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