Nutrition and Cancer

Dr Clare Shaw, Consultant Dietitian and Head of Rehabilitation Research, The Royal Marsden NHS Foundation Trust, Fulham Road, London

• Contributors xiPreface xiii1 Cancer in the twenty-first century 1Natalie Doyle and Clare ShawIntroduction 1What is cancer and what causes it? 1Development and spread of cancer 2What is the global burden of cancer? 4Whom does cancer affect? 5Historical perspective on cancer treatment 6Cancer survivorship – living with and beyond cancer 9Nutrition and cancer 10References 112 Cancer and nutritional status 13Alessandro Laviano, Isabella Preziosa and Filippo Rossi FanelliIntroduction 13Nutritional status and outcome in cancer patients 13Cancer cachexia 14Pathogenesis of anorexia and reduced energy intake 16Pathogenesis of wasting 20Cancer cachexia: a neurological disease? 23Summary 24References 243 Treatment of cancer 27Sanjay PopatIntroduction 27Treatment intent 27Treatment setting 28Treatment modalities 28Conclusion 43References 444 Effect of malnutrition on cancer patients 45Louise HenryIntroduction 45Prevalence of malnutrition amongst cancer patients 46Effect of malnutrition on outcome 61Mortality 68Type of cancer 69Nutritional status as a prognostic indicator 69Morbidity 70Quality of life 71References 755 Nutrition screening 83Sian LewisIntroduction 83Scored Patient-Generated Subjective Global Assessment 85Malnutrition Universal Screening Tool 89Mini Nutritional Assessment 90Nutritional Risk Screening 91Malnutrition Screening Tool 91Conclusion 93Summary 93References 946 Nutritional requirements of patients with cancer 97C. Elizabeth WeekesIntroduction 97Energy 98Methods used to estimate energy requirements 100Disease-specific requirements 102Staging and tumour burden 105Treatment 105Response to treatment 107Tumour recurrence 107Inflammatory response and cachexia 107Protein 108Micronutrients 111What should we do in clinical practice? 112Summary 114References 1157 The psychosocial influences of food choices made by cancer patients 121Lucy EldridgeIntroduction 121Food and cancer 121Influences to food choices 122Other dietary approaches patients choose to take and the reasons why 125Sourcing information 126Summary 127References 1288 Nutritional support for the cancer patient 130Clare Shaw and Jane PowerIntroduction 130Food provision in a health care setting 130Symptom management 136Oral nutritional supplements 141Artificial nutrition support 142Summary 153References 1549 Late effects of cancer treatment in adult patients 158Jervoise AndreyevCancer is a chronic disease 158What is survivorship? 160Who should the dietitian aim to help? 160The stocktaking interview at the end of the treatment 161The metabolic syndrome 163Management of the metabolic syndrome 164Malnutrition in the cancer survivor 164Summary 170References 17010 Nutrition and palliative care 173Clare ShawIntroduction 173The role of nutrition in palliative care 175Psychological aspects of food intake 177Nutrition support in palliative care 179Management of nutritional problems 180Artificial nutrition support in palliative care 182Summary 185References 18511 Head and neck cancer 188Bella TalwarIntroduction 188The impact of malnutrition 189Treatment in head and neck cancer 189Nutritional intervention and outcomes 192Immunonutrition 195Functional implications following surgery 196Nutrition effects in radiotherapy and chemoradiotherapy 201Nutritional management 204Nutritional screening 204Nutritional assessment 206Nutritional requirements 207Oral nutrition support 208Enteral nutrition support 209Nutrition monitoring and rehabilitation 212Summary 214References 21512 Nutrition in upper gastrointestinal cancer 221Saira Chowdhury and Orla HynesIntroduction 221Epidemiology and aetiology 221The upper gastrointestinal anatomy 223Clinical presentation 224Staging 226Treatment pathways and role of nutrition 227Advanced disease 242Summary 244References 24513 Cancers of the lower gastrointestinal tract 255Jane PowerIntroduction 255Nutritional management 261Symptom management in palliative care 267Summary 267References 26714 Gynaecological cancer 270Mhairi DonaldIntroduction 270Ovarian cancer 270Endometrial cancer 272Cervical cancer 272Vulval and vaginal cancers 273Nutritional issues 273Nutritional implications of treatment 274Medical problems 279Nutrition and survivorship 283Summary 283References 28315 Haemato-oncology 287Gayle BlackIntroduction 287Disease characteristics and nutritional implications at diagnosis 287Nutritional implications during induction and intensification treatment 289Stem cell transplantation (consolidation phase) 289Nutrition support post-transplantation 299Long-term implications following transplantation 304Summary 305References 30516 Paediatric oncology 311Evelyn WardIntroduction 311Types of childhood cancers 312Aetiology of malnutrition in children with cancer 315Identification of nutritional risk 317Nutritional support 318References 32917 Nutrition and breast cancer 334Barbara ParryIntroduction 334The role of diet in breast cancer aetiology and survival 336Gestational nutrition and subsequent birth weight 336Breastfeeding 341Body fatness, body composition and weight management 342Alcohol 343Dietary fat 345Fruits and vegetables (including beans and pulses) 347Dairy foods 351Meat and meat products 352Specific nutrient associations and nutritional supplements 353Contaminants in foods 353Physical activity 354Benefits of physical activity to breast cancer survivors 355Nutritional problems during breast cancer treatment 356Summary 358References 35818 Nutritional management in prostate cancer 363Kathryn ParrIntroduction 363Dietary factors that may reduce the risk of prostate cancer 364Factors that may increase risk of prostate cancer 367Dietary interventions and prostate cancer progression 368Obesity/weight management 371Nutritional issues during treatment for prostate cancer 371Nutrition-related side effects of medications used to treat prostate cancer 372Malnutrition in prostate cancer 373Palliative care in prostate cancer 373Summary 373References 37519 Lung cancer 379Cherry VickeryIntroduction 379Diet and development of lung cancer 380Nutritional status at presentation 381Treatment of non-small cell lung cancer 382Treatment of small cell lung cancer 383Treatment of mesothelioma 384Palliative treatments 384Symptom management 386Summary 388References 388Index 391

"This is a thoroughly researched and detailed guide for clinicians on the range of nutrition-related problems in cancer patients and appropriate interventions.  It is comparable to Nutritional Issues in Cancer Care, Kogut and Luthringer (Oncology Nursing Society, 2005), but it is more comprehensive and up to date." (Doody's, 26 August 2011)