Lymphoma treated with chemotherapy
By Allie Kruger
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
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.
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
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
Stage Criteria
Stage I •The lymphoma is in a lymph node or nodes in only 1 region, such as the neck, groin, underarm, and so on.•The cancer is found only in 1 area of a single organ outside of the lymph system (IE).
Stage II •The lymphoma is in 2 or more groups of lymph nodes on the same side of (above or below) the diaphragm..•The lymphoma extends from a single group of lymph node(s) into a nearby organ (IIE). It may also affect other groups of lymph nodes on the same side of the diaphragm.
Stage III •The lymphoma is found in lymph node areas on both sides of (above and below) the diaphragm.•The cancer may also have spread into an area or organ next to the lymph nodes (IIIE), into the spleen (IIIS), or both (IIISE).
Stage IV The lymphoma has spread outside of the lymph system into an organ that is not right next to an involved node.The lymphoma has spread to the bone marrow, liver, brain or spinal cord, or the pleura (thin lining of the lungs).
Classic Signs of Lymphoma
Denise’s Symptoms
Enlarge Lymph Nodes Abnormal Lymph Nodes
Shortness of breath or cough Cough
Fever Fever
Weight loss Weight loss
Night sweats Night Sweats
Fatigue Fatigue
Swollen abdomen _________
Feeling full after small amounts of food
_________
Chest pain or pressure _________
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
Affected Cell
Result Symptoms
Red Blood Cells
Anemia•Fatigue•Shortness of breath•Chest pain
White Blood Cells
Neutropenia
•Fever•Chills •Cough/sore throat•Skin or mouth rashes•Burning during urination•Severe diarrhea
PlateletsThrombocytope
nia
•Easy bruising•Bleeding from skin >10 minutes or poor clotting ability•Blood in urine or stool•headaches
Any rapidly reproducing cells in the body
Hair follicles, mucous
membranes, gastrointestinal cells, and bone
marrow.
•Hair loss•Nausea•Ulcers•Mouth sores
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
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
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
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
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)
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