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Chemotheraphy and Appetite

Cancer is treated in many ways, and Chemotherapy is one of them.

To treat a cancer patient through Chemo, some special drugs are used to kill the cancer cells that have grown in the body. Certain cancers can be treated only with Chemotherapy, and certain cancers are treated with Chemo combined with Radiation Therapy and Surgery.

Chemotherapy and Appetite:

Patients who are undergoing Chemotherapy, the intake of food is also important as they may experience nausea, vomiting, diarrhoea and constipation. 

Patient need not be on a special diet while undergoing chemo. But they need to have a nutritious and a well-balanced diet so that the patient can withstand the side effects of the treatment, stop weight loss, reduce the risk of infections and it also helps the patient recover fast. These days there are a variety of dietary supplements and anti-cancer diets, but nothing like a well-balanced diet-home made food.

Generally, it is very common during chemotherapy to lose appetite. The digestive system, from mouth, throat, stomach and intestines can get affected, causing the loss of appetite. Sometimes due to depression, also one may lose appetite. But still, this will not stay forever. After treatment, the patient will get back his appetite.

Weight loss with Chemotherapy:

  • As a result of chemotherapy treatment, there may be a weight loss.
  • This decreases strength, causes weakness & tiredness, and can also reduce the interest in performing daily activities.

The Side Effects of Weight Loss are

a) loss of appetite.

b) smell and taste changes.

c) Dry or sore mouth

d) nausea, vomiting

e) constipation or diarrhoea

An oncologist can help the patient with these side effects and advice the patient how to manage the diet.

Eating Well With Chemotherapy:

Eating well means taking a diet –variety and well-balanced one which provides all the calories and nutrients needed like-protein, fats, carbohydrates, vitamins and minerals.

Three meals every day, that should include foods that the patient enjoys.

Energy-rich foods are carbohydrates like-bread, rice, pasta, yam, potatoes, chapattis and cereals for each meal.

Protein-rich foods are—meat, poultry, fish, eggs, cheese, beans, yoghurt, tofu or lentils at least twice a day.

Food with minerals and vitamins include fruits and vegetables that should be included in every meal like carrots, cucumber, apples, plums, pears, oranges and peaches.

Fluids like-apart from water, tea, coffee, fruit juice, soups, milky drinks and smoothies at least six to eight cups, can squeeze a lime, add a fruit juice to water for better taste.

Avoid consuming alcohol totally during chemo treatment as chemotherapy is taxing on the liver.

Kidneys need plenty of fluid to excrete chemotherapy medicines.

WEIGHT GAIN:

Some patients may gain excess weight during chemotherapy. There are a few reasons for this-

  1. a) physical activity decreased,
  2. b) overeating,
  3. c) stress, boredom,

Immediately this may not be a concern, but in the long run gaining weight will be a problem.

Here again the treating doctor’s advice helps.

Food Safety And Chemotherapy

Chemotherapy can cause the skin to break down and reduce the white blood cells in the body. So food safety becomes a must while chemo treatment is going on to reduce the risk of food safety. 

The first and foremost of food safety is to cook the food properly to reduce the germs.

Store food at the right temperature to reduce the growth of germs.

Must avoid contamination of food after cooking.

The other ways of ensuring food safety are:

  1. Always check the expiry date on food labels.
  2. Avoid buying damaged vegetables and fruits.
  3. Avoid buying damaged or broken packaging.
  4. Chilled and frozen food should be brought home as early as it is bought.
  5. Avoid unpasteurized milk and milk products.
  6. Avoid smoked fish, raw sprouts, raw beef, raw eggs.

Duration To Get Back Appetite After Chemotherapy

  • Generally it takes two to three weeks once chemotherapy stops to get back the appetite.
  • If it does not, consult the treating doctor.
  • It also depends on the kind of chemotherapy medicine that was given.
  • you can also eat food that smells and tastes good.
  • go for a 30 minute walk before eating, it will help;
  • eat small meals and snacks each day after the chemo treatment.
  • set the table, play your favorite music, watch TV or eat with someone, so that you will eat well, after the treatment stops.

Eating Out During Chemo:

Eat freshly prepared food, ask for it.

  • served food should be very hot, and cooked thoroughly.
  • always avoid buying food from bars, outside vendors, ice cream vans and buffets- the food might be stale.

Food Preparation During And After Chemotherapy

  • Hands should be washed thoroughly.
  • If you touch any raw food such as eggs, fish, meat, poultry, vegetables and fruits, wash hands thoroughly.
  • Surface where the food is to be prepared, should also be clean.
  • Cooked food should not come into contact with raw foods, even the utensils and clothes should not be kept near cooked food.
  • Keep a separate chopping board for cutting raw food and ready to eat food.
  • Wash fruits, vegetables and salads thoroughly before eating.

Awareness About Chemotherapy And Appetite:

Many patients are not aware that appetite plays a major role before, during and after chemotherapy. They need to schedule the type of food, precautions to be taken and to eat a well balanced diet. To also take small meals, keep snacks handy and juices to take at regular intervals will help to recover fast.

It is always important to discuss with the doctor about the minerals, dietary supplements and herbs if you take before the chemotherapy begins and the advice is very helpful. This awareness is also a must. Awareness about your diet, exercise, talking to others and joining a support group also helps to talk about and listen to the diet plans of others, to cope with the treatment.

Cancer Treatment

WORKING OF CANCER TREATMENT

Cancer is deep inside the body. Even if it shrinks or grows, the patient won’t be able to see or feel it. So after the diagnoses of the cancer, the doctor generally will choose the treatments that can cure the cancer. Based on the location of the cancer in the body, the size, and the test results the doctor will decide whether to continue with the treatment that has been started or shift to another treatment.

WHAT DOES THE TREATMENT RESPONSE MEAN?

The terms used by the doctor to check how the treatment is working are:

  1. A partial response or remission: this means the tumor has shrunk by 50%, and it is still there.
  2. A complete response or remission: means the cancer can’t be measured, and the cancer too small to find through any tests.
  3. Stable:  The state of the cancer is the same it has not got worse or improved.
  4. Progression: means has grown or spread. The treatment needs to be changed to control it.

TESTS TO CHECK THE TREATMENT RESPONSE:

The treating doctor may call you a number of times after treatment to check if the cancer has come back or spread. The doctor also monitors for the side-effects of the treatment. A few tests will be conducted, like the ones done earlier to the treatment to see if the cancer treatment is working. The tests are:

  • BLOOD TEST: Certain enzymes or proteins are released by the cancer cells or the organs when the tumor grows, so the blood tests help to check the levels of these in the blood.
  • TUMOR MARKERS: The doctor tests the blood, urine or tissues to see if the proteins, enzymes and other chemicals which are released by the tumor have progressed.
  • X-RAY:  To check where the cancer cells are in the body and if the cancer has spread to the bones.
  • The other tests are CT scan, MRI and PET to check the location in the body and if the treatment is working.
  • MAMMOGRAM:  This test helps to look for cancer in the breasts.

The type of test and how often it is taken depends on the type of cancer and treatment given.

SYMPTOMS THAT CANCER HAS COME BACK OR SPREAD AFTER TREATMENT:

  • A new growth or lump under the skin.
  • Continuous pain in the bones, joints, or bones broken.
  • Headaches, dizziness, changes in the vision, if the cancer has spread to the brain.
  • Cough, trouble breathing, this means cancer has spread to the lungs.
  • Belly pain, itching eyes or skin turn yellow, this indicates cancer has spread to the liver.
  • Nausea, vomiting and fever.

These symptoms can also be the side effects of the cancer treatment, better to see the treating doctor immediately.

CANCER AND CHEMOTHERAPY

When cells in the body grow uncontrollably it leads to cancer. The deaths that are caused by cancer is second only to that from cardiovascular disease. Great improvements have been made in the treatment of cancer in the past 50 years. As it is a major health concern, efforts have been made to find new therapeutic approaches. In the past the treatments were surgery, chemotherapy and radiation therapy. Through these treatments the growth of the tumor was stopped and cured also. 

Chemotherapy, was started in 1940s, before that is was only surgery. The combination of treatment started in 1960s. One advantage in chemotherapy was that it targeted a specific difference between tumors and normal tissue. 

Chemotherapy drugs are used to treat a variety of cancers. Chemotherapy is a drug treatment where powerful chemicals are used to kill the fast growing cells in the body. 

  • Chemotherapy can be used as a sole treatment for cancer.
  • After surgery if any cancer cells are left in the body, chemotherapy is used to kill the remaining cancer cells.
  • Chemo is also used to shrink the cancer tumor. Chemotherapy is used to ease signs and symptoms of cancer by killing some of the cells.

SIDE EFFECTS OF CHEMOTHERAPY DRUGS

Not every chemotherapy drug has side effects; each drug has a different effect. The common side effects are:

Nausea, vomiting, diarrhea, hair loss, loss of appetite, tiredness, fever, pain, mouth sores, constipation, fever and bleeding.

There is no need to worry as most of these side effects can be prevented or treated, and once the treatment is over the side effects subside.

How often a patient should receive chemotherapy the doctor decides based on the drug that would be given. Chemotherapy can be received in a doctor’s clinic, in an outpatient chemotherapy unit or at home if pills are given. The doctor meets the patient often during the chemotherapy treatment to check for side effects, response to the treatment so that the treatment can be adjusted accordingly.

REASONS FOR THE FAILURE OF CHEMOTHERAPY

There are a number of reasons for the failure of chemotherapy:

  • Cancer becomes resistant to many drugs.
  • So some cancer cells survive and grow again.
  • The tumor cells can arise from stem cells.

CHEMOTHERAPY DOES NOT WORK. WHAT NEXT?

The doctor might suggest new treatments with different combinations of chemotherapy drugs.

The Oncologist along with the patient will consider whether with more treatment the health will improve. 

Whether it is better to stop chemo and start another treatment, this is called a second-line of treatment. Stopping the treatment does not mean care is stopped, another course of treatment starts which is best for the patient.

It is also better to take the opinion of your treating doctor, other members of the treatment team and family members.

SUCCESS RATE OF CHEMOTHERAPY:

Chemotherapy is a powerful treatment, where with drugs damaged cancerous cells are treated. The main goal of this treatment is to see that the cancer cells don’t grow or multiply.

It has been seen five years after the treatment 47% of the patients have survived, based on the grade and stage of the cancer and the type of treatment.

educating the family, friends and coworkers that after the last chemotherapy it would take 6,9 or even 12 months for improvement.

A perfect clean house and doing things that enjoy the patient can increase the survival rate.

Do not over do things and feel tired for a few more days.

AWARENESS OF TREATING CANCER WITH CHEMOTHERAPY:

Patients think that chemotherapy kills every single cancer cell in the body during the first treatment itself. They need to be educated that chemotherapy treatments are given in repeating cycles. The length depends on the drugs being given and that there is a gap between the treatments. Sometimes chemotherapy alone can’t cure the cancer, it has to be combined with other treatments. This awareness must be brought about especially among the educated public.

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DIABETES CANCER RISK—DNA DAMAGE

Diabetes is a disease, in which there is a defect in insulin secretion, insulin action or both. Diabetes can damage the eyes, kidneys, nerves, heart and blood vessels.

Diabetes is of two types- TYPE I—Insulin deficiency, resulting in Hyperglycemia.  

TYPE 2—It is associated with liver disorders like liver enzymes,

Fatty liver disease, cirrhosis and acute liver failure.

The patients who have diabetes are at a higher risk of getting cancers like Pancreatic, Liver, Breast, Gastric and Female Reproductive Cancers. Both diabetes and cancer are prevalent diseases in the world. In recent times people dying of cancer has increased among those who have diabetes than those without diabetes. Detecting cancer at an early and properly treating diabetic patients can improve the patients’ condition.

TYPES OF CANCERS IN DIABETIC PATIENTS:

LIVER CANCER

The highest risk in a diabetic patient is liver cancer. This risk is present in both men and women.

Liver steatosis, hepatitis and cirrhosis are common in diabetic patients and are risk factors for Hepatocellular Carcinomas (HCC ).

The patients who have type 2 diabetes are at a greater risk of developing HCC, the most common type of liver cancer.

The medicines diabetes patients take to control their blood sugar are a risk of getting liver cancer.

TREATMENT: 

a)The treatment is FIRST LINE TREATMENT—a drug known as METFORMIN is given.

b) SECOND LINE TREATMENT: Insulin and Sulfonylureas are given.

c) THIRD LINE TREATMENT: Glitazones are given.

PANCREATIC CANCER:

  • Type 2 diabetes is the risk factor for PANCREATIC Cancer.
  • Pancreatic Cancer can also cause diabetes.
  • Almost half of the patients with pancreatic cancer have high blood sugar levels.
  • This cancer develops when cancerous cells grow, divide and spread in the pancreas.
  • The 6-inch long, spongy tube, located in the back of the abdomen, behind the stomach is the pancreas.
  • Most of the pancreatic cancers are not diagnosed early as the symptoms are only back pain and indigestion. 
  • So it is better to check for pancreatic cancer first, for those who are above 50 years.
  • Doctors conduct a few tests for it like CT and MRI scans, only on those patients who have diabetes as its costly and try to diagnose pancreatic cancer.
  • Those people who have diabetes must often check the blood sugar levels, eat right, be active and take proper medicines to avoid major problems from occurring.
  • Sometimes after surgery automatically, diabetes becomes normal.

FEMALE REPRODUCTIVE CANCERS

If a patient has diabetes for a long time, it affects the blood vessels and nerves of the female genitals and leads to cancer.

Type 2 diabetes is a chronic disease and a risk factor for many Endometrial, Cervical, Ovarian and Vulvar Cancers in women. It is mainly on account of insulin resistance, chronic inflammation and high ovarian steroid hormones.

Obesity is a common factor of diabetes, which causes hormonal imbalance in the body, and that causes endometrial cancer.

Type 2 diabetes in women leads to breast cancer and mainly among women in their postmenopausal period. Breast cancer is mostly among well do families because of their lifestyle and socioeconomic status, sedentary life diet high in carbohydrates, sugars and consumption of animal fats.

Cervical cancer is one of the most common gynaecological cancers in women globally, and those having diabetes are prone to it. Ovarian cancer is diagnosed among women 65 years and who are already in the menopause stage.

DIABETES-DNA DAMAGE and CANCER

DNA is a chemical found in the nucleus cells that makes up chromosomes. It is important for all cells and organisms. An organism in a human body can do nothing without a DNA.

Diabetes can cause DNA damage, and it causes mutations, cancer, free fatty acids, high glucose, and hypoglycemia.

  • Patients with type 2 diabetes have increased levels of DNA damage.
  • DNA damage leads to various types of mutations to cause cancer cells changes and increase cancer risk.
  • If a person lives long enough, at least one of his cells will gather a set of mutations sufficient for cancer to develop.
  • DNA can also be a biological link between diabetes and cancer.
  • If DNA damage occurs in a gene, errors build up in other genes, and cancer occurs.
  • Obesity can cause DNA damage and lead to cancer.
  • Ultraviolet and other types of radiation can damage DNA.

DIABETES AND CANCER TREATMENT AND DIET

8% TO 18% of cancer patients have diabetes, a chronic condition where it becomes difficult to regulate blood sugar levels. When cancer sets in, diabetes treatment takes backstage. But managing blood sugar levels can help the patient’s health to improve faster.

  1. Radiation therapy, steroids and a few types of chemotherapy can play upon the blood sugar levels.
  2. If blood sugar levels are not controlled, the side effects of chemotherapy can lead to dehydration and affect other organs also.
  3. So during treatment, blood sugar levels must be controlled to stay hydrated and to feel better.
  4. Type 2 Diabetes can also be managed with a healthy DIET.
  5. A well-balanced diet throughout the day like eating fruits, vegetables, whole grains and eating low in fat and adequate calories helps the blood sugar levels under control.
  6. If the patient has energy light, exercise also helps, moderate to vigorous exercise as days go by helps.
  7. Alcohol is also high in calories and sugar and can damage the cells, which lead to cancer. So women can have one drink per day and men two drinks per day.
  8. During and after cancer treatment, blood sugar levels must be under control.

AWARENESS THAT DIABETES CAN LEAD TO CANCER

Many people urban or living in rural areas, educated or uneducated are not aware of the symptoms, risk factors and lifestyle choices are commonly associated with diabetes and can also lead to cancer. In future, these realities of the dangerous diseases must be made known to people at the earliest, so that if diagnosed, can be treated early for better living.

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World Cancer Day 2021

Super Car owners’ donning T- shirts & cars sporting stickers of “I AM and I WILL” spread the message of early detection & prevention of Cancer ​

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Cancer In Teenagers

A teenager or teen is a person who falls within the ages of 13 to 19 years old. A teenager is also addressed as an adolescent. WHO also considers ages between 10 and 21 as teenagers, as the brain develops in the 20s. After 20, a person is no longer a teenager. Adolescence is a transition period from childhood to adulthood.

Teenagers, these days get stressed out easily. They are very sensitive and vulnerable. They face unique medical, psychosocial and supportive care needs. The quality of life that should be led is lost before they are adults, so they face a number of medical problems, and Cancer is one of them.

Cancers in teenagers are different than in those found in adults and are more likely related to genetic and exposure to risk factors in early life. Though cancer is a common disease these days, teenagers getting it is rare. Less than 1% of cancer patients are teenagers.

Causes of Cancer In Teenagers:

  1. In adults the risk factors that have caused cancer is because the people have faced those risks for a long time, like lifestyle, smoking, too much consumption of alcohol exposure to pollution and so on
  2. Some teenagers inherit gene mutations from parents and are prone to some cancers.
  3. Exposure to ultraviolet light from the sun
  4. Tanning beds increase the risk of Melanoma
  5. If treated with Chemotherapy and Radiation in childhood, cancer can increase the chances of getting a second cancer for a teenager, like leukemia
  6. Infection with HIV can get Non-Hodgkin Lymphoma and other cancers.

Symptoms of Cancer in teenagers

  • Generally, in teens, the symptoms are not seen immediately as they can overlap with other illnesses or injuries.
  • Teenagers may feel run-down, get sick, have bumps or bruises but may not be cancer.
  •  The common symptoms of cancer can be:
  • A lump or swelling in the neck, belly, testicle or in any other part of the body.
  • Tiredness or loss of energy.
  • Bruises and abnormal bleeding
  • Fever that remains and pain in one part of the body
  • Headache, vomiting
  • Changes in the vision
  • Loss of appetite and weight loss
  • A new mole or spot on the skin that changes color, size and shape

Seeing a Doctor:

If these symptoms are there, it’s better to see a doctor without any delay. Then medical history is seen, and a physical exam is done. Special tests and exams are taken, like blood test, X-rays, CT scans. If the doctor thinks that in these tests there are signs of cancer then the teenager will be referred to a specialist. The specialist will go in for biopsies depending on the location of the tumor or lump.

Things that Don't Cause Cancer

Kissing, getting killed in the balls, sitting on the toilet seats if public places, overeating ketchup, mobile phones, keeping the phone in the bra, cancer causes hair fall and so on.

Types of cancers in Teenagers:

Lymphomas that starts in the immune system cells known as lymphocytes. It starts in the lymph nodes or lymph tissue like tonsils or thymus.

Leukemia Cancers of the bone marrow and blood. This cancer is fast growing in teenagers, so they need to be treated as soon as diagnosed.

Thyroid Cancer. This is common in young women than in young men. A lump is found in the front part of the neck. The patient can experience pain or swelling in the neck. Problem in breathing, swallowing or there may be a change in the voice.

Brain and spinal cord tumors. In teenagers tumors may be found in lower or upper part of the brain. They may experience numbness, weakness, problems in the coordination of the arms and legs and bladder or bowel problems.         

Testicular cancer.  A lump is found on the testicle or it is swollen or becomes larger in size. They may or not be a pain. Most of these cancers are cured.

Sarcoma bone or soft tissue cancer. Patient can have pain and swelling around the bone area. The common places for this cancer is the hip, the chest wall—ribs and shoulders. While the soft tissue Sarcoma can occur in any part of the body, generally arms or legs.

Melanoma, if this runs in the family than teenagers can get it. A new spot on the skin can appear that changes the color, size and shape. It can be treated if diagnosed early.

Ovarian cancer. In young women this cancer is known as Germ Cell tumors. Bloating, belly pain or urinary symptoms are seen. 

Late Effects of Cancer in Teenagers

Even after surviving, teenagers continue to go through physical, psychological and social risks.

When compared with older survivors, teenagers have psychosocial difficulties, pulmonary complications and the fear of a second malignancy.

Discontinue of education, employment and marital status also face problems.

The treating doctor can always be a guide and his involvement during the follow up stage can remove and solve some of these psychological problems and fear from the patient and family.

A good diet and exercise will help.

The patient must also follow the instructions given by the health care team how to prevent and manage late effects of cancer. This is very important.

Causes of late Effects

Any cancer treatment causes late effects. So the teenagers also face late effects for a number of reasons:

  • The type of cancer and its location in the body.
  • The area in the body, where it was treated.
  • Age and type of treatment.
  • Genetics and family history.
  • General health of the patient before the treatment and after the treatment. 

Awareness and knowledge of cancer Among Teenagers

Most of them may not believe that they have cancer, because of their age and the feeling that they have a good health. So a new approach is needed to convince them and assured that they can be treated as they are young. Interacting with them, group discussions, and their serious participation will help. If a close relative participates in the discussion also helps. Information on sex and fertility, social physical environments during treatment and psychosocial support after treatment helps to a large extent.