Lymphoma treated with chemotherapy

1. Lymphoma treated with chemotherapy By Allie Kruger

2. Cheesy Jokes • What do you call bugs with cancer? • MalignANT and BEEnign • What do you call a doctor who is always on the telephone? • An ON- CALLogist • How can nurses stand to work in busy hospitals? • They have lots of patients

3. Denise Mitchell • 21 years old • Female • Caucasian • 5’6’’ Tall • 120 lbs • Full time college student • Denise had the flu several weeks ago and says she has never fully recovered. She will occasionally get a fever, still has a cough, feels fatigued, and has severe night sweats.

4. Lymphoma • Cancer of the Lymph Node • Lymph nodes can be found in the chest, abdomen, neck, and armpit • Starts as a growing mass in a lymph node, but can spread to other areas such as intestine, bone, brain, or spinal chord

5. 2 Types of Lymphoma • Hodgkin’s Lymphoma- spreads in an orderly manner from one group of lymph nodes to another. Also Hodgkin’s contains a special type of cell that NH does not • Non-Hodgkin’s- spreads through lymphatic system in no orderly manner

8. Treatment • Chemotherapy – Blocks mitosis, or stops cells from dividing, limiting cancer cell production • Radiation – used when a large amount of cancer cells have accumulated in one area of the body. It damages genetic material (DNA) within cells

10. Factors Affecting Nutritional Status of Cancer Patient • Constipation, diarrhea, inhibition of bowel mobility, taste abnormalities, chewing and swallowing problems, corticosteroids causing tissue breakdown, excessive loss of urinary protein, calcium, and potassium • Cancer- cachexia may occur, which is characterized by weight loss, anorexia, muscle wasting and weakness, and immunosuppression. Patients with cachexia will require increased energy and protein in their diets. • Until the tumor growth is under control, it will continue to increase the body’s protein, carbohydrate, and fat metabolism

11. Nutrition Therapy for Symptoms from chemotherapy • Compromised immune system-safe food practices, avoid communal foods, proper hygiene • Loss of calcium and potassium: take a multivitamin or a nutritional supplement. • Chewing and swallowing problems: softened or pureed foods. • Taste abnormalities: Try different seasonings or bland tasting foods. • Constipation: increased fiber and fluids • Diarrhea: increased fluids, reduced dietary fat, sugar, caffeine, and spicy foods which may irritate the problem • Cancer-cachexia: increase protein and caloric intake

12. Body Weight Evaluation • BMI • 120lbs/2.2 = 54.5kg • 66in x 2.54 = 168/100 = 1.68 m • 54.5/(1.68)(1.68) = 19.7 kg/m2 • %UBW • 120lbs/130lbs x 100 = 92% UBW Patient lost 8% body weight over 2 -3 months >7.5% weight loss in 3 months is considered significant

13. Factors contributing to the weight loss • Severe night sweats causing water loss and dehydration • Fatigue causing lack of physical activity • Sore throat causing less caloric intake • Glucose, protein, and fat are metabolized at a faster rate to aid the tumor in growth

14. Possible Nutrition Problems • Increased Nutrient Needs (N1-5.1) • Inadequate Protein-energy intake (N1-5.3) • Inadequate Fluid intake (N1-3.1) • Increased energy expenditure (N1-1.2)

15. Resources American Cancer Society. (10-25-2010). Non-Hodgkin Lymphoma. http://www.cancer.org Center for Disease Control and Prevention. (3-3-2011). Hematologic (Blood) Cancers. http://www.cdc.gov/cancer/hematologic/lymphoma/ Leukemia and Lymphoma Society. (3-16-2011). Disease Information and Support. http://www.lls.org/diseaseinformation Mahan, K. L., & Scott-Stump, S. (2008). Krause’s Food and Nutrition Therapy. St. Louis, Missouri: Sanders Elsevier Schmidt, Char. Medical Nutrition Therapy for Cancer Prevention, Treatment, and Recovery. [PowerPoint]. Retrieved from D2L website. https://uwstout.courses.wisconsin.edu http://www.thefurrymonkey.co.uk/jokes_cancer.htm