Scribd Logo
Upload

Welcome to Scribd!

  • 111 views

    Gizi Pada Penderita Kanker

    Uploaded by

    Hadhy Az
    This document discusses the relationship between nutrition and cancer. It covers how nutrition plays a role in the etiology, progression and treatment of cancer. Specifically, it notes that 35% of cancers are caused by diet and are preventable. Nutritional status can impact the balance between immune cell formation and destruction by cancer cells. The document recommends a nutritional care package for cancer patients that aims to maintain nutritional status, boost the immune system, slow cancer progression and improve quality of life. This involves monitoring nutritional status, providing nutritional interventions tailored to local foods, and nutritional counseling.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Gizi Pada Penderita Kanker

    Uploaded by

    Hadhy Az
    111 views46 pages
    This document discusses the relationship between nutrition and cancer. It covers how nutrition plays a role in the etiology, progression and treatment of cancer. Specifically, it notes that 35% of cancers are caused by diet and are preventable. Nutritional status can impact the balance between immune cell formation and destruction by cancer cells. The document recommends a nutritional care package for cancer patients that aims to maintain nutritional status, boost the immune system, slow cancer progression and improve quality of life. This involves monitoring nutritional status, providing nutritional interventions tailored to local foods, and nutritional counseling.

    Original Description:

    penatalaksaan gizi pada penderita kanker

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses the relationship between nutrition and cancer. It covers how nutrition plays a role in the etiology, progression and treatment of cancer. Specifically, it notes that 35% of cancers are caused by diet and are preventable. Nutritional status can impact the balance between immune cell formation and destruction by cancer cells. The document recommends a nutritional care package for cancer patients that aims to maintain nutritional status, boost the immune system, slow cancer progression and improve quality of life. This involves monitoring nutritional status, providing nutritional interventions tailored to local foods, and nutritional counseling.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    111 views46 pages

    Gizi Pada Penderita Kanker

    Uploaded by

    Hadhy Az
    This document discusses the relationship between nutrition and cancer. It covers how nutrition plays a role in the etiology, progression and treatment of cancer. Specifically, it notes that 35% of cancers are caused by diet and are preventable. Nutritional status can impact the balance between immune cell formation and destruction by cancer cells. The document recommends a nutritional care package for cancer patients that aims to maintain nutritional status, boost the immune system, slow cancer progression and improve quality of life. This involves monitoring nutritional status, providing nutritional interventions tailored to local foods, and nutritional counseling.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    You are on page 1of 46

    NUTRISI DAN KANKER

    Prof.DR.Dr.SURYANI ASAD,MSc,SpGK

    CHAPTER OUTLINE

    NUTRITION IN ETIOLOGY OF
    CANCER
    NUTRITIONAL EFFECTS OF CANCER
    NUTRITIONAL EFFECTS OF CANCER
    THERAPY
    NUTRITIONAL CARE OF PATIENTS
    WITH CANCER

    KEY TERMS

    CANCER CACHEXIA
    GLUTHATION PEROXIDASE
    GRAFT VERSUS HOST DISEASE
    INITIATION
    OLIGOPHAGY
    PROMOTION
    TUMOR NECROSIS FACTOR (CACHECTIN)
    VENO OCCLUSIVE DISEASE (VOD)
    XEROSTOMIA- MOUTH DRYNESS

    INTRODUCTION

    cancer is now in virtually every country in


    the world
    The challenges & experiences vary from
    continent to continent, country to country
    and city to village
    Tingginya Mortality Rate dan Short life of
    Survival Rate pada penderita Status Gizi
    Buruk dan keamanan makanan.

    DIET & NUTRITION ----- CANCER

    CAUSES
    CONSEQUENCES OF
    CANCER

    TUMEROGENESIS OR
    CARCINOGENESIS

    MULTISTAGE PROCESS:

    INITIATION
    PROMOTION
    TUMOR PROGRESSION

    NUTRITION IN THE ETIOLOGY


    OF CANCER

    80 90 % ENVIRONMENTAL FACTOR

    35% CAUSED BY DIET


    CANBE PREVENTED

    NUTRITION -- CANCER

    ENERGY
    LIPID (PROMOTION STAGE)
    IMPORTANT IN COMPOSITION OF
    DIET

    PROTEIN
    FIBER
    VITAMIN A
    VITAMIN C
    VITAMIN E

    NUTRITION -- CANCER (conti..)

    CALCIUM AND VIT.D


    SELENIUM
    ALCOHOL
    COFFEE
    ARTIFICIAL SWEETENER
    PRESERVATIVES
    NITRATES, NITRITE AND
    NITROSAMINE

    NUTRITIONAL EFFECTS OF
    CANCER

    CACHEXIA
    ENERGY METABOLISM
    SUBSTRATE METABOLISM
    OTHER METABOLIC ABNORMALITIES
    SENSORY CHANGES

    NUTRITIONAL EFFECTS OF
    CANCER THERAPY
    CHEMOTERAPY
    RADIOTHERAPY
    SURGERY
    IMMUNOTHERAPY
    COMBINATION

    NUTRITIONAL THERAPY

    CHEMOTHERAPY

    NOT ONLY SEL TUMOR BUT ALSO


    NORMAL CELLS AS WELL
    CAN ADVERSE
    DIETARY INTAKE
    NUTRITIONAL STATUS ADVERSELY
    AFFECTED

    FOOD INTAKE IS INHABITED BY:

    MUCOSITIS
    CHEILOSIS
    GLOSSITIS
    STOMATITIS
    ESOPHAGITIS

    COMMON PROBLEMS ASSOCIATED


    WITH ONCOLOGIC MEDICATION

    ANOREXIA, NAUSEA, VOMITING


    MUCOSITIS
    CONSTIPATION
    FLUID RETENTION
    LIVER TOXICITY
    REACTION TO MONOAMINE OXIDASE
    INHIBITOR

    RADIATION THERAPY
    IN THE HEAD & NECK
    FOOD INGESTION PROBLEM
    SORE THROAT
    MUCOCITIS
    XEROSTOMIA
    SEVERE DENTAL & GUM DESTRUCTION
    ALTERED TASTE & SMELL

    ANOREXIA IS COMMON AND


    WEIGHT LOSS

    RADIATION IN THE THORAX


    INDUCE:
    ESOPHAGYTIS
    ESOPHAGIAL STRICTURE

    LEADING TO OBSTRUCTION CAN


    OCCUR

    RADIATION IN ABDOMEN
    MAY PRODUCE
    ACUTE GASTRITIS
    OR
    ENTERITIS WITH NAUSEA,
    VOMITING, DIARRHEA AND
    ANOREXIA

    RADIATION DEPRESS IMMUNE


    FUNCTION
    THUS LIMITING THE
    APPLICABILITY OF IMMUNE
    RESPONSE AND DEFENCE
    MECHANISM

    NUTRITIONAL CARE OF
    PATIENTS WITH CANCER
    SURYANI ASAD

    GIZI - ONKOLOGI

    Peran GIZI pada kanker :


    a. sel kanker
    to destroy cells
    and immune bodies
    b. Sel-sel yg rusak Radikal bebas
    |
    menyerang sel-sel baru
    c. Pentingnya Zat Gizi untuk pembentukan
    Immune bodies
    Keseimbangan antara pembentukan dan
    pengrusakan dari immune bodies
    oleh sel kanker

    GIZI - ONKOLOGI
    contd..

    KOMPETISI
    - Zat-zat Gizi bentuk sel Imun baru
    perbaiki Metabolisme
    meningkatkan BB

    - selkankermerusak/ menghancurkan
    - Siapa yang lebih cepat Menang

    GIZI - ONKOLOGI
    contd.
    Balloon Syndrome
    - Progress cancer cells

    - Tahap awal suplementasi zat-zat


    Gizi dapat meningkatkan BB
    - Tahap lanjut Tidak dpt mencapai
    kondisi N/awal
    Kegagalan metabolisme
    Syndroma Balloon

    GIZI - ONKOLOGI

    contd
    Zat Gizi esensial to restore newcellsimmune
    bodies dan mempertahankan Status Gizi :
    1. Zat Gizi Mikro :
    - A,B-caroten, C, E, Se = antioxidants
    - Selenium = Glutathione > protect cell
    against Oxidative damage
    NK cell > cytotoxic activities
    - Zinc
    = Regulation of DNA
    RNA synthesis, NK cell
    - Fe
    = Electron carrier in cytochromes
    - B1,B6,B12 = neurotropic (nerves tonic)

    GIZI - cancer
    2. Zat Gizi Makro :
    - Karbohidrat = sumber Kalori
    - Protein = Maintenance of immune
    system, restore destructive
    cells, lean body mass
    - Lemak = sumber energy lainnya,
    kompone esensial membranes
    cell, penting utk sintesa
    prostaglandin, free radical.

    contd

    FOOD AND NUTRITION


    MANAGEMENT PACKAGE

    Tujuan Asuhan Gizi ( FNMP ) :

    1. Mempertahankan Status Gizi dan


    Kesehatan penderita
    2. Meningkatkan Kekebalan tubuh
    3. Memperlambat progress sel kanker
    4. Meningkatkan Quality of life

    ASUHAN GIZI

    contd
    3 Aktivitas dari Asuhan Gizi :
    A. Pemantauan Status Gizi & Makanan
    B. Intervensi Gizi & Makanan
    C. Konseling Gizi & Makanan

    A) PEMANTAUAN STATUS GIZI DAN


    MAKANAN penderita
    TUJUAN :
    1. Mengetahui status Zat Gizi Makro dan
    Zat Gizi Mikro penderita
    2. Mengetahui efek dari sel kanker pada
    status Gizi dan Kesehatan penderita

    DAN MAKANAN
    a. Anamnesa Diet :
    - Dietary recall selama 48 72 jam
    - Konsumsi Makanan dan intake
    Zat-zat Gizi
    - Potensi terjadinya defisiensi Zat Gizi
    b. Assessment dari Anthropometry klinik :
    - Pengukuran BB dan TB
    - Body Mass Index ( IMT )
    - Protein Energy Malnutrition

    c. Pemeriksaan Klinik :
    - Deteksi kelainan Fungsi
    - Menemukan tanda Mayor dan
    Minor
    - Defisiensi Zat Gizi Makro dan
    Mikro
    d. Pemeriksaan Laboratorium :
    - Haemoglobin, Albumin &
    Globulin,
    Cholesterol, Triglycerides

    B) INTERVENSI GIZI DAN MAKANAN

    Dapat memenuhi Kebutuhan Zat Gizi Makro


    - Adekuwat Intake Kalori Protein, Lemak
    & Karbohidrat
    - Mempertahankan status Gizi penderita
    - Meningkatkan BB
    - Mencegah penurunan BB yang drastis
    Dapat memenuhi Kebutuhan Zat Gizi Mikro
    - Vit A, B-caroten, C, E, B1, B6, B12
    - Zn, Se, Fe, H2O build up Immune bodies
    Anti Oxidants; Neurotropik agen
    Food hygiene and safety, food radiation, food

    DEVELOPMENT OF FOOD INTERVENTION


    BASE ON INDONESIAN FOOD
    TEMPE (fermented soybean) :

    - Tinggi protein dan vitamin B12


    - bactericide dapat obati & cegah diarhoea
    Kelapa (coconut) :
    - mengandung Medium Chains Triglycerides
    - sumber energy yg efektif utk meningkatkan
    pembentukan sel T4

    Carrots ( wortel ) :
    - tinggi kandungan B-caroten
    tingkatkan
    immune bodies dengan tingkatkan CD4+
    - bersama dgn Vitamin E, C
    antioxidants
    ( menangkal Radikal
    bebas )

    Broccoli & cauli-flower :


    - tinggi kandungan minerals : Zn, Mn, Fe,
    Se

    Green Vegetables dan Beans


    Mengandung Vitamin B dan Trace

    Elements
    Tinggi Calcium
    Meningkatkan CD4 +
    Avocadoes (Persea Americana)
    Kandungan Lemak (60%) tertinggi dr

    buah
    16% MUFA (Mono-Unsaturated Fatty
    Acid)
    sumber Enersi terbaik

    KEBUTUHAN ZAT GIZI


    MAKRO

    Pd umumnya, konsumsi penderita


    dibawah optimal requirement
    Kalori 70% dan Protein 65%
    Adanya Infeksi Akut meningkatkan
    Proses Metabolisme
    Pemenuhan Zat Gizi Makro
    mencegah penurunan BB secara
    DRASTIS

    KEBUTUHAN ZAT GIZI


    MAKRO
    contd.

    Kebutuhan KALORI : 2000-3000 Kal


    per hari

    Kebutuhan PROTEIN: 1,5-2 gr/Kg BB


    per hari
    LEMAK 10-15% dr Total Kalori/hari
    -- berasal dari MCT absorbsi lebih baik
    mencegah diarhoea
    -- baik krn tinggi Protein, rendah Lemak

    KEBUTUHAN ZAT GIZI


    MIKRO

    Membentuk seldanSel Imun bodies baru

    Diperlukan Vit. A, B-caroten, C, E

    Se, Zn, Fe, Cu, Vit. B1, B6, B12

    Diperlukan 2-5 kali RDA

    Kebutuhan H2O penting utk body


    restore

    KEBUTUHAN ZAT GIZI


    MIKRO
    contd

    Sel kanker merusak selSomadanSel Imun


    bodies
    Cegah terjadinya defisiensi
    mempercepat progres selkanker
    Karena Kegagalan Metabolisme
    Pemberian suplementasi TIDAK kembali
    ke Normal Sindrom Baloon
    Suplementasi Megadosis dpt menekan
    imunitas

    C) KONSELING GIZI DAN MAKANAN

    Penderita dipastikan utk mendapatkan


    Kebutuhan Zat Gizi yg adekuwat
    pd setiap kondisi Kesehatan dan
    Ekonomi keluarga
    Cukup intake Zat Gizi, aman dan
    available
    Dapat informasi ttg kanker yang benar dan
    tepat
    Bagaimana pengaruh infeksi kanker pd Gizi

    KONSELING GIZI DAN MAKANAN contd..

    Penatalaksanaan Gizi, pilihan Bahan


    makanan setempat/lokal
    Bagaimana menyediakan makanan
    dan cara memasaknya
    Keamanan Makanan dan Minuman
    Kebiasaan makan
    Makanan disiapkan sendiri dirumah,
    jangan beli diluar/jajan
    Dampak penggunaan obat anti

    IMPLEMENTASI

    Pada 20 kasus penderita kanker


    Pengamatan pd 7 kasus
    Implementasi FNMP dgn Menu
    Spesifik menggunakan Kelapa,
    Tempe, Wortel, Buah-buahan
    Diamati Clinical symptoms and signs,
    Anthropometry & Blood test

    continued

    Pengaruhnya pada 20 penderita :


    - Peningkatan Status Gizi dan Kesehatan
    - Memperlambat progress sel kanker
    - Tidak jatuh dalam keadaan Defisiensi
    cegah Balloon syndrome

    Pengaruhnya pada 7 penderita :


    - Sedikitnya 6 bulan survive
    dgn better life
    - Meningkatnya Quality of Life

    CONCLUSION &
    RECOMMENDATION

    Kompetisi antara pengrusakan oleh


    selkanker dan pembentukan sel baru
    dari Gizi STATUS PENDERITA
    Suplementasi Gizi dan Makanan penting
    dalam peningkatan Status Gizi dan
    Kesehatan penderita
    Suplementasi Gizi dan Makanan mencegah
    penderita jatuh kedalam defisiensi

    contd.

    Pentingnya meningkatkan Quality of


    Life pada penderita
    Memerlukan design study yang
    lebih spesifik (Quasi Experimental),
    lebih banyak kasus
    Perlu biaya tinggi utk pemeriksaan
    Laboratorium utk serum nutrients

    You might also like