin regularly, and certain substances that are breathed in,
such as tobacco smoke.
 Carcinogens are not known to cause cancer from one or
even a few exposures, but after prolonged exposure. For
example, skin cancer does not develop after one sunburn.
Environmental factors that increase cancer risk
Environmental factors Cancer site
Aflatoxins (toxins in moldy grains or Liver
nuts)
Alcohol Oral cavity, pharynx, esophagus,
larynx, liver, colon, rectum, breast
Chromium (hexavalent) compound lung
Estrogen/progesterone therapy Breast
Immunosuppressive medication Lymphoid tissues
Infection with Helicobacter pylori Stomach
Infection with hepatitis B and C viruses Liver
Radiation Skin
Tobacco Oral cavity, pharynx, esophagus,
larynx, lungs, pancreas, bladder, kidney
CLASSIFICATIONS OF CANCER

 There are many types of cancer. A classification system

was developed based on the type of cell that produced the
cancer. The majority of all cancers fall under four
headings: carcinomas, sarcomas, lymphomas, and
leukemias.
 Carcinomas involve the epithelial cells (cells lining the
body). These include the outer layer of the skin, the
membranes lining the digestive tract, the bladder, the
womb, and any duct or tube that goes through organs in the
body.
 Sarcoma is cancer of the soft tissues of the body, such as
muscle; fat; nerves; tendons; blood and lymph vessels; and
any other tissues that support, surround, and protect the
organs in the body. Soft-tissue sarcomas are uncommon.
Sarcomas can also occur in bone rather than soft tissue
and primarily in the legs.
 Lymphomas are cancer of the lymphoid tissue. This
includes the lymph nodes, bone marrow, spleen, and
thymus gland.
 Leukemias develop from the white blood cells and also
affect the bone marrow and spleen.

 The site where the cancer is located will become part of

the diagnosis, such as basal cell carcinoma.
 RELATIONSHIPS OF FOOD AND
CANCER

 Certain substances in foods, for example, are thought to be

carcinogenic.
 Nitrites in cured and smoked foods such as bacon and ham
can be changed to nitrosamines (carcinogens) during
cooking. Regular ingestion of these foods is associated
with cancers of the stomach and esophagus.
 High-fat diets have been associated with cancers of the
uterus, breast, prostate, and colon.
 The regular, excessive intake of calories is associated with
cancers of the gallbladder and endometrium.
 People who smoke and drink alcohol immoderately appear
to be at greater risk of cancers of the mouth, pharynx, and
esophagus than those who do not.
 On the positive side, it is thought that diets high in fiber
help to protect against colorectal cancer.
 Diets containing sufficient amounts of vitamin C–rich
foods may protect against cancers of the stomach and
esophagus.
 Diets containing sufficient carotene and vitamin A–rich
foods may protect against cancers of the lung, bladder, and
larynx.
 Phytochemicals, substances that occur naturally in plant
foods, are thought to be anticarcinogenic agents. Examples
include flavonoids, phenols, and indoles, and fruits and
vegetables appear to have an abundance of them.
 It is advisable to eat nine or more servings of fruits and
vegetables each day, including 21⁄2 cups of vegetables
and 2 cups of fruit, on a 2,000-calorie diet.
 Legumes such as soybeans, dried beans, and lentils contain
vitamins, minerals, protein, and fiber and may protect against
cancer. High intakes of soy foods are associated with a
decreased risk of breast and colon cancer.
 Appropriate amounts of protein foods are essential for the
maintenance of a healthy immune system. An immune
system that has been damaged— possibly through
malnutrition—may be a contributing factor in the
development of cancer.
 Excessive protein and fat intake, however, may be a factor in
the development of cancer of the colon.
 The most important principle is moderation.
 An occasional serving of bacon or buttered popcorn or
wine is not likely to cause cancer, but the regular,
excessive use of carcinogenic foods may contribute to
cancer.
 Vitamins that are thought to prevent cancer should be
ingested in foods that naturally contain them.
 Excessive intake of vitamin supplements can be harmful.
For example, abnormally large amounts of vitamin A can
cause bone pain and fragility, hair loss, headaches, and
liver and skin problems.
Nutrition related factors that increase cancer risk

Nutrition related factor Cancer site

Obesity Colon, kidney, pancreas,

esophagus, endometrium,
gallbladder, breast

Total fat (red meat, processed Colon, prostrate, rectum

meat)

Salted and salt preserved foods Stomach

 THE EFFECTS OF CANCER

 One of the first indications of cancer may be unexplained

weight loss because the tumor cells use for their own
metabolism and development the nutrients the host has
taken in.
 The host may suffer from weakness, and anorexia may
occur, which compounds the weight loss.
 Metabolic changes that arise in cancer exacerbate the
muscle wasting. Rate of protein turnover increases but
reduced muscle protein synthesis

 Triglycerides breakdown increases, elevating serum lipid

 Many patients develop insulin resistance
 Anorexia and reduced food intake: anorexia is a major
contributor to the muscle wasting associated with cancer
 Chronic nausea and early satiety: people with cancer frequently
experience nausea and a premature feeling of fullness after
eating small amounts of food
 Fatigue: people with cancer often tire easily and lack the energy
to prepare and eat meal
 Pain: people in pain may have little interest in eating,
particularly not eating makes the pain worse
 Mental stress: cancer diagnosis can cause distress, anxiety and
depression, all of which may reduce appetite
 The sense of taste and smell may be affected. Some foods
may taste different: They may not have much taste, or
everything may taste the same.

 Cancer clients, after chemotherapy, may experience a

metallic taste when eating protein foods. Many clients
complain of food tasting too sweet.

 Radiation to the neck and head can cause damage to the

taste buds and could also affect taste and smell, causing
loss of appetite and weight loss.
 Cancer clients become satiated earlier than normal,
possibly because of decreased digestive secretions.

 Insulin production may be abnormal, and hyperglycemia

can delay the stomach’s emptying and dull the appetite.

 Some cancers cause hypercalcemia. If this is chronic, renal

stones and impaired kidney function can occur.
 The effects of cancer on the host are particularly determined by the
location of a tumor. For example, an esophageal or intestinal tumor
can cause blockage in the gastrointestinal tract, causing
malabsorption.

 If the cancer is untreated, the continued anorexia and weight loss

will create a state of malnutrition, which in turn can lead to
cachexia (severe malnutrition and body wasting caused by chronic
disease) and, ultimately, death.
THE TREATMENT OF CANCER

 Medical treatment of cancer can include surgical removal,

radiation, chemotherapy, or a combination of these
methods.
 These treatments, unfortunately, have side effects that can
further undermine the nutritional status of the client.
 Cancer surgery, however, can have some additional
effects.
 Surgery on the mouth, for example, might well affect the
ability to chew or swallow. Gastric or intestinal resection
can affect absorption and result in nutritional deficiencies.
 The removal of the pancreas will result in diabetes
mellitus.
 Radiation of the head or neck can cause a decrease in
salivary secretions, which causes dry mouth (xerostomia)
and difficulty in swallowing (dysphagia).
 This reduction in saliva also causes tooth decay and
sometimes the loss of teeth.
 Radiation reduces the amount of absorptive tissue in the
small intestine. In addition, it can cause bowel obstruction
or diarrhea.
 Chemotherapy reduces the ability of the small intestine to
regenerate absorptive cells, and it can cause hemorrhagic
colitis.
 Both radiation and chemotherapy depress appetite. They
may cause nausea, vomiting, and diarrhea leading to fluid
and electrolyte imbalances, which can lead to fluid
retention.
 However, when the therapy is completed and the client is
able to return to a well-balanced diet, these problems may
disappear.
Nutrition related side effects of surgery
Region of surgery Altered metabolism
Head and neck Difficulty in chewing/swallowing
Inability to chew
Esophageal resection Diarrhea
Reduced gastric secretion
Reduced gastric motility
Steatorrhea (fat malabsorption)
Gastric resection Dumping syndrome
General malabsorption
Hypoglycemia
Lack of gastric acid
Vitamin b12 malabsorption
Intestinal resection Diarrhea
Fluid and electrolyte imbalance
Malabsorption
Steatorrhea
Pancreatic resection Diabetes mellitus
Malabsorption
Nutrition related side effects of chemotherapy

Reduced nutrient intake Accelerated nutrient losses Altered metabolism

Abnormal pain Diarrhea Fluid and electrolyte imbalances

Anorexia Intestinal ulcers Hyperglycemia
Mouth ulcers Malabsorption Interference with vitamins or other
Nausea Vomiting metabolites
Taste alterations Negative nitrogen and calcium
Vomiting balances
Secondary effects of malnutrition,
infection or tissue damage
Nutrition related side effects of radiation
Reduced nutrient intake Accelerated nutrient losses Altered metabolism

Anorexia Blood loss from intestine and Fluid and electrolyte imbalances
Damage to teeth and jaws bladder Secondary effects of malnutrition,
Dysphagia Diarrhea infection or tissue damage
Esophagitis Intestinal obstructions
Mouth ulcers Malabsorption
Nausea Radiation enteritis
Reduced salivary secretions Vomiting
Taste alterations
Thick salivary secretions
Vomiting
Reference

 Nutrition and diet therapy, 10th edition. Ruth A. Roth.