Contributors xi
Preface xiii
1 Cancer in the twenty-first century 1
Natalie Doyle and Clare Shaw
Introduction 1
What is cancer and what causes it? 1
Development and spread of cancer 2
What is the global burden of cancer? 4
Whom does cancer affect? 5
Historical perspective on cancer treatment 6
Cancer survivorship - living with and beyond cancer 9
Nutrition and cancer 10
References 11
2 Cancer and nutritional status 13
Alessandro Laviano, Isabella Preziosa and Filippo Rossi Fanelli
Introduction 13
Nutritional status and outcome in cancer patients 13
Cancer cachexia 14
Pathogenesis of anorexia and reduced energy intake 16
Pathogenesis of wasting 20
Cancer cachexia: a neurological disease? 23
Summary 24
References 24
3 Treatment of cancer 27
Sanjay Popat
Introduction 27
Treatment intent 27
Treatment setting 28
Treatment modalities 28
Conclusion 43
References 44
4 Effect of malnutrition on cancer patients 45
Louise Henry
Introduction 45
Prevalence of malnutrition amongst cancer patients 46
Effect of malnutrition on outcome 61
Mortality 68
Type of cancer 69
Nutritional status as a prognostic indicator 69
Morbidity 70
Quality of life 71
References 75
5 Nutrition screening 83
Sian Lewis
Introduction 83
Scored Patient-Generated Subjective Global Assessment 85
Malnutrition Universal Screening Tool 89
Mini Nutritional Assessment 90
Nutritional Risk Screening 91
Malnutrition Screening Tool 91
Conclusion 93
Summary 93
References 94
6 Nutritional requirements of patients with cancer 97
C. Elizabeth Weekes
Introduction 97
Energy 98
Methods used to estimate energy requirements 100
Disease-specific requirements 102
Staging and tumour burden 105
Treatment 105
Response to treatment 107
Tumour recurrence 107
Inflammatory response and cachexia 107
Protein 108
Micronutrients 111
What should we do in clinical practice? 112
Summary 114
References 115
7 The psychosocial influences of food choices made by cancer patients 121
Lucy Eldridge
Introduction 121
Food and cancer 121
Influences to food choices 122
Other dietary approaches patients choose to take and the reasons why 125
Sourcing information 126
Summary 127
References 128
8 Nutritional support for the cancer patient 130
Clare Shaw and Jane Power
Introduction 130
Food provision in a health care setting 130
Symptom management 136
Oral nutritional supplements 141
Artificial nutrition support 142
Summary 153
References 154
9 Late effects of cancer treatment in adult patients 158
Jervoise Andreyev
Cancer is a chronic disease 158
What is survivorship? 160
Who should the dietitian aim to help? 160
The stocktaking interview at the end of the treatment 161
The metabolic syndrome 163
Management of the metabolic syndrome 164
Malnutrition in the cancer survivor 164
Summary 170
References 170
10 Nutrition and palliative care 173
Clare Shaw
Introduction 173
The role of nutrition in palliative care 175
Psychological aspects of food intake 177
Nutrition support in palliative care 179
Management of nutritional problems 180
Artificial nutrition support in palliative care 182
Summary 185
References 185
11 Head and neck cancer 188
Bella Talwar
Introduction 188
The impact of malnutrition 189
Treatment in head and neck cancer 189
Nutritional intervention and outcomes 192
Immunonutrition 195
Functional implications following surgery 196
Nutrition effects in radiotherapy and chemoradiotherapy 201
Nutritional management 204
Nutritional screening 204
Nutritional assessment 206
Nutritional requirements 207
Oral nutrition support 208
Enteral nutrition support 209
Nutrition monitoring and rehabilitation 212
Summary 214
References 215
12 Nutrition in upper gastrointestinal cancer 221
Saira Chowdhury and Orla Hynes
Introduction 221
Epidemiology and aetiology 221
The upper gastrointestinal anatomy 223
Clinical presentation 224
Staging 226
Treatment pathways and role of nutrition 227
Advanced disease 242
Summary 244
References 245
13 Cancers of the lower gastrointestinal tract 255
Jane Power
Introduction 255
Nutritional management 261
Symptom management in palliative care 267
Summary 267
References 267
14 Gynaecological cancer 270
Mhairi Donald
Introduction 270
Ovarian cancer 270
Endometrial cancer 272
Cervical cancer 272
Vulval and vaginal cancers 273
Nutritional issues 273
Nutritional implications of treatment 274
Medical problems 279
Nutrition and survivorship 283
Summary 283
References 283
15 Haemato-oncology 287
Gayle Black
Introduction 287
Disease characteristics and nutritional implications at diagnosis 287
Nutritional implications during induction and intensification treatment 289
Stem cell transplantation (consolidation phase) 289
Nutrition support post-transplantation 299
Long-term implications following transplantation 304
Summary 305
References 305
16 Paediatric oncology 311
Evelyn Ward
Introduction 311
Types of childhood cancers 312
Aetiology of malnutrition in children with cancer 315
Identification of nutritional risk 317
Nutritional support 318
References 329
17 Nutrition and breast cancer 334
Barbara Parry
Introduction 334
The role of diet in breast cancer aetiology and survival 336
Gestational nutrition and subsequent birth weight 336
Breastfeeding 341
Body fatness, body composition and weight management 342
Alcohol 343
Dietary fat 345
Fruits and vegetables (including beans and pulses) 347
Dairy foods 351
Meat and meat products 352
Specific nutrient associations and nutritional supplements 353
Contaminants in foods 353
Physical activity 354
Benefits of physical activity to breast cancer survivors 355
Nutritional problems during breast cancer treatment 356
Summary 358
References 358
18 Nutritional management in prostate cancer 363
Kathryn Parr
Introduction 363
Dietary factors that may reduce the risk of prostate cancer 364
Factors that may increase risk of prostate cancer 367
Dietary interventions and prostate cancer progression 368
Obesity/weight management 371
Nutritional issues during treatment for prostate cancer 371
Nutrition-related side effects of medications used to treat prostate cancer 372
Malnutrition in prostate cancer 373
Palliative care in prostate cancer 373
Summary 373
References 375
19 Lung cancer 379
Cherry Vickery
Introduction 379
Diet and development of lung cancer 380
Nutritional status at presentation 381
Treatment of non-small cell lung cancer 382
Treatment of small cell lung cancer 383
Treatment of mesothelioma 384
Palliative treatments 384
Symptom management 386
Summary 388
References 388
Index 391
