Cancer Cancer

• Classification of tumors is based on their tissue of origin; their

growth properties, and their invasion of other tissues
Cancer (CA) ranks just below CVD as a cause of death for • Adenomas arise from glandular tissues
the entire population • Carcinomas arise from epithelial tissues
• One in 2 males & a little more than 1 in 3 females are at risk of • Gliomas arise from glial cells of CNS
developing CA in US
• Common CA in men are prostrate, lungs, bronchus, colorectal & • Leukemias arise from WBC precursors
urinary bladder
• Common CA in women are breasts, lungs, bronchus, colorectal, • Melanomas arise from skin cells
uterine • Myelomas arise from plasma cells in bone marrow
• Children usually develop CA of connective tissues, brain, bones, • Sarcomas arise from connective tissues eg. Muscle, bone
muscles, nervous tissue (Sarcomas) & adults of epithelial linings
eg. skin, circulatory, digestive, endocrine, respiratory, urinary, • Advanced CA, especially in GI tract and pancreas, can
reproductive systems (carcinomas) seriously impair nutrition status
• Response to treatment is complete, partial, stable, or
progressive

1 2

Cancer
• Cancer is abnormal cell division and reproduction that Tumor Formation
can spread throughout the body
• Carcinogenesis (origin or development of cancer) is thought to be
biologic, multistage process that proceeds on a continuum.
Three stages:
• Initiation (transformation of cell (mutation) produced by chemicals,
radiations or viruses with cellular DNA- the resultant may remain
dormant until activated by a promoting agent)
• Promotion (initiated cells multiply & escape the mechanisms set in
place to protect the body from growth & spread of such cells. A
neoplasm, a new & abnormal tissue with no useful function is
established)
• Tumor progression, includes metastasis (tumor cells aggregate
& grow, proceeds, leading to a fully malignant neoplasm or tumor with
the capacity for tissue invasion that may spread to distant tissues or
organs, process called metastasis)

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1
 Cancer etiology and progression
CRC: A Multistage Disease

Surh. (1999). Mutation Research, 428: 1999. 305–327. 5

5 6

Diagnostic Tests
According to American Cancer Society (ACS), following
early warning signs and symptoms of cancer are described
using the acronym “CAUTION”
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty in swallowing or chewing
Obvious change in the wart or mole
Nagging cough or hoarseness

When symptoms suggest cancer, physicians use other definite

diagnosis:
Evaluation of individual’s medical, social, family history,
physical examination, lab. tests, imaging procedures & tissue
https://www.cell.com/action/showPdf?pii=S0092-8674%2811%2900127-9
biopsies

7 8

2
 Diagnostic Tests

A non-morphological diagnostic test is not usually 100% reliable by itself because there Staging of Cancer
may be false-negative or false-positive results.
The staging system describes the extent of the disease at the time
1. Blood tests. Hemoglobin and erythrocyte counts may be low.
Leukemia characteristics cell are diagnostic when confirmed by a bone marrow and therefore provides a basis for treatment and prognosis.
examination. Staging systems (Stage I to Stage IV) are based on the:
• size of the primary tumor (T);
2. Tumor markers are substances, enzymes, antigens, or hormones, produced by
some malignant cells and circulatie in the blood or other body fluids. These
• extent of involvement of regional lymph nodes (N); and
markers can be used to screen high-risk individuals, to confirm a diagnosis, or to • spread (invasion or metastasis) of the tumor (M).
monitor the clinical course. Examples include carcinoembryonic antigen (CEA) for
colon cancer, human chorionic gonadotropin (HCG) for testicular cancer, alpha-
fetoprotein for hepatocellular cancer.
All are non-specific.

3. Imaging techniques: X-ray, ultrasound, magnetic resonance imaging (MRI), and

computed tomography (CT scans). Radioisotopes may be incorporated to trace
metabolic pathways and function.

4. Morphological methods: Histologic and cytologic examinations are used to

evaluate biopsies of suspicious masses and to check sloughed cells in specific tissues.
This is the only dependable confirmation of malignancy. An accurate evaluation
depends on good technique and preservation of the specimen. For example, a regular Non-malignant (non-cancerous) tumors are called benign
Pap test examining cervical cells.

9 10

Cancer Nutrition in the Etiology of Cancer

How cancer develops
• Genetic factors
• Nutrition may modify carcinogenic process at any
stage: carcinogen metabolism, cellular and host
• Environmental factors and genes interaction defense, cell differentiation, and tumor growth
• Nutrition is adversely affected by cancer itself,
treatment (radiation therapy, chemotherapy, and
surgery), and current health and nutritional status
• One-third of all cancer deaths attributed to diet,
nutrition, and lifestyle behaviors such as poor diet,
physical inactivity, overweight and obesity, and
alcohol use; another third related to cigarette and
tobacco use

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3
 Types of Epidemiologic Studies Nutrition in the Etiology of Cancer– cont’d
of Cancer
• Complex relationship
Case Control Studies • Dietary carcinogens: naturally occurring (pesticides
The diets of individuals with cancer are compared with those of produced by plants to protect against fungi, insects, or animal predators; or
cancer-free controls matched for age, sex, and other key factors. mycotoxins eg. afltatoxins) and added in food preparation
Cohort Studies and preservation
The diets of different groups of subjects are determined before
cancer onset, and the incidences of developing cancers in each • Inhibitors of carcinogenesis: antioxidants (Se,
group are compared. carotenoids, vit. C, E), phytochemicals (anthocyanins, lycopene,
Cross-sectional Studies indoles, sulforphanes)
The diets of different groups of subjects are compared, using the • Enhancers of carcinogenesis: fat in red meat or polycyclic
same measures at a single point in time. aromatic hydro carbons (PHC) formed with grilling of meat at high temps.
• Latency period between initiation and promotion:
diet at initiation more important than at diagnosis

13 14

Energy Intake, Body Weight, Obesity, and Physical

Activity Nutrition and Cancer Etiology
• Energy restriction inhibits cancer and extends life span in
animals & molecular damage • Fat: fat calories obesity cancer risk of
• Positive associations between overweight and cancers of usually colon, rectum, esophagus, gallbladder, breast
the breast, endometrium, kidney, colon, prostate, and in post menopausal women
others • Type of fat (red meat/animal fat cancer )
• Omega 3 & omega 6 cancer
• Overweight increases risk of cancer recurrence and
decreases survival eg. in lower oesophagus, stomach, small intestine, colon, • Protein: plant proteins, animal proteins cancer
rectum, gall bladder, breast, prostrate, bladder, thyroid, connective tissue, melanoma,
multiple myeloma & leukemia • Soy and phytoestrogens: (weak plant-based estrogens & compounds
• BMI related to death rates of 11 types of cancers in eg. Isoflavones & lignans) may
breast cancer risk. Controversial in
men & 12 types in women women with estrogen-receptor +ve breast cancer

• Physical activity is inversely associated with cancer

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4
 Color Code System of Vegetables and
Nutrition and Cancer Etiology Fruits
Color Phytochemical Vegetables and Fruits
• Carbohydrates: fiber cancer risk Red Lycopene Tomatoes and tomato
products, pink grapefruit,
• sugars blood glucose, TGs, insulin & other hormones watermelon
cancer Red/purple Anthocyanins, Berries, grapes, red wine,
polyphenols prunes
• high glycemic index foods cancer (ovary, endometrium, Orange α-, β-carotene Carrots, mangoes,
breast, colorectal, pancreas, lungs) pumpkin

• Fruits and vegetables: 128 of 156 dietary studies Orange/yellow β-cryptoxanthin,

flavonoids
Cantaloupe, peaches,
oranges, papaya,
showed protective role of higher intakes (fiber, vitamins, nectarines
minerals, biologically active subs. like antioxidants, phytochemicals, carotenoids, Yellow/green Lutein, zeaxanthin Spinach, avocado,
honeydew, collard and
flavonoids, plant sterols) turnip greens

• Nonnutritive sweeteners: FDA approved 5 sweeteners to be used as Green Sulforaphanes, indoles Cabbage, broccoli,
Brussels sprouts,
additivies- ascesulfame-K, aspartame, neotame, saccharine, sucralase. Stevia as a cauliflower
dietary supplement White/green Allyl sulphides Leeks, onion, garlic,
chives
Data from Heber D: Vegetables, fruits and phytoestrogens in the prevention of diseases, F Postgrad Med 50:145, 2004.

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Nutrition and Cancer Etiology– cont’d Nutrition and Cancer Etiology– cont’d
• Alcohol: No more than 2 drinks per day for men & 1 for
women. Folate for alcoholic is good • Cancer chemoprevention: Involves pharmacologic
• Coffee and tea: Controversial. Green tea polyphenols may reduce risk intervention with specific nutrients or chemicals to reverse
of stomach cancer. Very hot drinks esophageal cancer or suppress carcinogenesis. However, there has been a
high incidence of lung cancer in smokers associated with β
• Methods of food preparation and preservation: Carcinogens carotene supplementation, especially in heavy alcoholics.
formed: On the other hand, chemoprevention holds promise for
suppressing or reversing cancers
• High heat cooking methods polycyclic aromatic Hydro -
carbons & heterocyclic amines (grilling, broiling, barbecuing,
smoking of meats) • Cancer prevention recommendations: nutrition and
physical activity: ACS (American Cancer Society) comprises
• N-nitrosocompounds (NOCs) is a carcinogen formed in smoked, of the recommendations (next slide)
salted, pickled foods & tobacco cured with NO3 or NO2. Vitamin C &
phytochemicals can retard conversion of nitrites to NOCs
• Acrylamide in CHO rich foods as potatoes formed as a by-product
during frying, baking, roasting.

19 20

5
 Guidelines for Cancer Prevention

1. Choose a diet rich in a variety of plant-based foods.

2. Eat plenty of vegetables and fruits.
3. Maintain a healthy weight and be physically active.
4. Drink alcohol only in moderation, if at all.
5. Select foods low in fat and salt.
6. Prepare and store food safely.

And always remember . . . Do not use tobacco in any form.

From American Institute for Cancer Research: Simple steps to prevent cancer, Washington, DC, 2000, AICR.

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Nutritional Implications of Cancer

• Adverse nutritional effects of cancer compounded by

treatment
• Even small weight loss (<5% body weight) before treatment
adversely affect prognosis

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6
 Factors That Affect Appetite Cancer Cachexia

• Progressive weight loss

• Anorexia
• Generalized wasting and weakness
• Immuno-suppression
• Altered BMR
• Abnormalities in fluid and energy metabolism
• Cytokines are producd including tumor necrosis factor (TNFa
and TNFb), cachectin, interleukin-1, interleukin-6, and
interferon-a
• Anticytokine antibodies or other cytokine inhibitors might be
considered for treatment intervention

25 26

Metabolism and Tumor Growth Metabolism and Tumor Growth

• Energy needs are variable- hypo, normo or hyper metabolic states • Fluid and electrolyte imbalances in cancers promoting vomiting
& diarrhoea caused by chemotherapeutic agents, antibiotics, partial
• Protein, fat, and carbohydrate: tumors exert consistent demand for bowel obstructions, steatorrhea; endocrine secreting tumors- eg.
those secreting serotonin, calcitonin, gastrin. Persistent vomiting is
glucose, exhibit high rate of anaerobic metabolism, yielding lactic acid that associated with intestinal obstruction, radiation therapy to abdomen
requires high rate of host gluconeogenesis protein breakdown & or whole brain, emetogenic (vomit producing) chemotherapy agents,
lipolysis ,insulin resistance & skeletal muscle loss intracranial cancers or terminal cancers
• Nutrition, Tumor growth & Treatment Outcome • Enzyme activities and endocrine functions immunologic function

• Loss of appetite and sensory changes associated with disease itself,

• Nutrition support preserves lean body mass; also benefits malignancy. Others report chemotherapy agents, radiation therapy, or surgery of head or neck.
wt. loss & mucositis on receiving nutrition support. Avoid aggressive nut.. support
Individuals may also experience heightened sense of smell & can be
helped by serving cold instead of hot foods to decrease aroma of food
• Other Metabolic Abnormalities
• Hypercalcemia in bone metastasis caused by osteolytic activity of tumor cells Careful assessment of the patient and regular monitoring is most
(breast cancer, multiple myeloma), thereby releasing Ca in external fluid Symptoms are
nausea, weakness, lethargy, confusion. Treatment includes rehydration, use of crucial to decide on the nutrition therapy
biphosphonates & other antihypercalcemic agents; Ca supplementation avoided but
dietary intake of Ca containing foods continued

27 28

7
 Medical Nutrition Therapy Energy and Protein Requirements
• Energy
• Goals: prevent or reverse nutrient deficiencies, preserve lean • Standardized equations (Mifflin- St. Jeor and Ireton-Jones), indirect
body mass, minimize nutrition-related side effects, maximize calorimetry based on the individual’s clinical status & availability of
quality of life assessment information & equipment. Harris Benedict equations often
overestimate needs in healthy individuals. After REE, activity & stress
• Nutritional screening and risk assessment factors are added to calculate TER. Factors from 1.1 to 1.6 times
through PG-SGA (Patient Generated Subjective Global greater than usual may be used for patients with stem cell transplant,
Assessment) sepsis or surgery. Close monitoring & follow-up reqd.
• Protein
• Body weight (challenge is to maintain the lean body mass) • Consider degree of malnutrition, extent of disease, degree of stress, ability
to metabolize and use protein

29 30

Daily Protein Requirements for Patients Fluid and Micronutrient Requirements

with Cancer
• Fluid to maintain adequate hydration, tissue
perfusion & electrolyte balance
• Body surface area: 1500 mL/m2 or BSA × 1500 mL
RDA for adults: 0.8 g/kg • Daily requirements method: 1 mL fluid per 1 kcal of
Normal maintenance: 0.8 to 1 g/kg estimated needs
Nonstressed cancer patient: 1 to 1.2 g/kg • Holliday-Seger method: >20 kg of body weight = 1500 mL +
20 mL/kg for each kg >20 kg
Hypercatabolic cancer patient: 1.2 to 1.6 g/kg
Severely stressed cancer patient: 1.5 to 2.5 g/kg • Age based method: <55 year of age – 30 to 40 mL/kg, 55 to
65 years of age – 30 mL/kg, >65 years of age – 25 mL/kg
Hematopoietic stem cell transplant patient: 1.5 to 2 g/kg
• Micronutrients
• High-dose supplements common
• Pre-existing deficiencies
Data from Charuhas PM et al: Medical nutrition therapy in bone marrow transplantation: energy, protein,
micronutrient, and fluid requirement. In Elliott L et al, editors: The clinical guide to oncology nutrition, ed 2,
Chicago, 2006, American Dietetic Association.
• Recommend supplement not more than100% DRI

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8
 Cancer Treatments
Antioxidants
• Chemotherapy
• Controversy over whether the use of antioxidant • Chemical agents or medications to treat cancer. It is a systemic
supplementation such as vitamin A, C, E, β therapy affecting the whole body. Target of action are
carotene, Zn, Se actually inhibits or enhances malignant & normal cells. Cells with rapid turnover (bone
the antitumor effects of radiation/chemotherapy marrow, hair follicles, & mucosa of alimentary tract) are most
continues
affected

• Immunotherapy or Biotherapy
• Group of drugs that stimulate the body’s own immune system
and natural defenses to treat cancer used in isolation or in
combination with chemotherapy drugs.

Cytokines: α-Interferon (to treat leukemia) and Interleukin-2 (to treat renal
carcinoma) Monoclonal
antibodies: for specific types of breast cancer Cancer
vaccines: made from individual’s own cancer or substances from tumor cells) are
proteins that cause blood cells to grow & mature

33 34

Cancer Treatment (contd.) Cancer Treatment and

Nutritional Implications (Table 37-4A-4C)
• Radiation therapy • Chemotherapy- nutrition impact symptoms
• Myelosuppression (suppression of bone marrow production), anemia, fatigue,
• High-energy rays (ionizing radiations) in multiple nausea, vomiting, loss of appetite, mucositis, changes in taste and smell,
fractioned doses to cure, control or palliate cancer xerostomia (mouth dryness), dysphagia, diarrhea, constipation
• Affects the localized cancer cells & the surrounding area • Chemotherapy- induced toxicities
only
• Diarrhea, constipation, adynamic ileus ( bowel motility)
• Surgery
• Anorexia, oligophagy (eating few foods)
• Surgical resection or removal of any part of alimentary
tract can impair digestion & absorption significantly, • Chemotherapy- nutrient interactions
fatigue & diarrhea
• Pemetrexed based treatment for lung cancer require folic acid & vitamin B12 to
avoid anemia;
• Surgery may be used as the only mode of cancer
treatment or may be combined with chemo or radiation • Procarbazine agent to treat brain cancer may result in severe hypertensive
therapy events when tyramine-rich foods are consumed with it

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9
 Cancer Treatment and Cancer Treatment and Nutritional
Nutritional Implications (contd.) Implications–cont’d
• Immunotherapy • Hematopoietic Stem Cell Transplantation (HSCT)
• Treatment performed for certain hematologic malignant
• Fatigue, chills, fever, flu-like symptoms, decreased food intake diseases- leukemia, lymphoma, malignant solid tumors &
autoimmune disorders
• Radiation therapy (Acute & Late nutritional effects according to the area • Stem cells used for HSCT arise from bone marrow,
of radiation)
peripheral blood or umbilical cord blood
• Fatigue, loss of appetite, skin changes, & site-specific effects • Preparation includes cytotoxic chemotherapy with or
without total body irradiation to suppress immunologic
• Radiation therapy to abdomen results in Radiation-induced
reactivity & eradicate malignant cells. This is followed by IV
enteritis with symptoms of ulceration or obstruction, thereby
increasing malnutrition infusion of hematopoietic cells:
• from the patient (autologous) or
• from histocompatible donor (allogenic)
• Surgery
• or from identical twin (syngeneic)
• Fatigue, pain, loss of appetite & changes in bowel function

37 38

HSCT– cont’d HSCT– cont’d

• Acute toxicities of immuno-suppression last for about 2 to • Graft versus host disease (GVHD)
4 weeks & include nausea, vomiting, anorexia, dysgeusia • Complication primarily after allogeneic transplants , in which
(impaired taste), stomatitis (inflammation of mucus lining donor stem cells react against tissues of the “foreign” host;
of mouth), oral and esophageal mucositis (inflammation functions of target organs (skin, gut, liver, lymphoid cells)
disrupted & risks of infections increase
& ulceration of mucus lining of GIT), fatigue, and diarrhea
• Acute GVHD manifested within first 100 days post-transplant &
may be seen as early as 7-10 days after transplant
• Skin GVHD is characterized by maculopapular (red, spotty, bumpy) rash
• Liver GVHD by jaundice, abnormal LFTs
• GI-GVHD symptoms may be acute & severe- gastroenteritis (secretory
diarrhea, abdominal pain, nausea & vomiting). Treatment includes immuno-
suppressive medicines & diet. 1st phase involves total bowel rest ; 2nd phase
reintroduces oral feedings of isosmotic, low residue & lactose free beverages
in 3rd phase & reintroduction of solids (soft , bland & then regular diet) in 4th
phase. Phase 5 includes resumption of individual’s regular diet.

Severe Oral Mucositis Following Marrow Transplantation-

Bland liquids & soft diets are better tolerated. Salivary
stimulants & substitutes are beneficial

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10
 HSCT– cont’d

• Sinusoidal Obstructive Syndrome (SOS) or Veno-Occlusive

HSCT– cont’d
Disease (VOD)
• Chemotherapy or radiation therapy induced damage to the hepatic • Dietary precautions with neutropenia ( neutrophils
venules WBC in blood)
• Can develop 1 to 3 weeks after transplant • Patients are immuno-compromised & require supportive therapy to avoid infections
• Medications
• Right upper quadrant discomfort (pain, tenderness in right upper • Dietary changes- food safety, avoid raw, uncooked, unpasteurized items
abdomen), hepatomegaly, retention, & jaundice, progressive hepatic • Foods should be stored appropriately below 40 0F and above 140 0 F (or less than 4 0C and
failure leading to encephalopathy & multiple organ system failure more than 60 0C)
• Introduce neutropenic diets with low microbial or low bacteria in food supply
• Conc. Parenteral nutrition & judicious fluid & electrolyte mgt.
• Other acute or chronic complications
• Pulmonary disease, impaired renal function, rejection of graft,
growth abnormalities in children, sepsis, infection

41 42

Management of Nutrition Impact Symptoms Management of Nutrition Impact Symptoms (contd.)

• Cancer & its treatment can impact nutritional needs &
affect digestion, absorption & metabolism
• Oral nutritional management strategies- preferred
• Symptoms with nutrition impact are nausea, vomiting,
changes in taste & smell, dysphagia, bowel changes, • Liquid nutritional supplements for sufficient energy
anorexia, pain & fatigue
• Altered taste acuity (ageusia, hypogeusia, dysgeusia):
• Determining routes of nutritional therapy- individualized • Use flavors & seasonings ; eliminate red meats having strong flavor

• Oral nutritional management strategies- preferred • Artificial saliva preparations & saliva stimulants for diminished
• Management of chemotherapy-induced nausea and vomiting salivation.
• High moisture foods & plenty of fluids are also beneficial
• Pharmaceutical management of anorexia-cachexia syndrome
• Enteral nutrition • GI symptoms require modifications of lactose, fat, fiber

• Parenteral nutrition • Timing of food presentation based on individual’s responses

• Rehabilitation and physical therapy • Fatigue: Encourage small, frequent meals, emphasis on morning feedings
• Palliative care for advanced cancer • Timing of meals & snacks relative to GI side effects (food aversions)

43 44

11
 Management of Nutrition Impact Symptoms (contd.) Management of Nutrition Impact Symptoms (contd.)
• Parenteral nutrition
• Management of chemotherapy-induced nausea and vomiting • Appropriate for whom oral & enternal nutrition not tolerated
• Factors to consider include the patient’s prognosis, prescribed therapy, degree of
• Conditioned response for anticipatory form of nausea & vomiting after 3-4 malnutrition, GI function
chemo. cycles in 1/3 patients.
• Immune enhancing nutrients may be supplemented through parenteral feeding
• Requires behavioral intervention (glutamine)

• Pharmaceutical management of anorexia-cachexia syndrome • Type of parenteral feeding (central IV access or peripheral catheter) is determined
by the clinical & nutritional status of patient
• Appetite stimulants, metabolic agents, cytokine blockers, prokinetic & • Potential complications: fluid overload, hyperglycemia, insulin resistance,
anabolic agents (side-effects, monitoring, evaluation, nutritional counseling infections
& physical activity)
• Rehabilitation and physical therapy
• Enteral nutrition (preferred over TPN till gut is functional) • To rebuild muscle & regain strength and energy
• Naso-gastric or naso-jejunal for short-term administration • Palliative care for advanced cancer
• Gastrostomy or jejunostomy for long term administration • Active total care of an individual when curative measures are no longer considered
an option by either the medical team or the individual; focusing relieving
• Formula selection based on factors: immune-enhancing EN formulae symptoms and supporting individuals with a life expectancy of months, not years
(supplemented with arginine, glutamine, omega 3 fatty acids) (Hospice care- life expectancy of months & focus on relieving symptoms, pain &
provide support to the family)
• Tumor development at site of percutaneous feeding stoma site

45 46

Nutritional Care of Children Complementary and Alternative Medicine

(CAM) Therapies
• Families and caregivers often have extreme preoccupation with eating
and weight
• Creativity in feeding • Complementary therapies are supportive methods that are
used to complement evidence based treatment, to help
• Enteral nutrition support control symptoms & to improve well being and quality of life
• Individualize requirements
• Requirements for growth and development
• Alternative therapies are treatments that are promoted as
cancer cures and are unproven or scientifically disapproved
methods

• Integrative medicine works to integrate the evidence-based

complementary therapies into conventional cancer
treatment (self-empowerment, individual responsibility,
lifestyle changes)

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12
 Complementary Alternative Medicine (CAM) Therapies are Alternative Medicine (AM) (contd.):
classified into 5 major domains:
• Whole medical systems • Patients usually explore AM when:
• Traditional Chinese Medicine, ayurvedic medicine, homeopathy,
naturopathy • Health promotion and disease prevention are sought
• Mind-body interventions • Conventional therapies have been exhausted
• Mindfulness, meditation • Conventional therapies are of indeterminate
• Biologically based therapies effectiveness or are commonly associated with side
• Botanicals, dietary supplements, vitamins, minerals effects or significant risks
• Manipulative and body-based methods • No conventional therapy is known to relieve the patient’s
• Massage, yoga, reflexology
condition
• Energy therapies (work to affect the purported energy • The conventional approach is perceived to be
field that surrounds & penetrates the body) emotionally and spiritually without benefit
• Biofield therapies include qi, Reiki, therapeutic touch
• Bioelectric magnetism includes unconventional use of pulsed &
magnetic gields

49 50

CAM Therapies (contd.): CAM Therapies (contd.):

• CAM therapies by cancer patients usually include • Nutrition and Diet therapy are based on “you are what you eat” principle.
nutrition (diet), metabolic therapies, vitamin & mineral • Macrobiotic diet is a quasi-religious diet, philosophic system. It derives 50 % to 60 %
energy from whole grains; 25 % to 30 % from vegetables; and remainder from beans,
supplementation, herbal & botanical therapies seaweed, soups. Meat and certain vegetables are avoided, and soyabean consumption
is promoted
• Metabolic therapy is a term used for variety of cancer
management methods (unproven or disproved diagnostic Side effects: Calcium and vitamin B12 deficiency. Efficacy of this diet in cancer is not yet
studied
methods & treatments) . Generally, these practitioners claim
• Megavitamin therapy uses large doses of one or more vitamins believing that the body’s
that diseases are caused by an accumulation of toxic ability to destroy the tumor is enhanced by large doses of vitamins, anti-oxidants and
substances in the body other substances
• If these toxins are removed, the body will heal naturally
• Three basic steps are commonly employed:
• Detoxification
• Strengthening of immune system
• Use of special modalities to attack cancer
• However, the above may have associated complication or side-
effects

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