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Chemoprevention

Specific compounds or drugs used to prevent, delay, or retard the development of cancer NSAIDS may protect against colon cancer Being tested: polyphenols from fruits and vegetables; green tea; curcumin from curry; resveratrol from grapes and berries

Cancer Tx Protein

Hematopoietic cell transplant (1.5 - 2 g/kg/day) Severe stress (1.5 - 2.5 g/kg/day) Fluids Assure adequate hydration and electrolyte balance to prevent dehydration General recommendation: 30-35 ml/kg/day

Cancer Tx Caloric goals

Nutrition therapy goal: maintain body weight and prevent weight loss associated with cancer Estimated energy needs of people with cancer

Meat consumption, in the form of red meat and processed meat, have showing an increased risk for several types of cancer WHICH ONES?

(colon, rectum, prostate) Red or processed meat and colorectal cancer have the strongest link

Cartenoids

5 are plentiful in human serum (βcarotene, α carotene, lycopene, lutein/zeaxanthin, β cryptoxanthin) -Concentrated sources: fruits and vegetables -β carotene has been studied for lung cancer

Recommendation VITAMIN D

: 2000 IU of vitamin D daily to achieve levels of 40-60 ng/mL

Proposed mechanism: fat to cancer

: obesity, hyperglycemia, and metabolic syndrome increase insulin-like growth factors-1, a potentially cancer causing compound. It may stimulate the growth of cancer cells and inhibit their death. (Fuel for cancer cells!!)

recommendation: toxic environments

A high intake of antioxidant-rich foods and nutrient rich diet (not supplementation) is suggested to combat this exposure

ACS cancer prevention recommendations

Adopt a physically active lifestyle Engage in at least 30 minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week and 45-60 minutes of intentional activity at least 5 days per week Achieve and maintain a healthy body weight throughout life Eat a variety of healthy, colorful foods, with an emphasis on plant sources Limit consumption of alcohol

Cancer Tx neutropenia

Avoid foods that contain unsafe levels of bacteria (raw meat, spoiled or moldy foods, and unpasteurized foods/beverages) Thorough hand washing Special handling of raw meats, game, poultry, and eggs, utensils, cutting boards, and countertops Avoidance of untested well water Storage of foods at appropriate temperatures (below 40®F and above 140 ®F)

Recommendation

BPA free products

Bisphenol A (BPA)

BPA is an industrial chemical used since the 1960s in the manufacturing of many hard plastic bottles and the lining of metal-based food and beverage cans -It is an ingredient in the production of epoxy resin used in paints and adhesives -Recent studies have raised health concerns, especially in developing fetuses, infants, and children -The US department of Health and Human Services supports the elimination of BPA from all infant products and food - related production -Leaches from plastic in hot and cold temperatures

Cancer prevention recc (american institute of cancer research)

Body fatness: be as lean as possible Physical activity: be physically active as part of everyday life Limit food and drinks that promote weight gain Limit energy dense foods (junk food) Avoid sugary drinks Plant foods: eat mostly foods of plant origin Animal foods: limit intake of red meat and avoid processed meat Alcoholic beverages: limit alcoholic beverages Preservation, processing, preparation: limit consumption of salt. Avoid moldy cereals and legumes Dietary supplements: aim to meet nutritional needs through diet alone Remember, high doses of some supplements can increase cancer risk in certain populations. Ex: beta carotene Breastfeeding: mothers to breastfed; children to be breastfed Cancer survivors: follow the same recommendations

Calcium & Vitamin D

Calcium supplementation and diary, especially from milk, may be associated with a lower colorectal cancer risk -However, some studies have shown a increased risk of prostate cancer -Higher vitamin D levels have been associated with lower incidence of colon, breast, ovarian, renal, pancreatic, prostate, and other cancers

Eating more omega-3 fatty acids

Eating more omega-3 fatty acids fatty acids in relation to omega-6 fatty acids may reduce the risk of colon and prostate cancers

Folate & Folic Acid

Folate affects DNA methylation, synthesis, and repair -High intake has been associated with lower colorectal cancer and breast cancer -Genetic polymorphisms and alcohol consumption complicate the interaction

Cancer Tx interaction with chemotherapy

Food and drug interactions with common chemotherapy agents

fruits and vegetables

Fruit intake is protective against cancers of the mouth, pharynx, larynx, esophagus, cervix, lung, and stomach -Nonstarchy vegetables protect against mouth, pharynx, larynx, and esophageal cancers -Contain antioxidants and phytochemicals -Many different substances are likely protective so food is much better than supplementation -Recommendation: Eat at least 2.5 cups of vegetables and fruits each day

Grilling food

Grilling, or charring meat at high temperatures over an open flame (400 degrees or more) can cause the formation of polycyclic aromatic hydrocarbons (PAHs)

fiber

High fiber intake is protective against the development of gastrointestinal, breast, endometrial, and liver cancer -Proposed mechanism: decreasing insulin resistance, modulation of immunity, and DNA damage-repair -Recommendation: Consume 30 grams of fiber per day (ACS)

coffee & tea

May be a good source of various antioxidants and phenolic compounds -Caffeine may also be protective -Green tea contains catechins that possess biologic activity with antioxidant, antiangiogenesis, and antiproliferative properties for cancer prevention

Preservatives

Nitrates are added as preservatives to processed meats: used to smoke, salt, or pickle food Sodium and potassium nitrate are present in a variety of processed foods (deli meat, hot dogs, etc) nitrosamines and nitrosamides

SWEETENERS

Nonnutritive sweeteners (acesulfame -K, aspartame, neotame , saccharin, and sucralose) -REASONABLE amounts = safe Stevia, sugar alcohols (mannitol, sorbitol, etc) and blue agave also appear safe

Cancer Tx specific nutrition

Nutritional Intervention Strategies for Patients with Cancer (see Table 37-5 that is attached)

recommend: folate and folic acid

Obtain adequate amounts of folate from vegetables, fruits, and enriched or whole-grain products

Recommendation

Physical activity of at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week (American Cancer Society) and achieve a normal weight

Recommendation:

Physical activity of at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week (American Cancer Society) and achieve a normal weight

Mechanism of meat-->cancer

Production of carcinogens from a high fat diet heterocyclic amines or polycyclic aromatic hydrocarbons from cooking of meat N-nitroso compounds (NOCS) from processed heme iron in red meat may stimulate endogenous NOC production

Soy and Phytoestrogens

Soy contains phytoestrogens and isoflavones that protect against hormone - dependent cancers The use of soy in women already diagnosed with hormone-sensitive breast cancer and for postmenopausal women is controversial due to the estrogenic properties of soy The American Cancer Society advises breast cancer survivors to limit the consumption of soy foods to no more than 3 servings per day and to avoid supplements and powders Men with hormone-sensitive cancers may benefit from soy foods due to the cancer being testosterone driven (estrogens are agonists)

toxic environments

The Environmental Protection Agency (EPA) was established in 1970 to oversee the acute and long-term health threats caused by substances in the environment

Cancer Tx supplements

Watch for patients who are taking large amounts of supplements to enhance immune system or even try to reverse the disease state The American Institute for Cancer Research recommends against the use of high dose supplementations because some supplements can have cancer-promoting effects A MVI with no more than 100% of the DRIs is considered safe Some supplements such as vitamins A, C, E, beta carotene, zinc, and selenium may inhibit or enhance the antitumor effects of radiation and chemotherapy; therefore they should be avoided Recommendations: Avoid supplementation and get your vitamins and minerals from a well balanced diet

Being overweight or obese

also appears to increase the risk of cancer recurrence and decreases cancer survival

alcohol increases risk of

cancers of the mouth, pharynx, larynx, esophagus, lung, colon, rectum, liver, and breast

Recommendation: Preservatives

consume a diet that is high in fruits and vegetables that contain vitamin C and phytochemicals to retard the conversion of nitrites to NOCs

Being overweight as a chil

has been correlated with a 2 fold increased risk of death from colon cancer

women

increased BMI correlates with endometrium, gallbladder, kidney, and esophageal cancers

men

increased BMI correlates with esophageal, thyroid, colon, and kidney cancers

recommendation: MEAT

limit red and processed meats`