Question

Linda is a 35-year-old divorced mother. She has 2 boys aged 7 and 10, in her care. She has started a new job which requires her to move out of the city frequently. She feels very guilty about having to leave her children with a babysitter while she travels. Her work is very stressful, and includes many meetings that include lunches, dinners and cocktails. She noticed that she has nausea frequently, and moreover, 3 weeks ago, she had an incident of vomiting with blood. Therefore, she decided to see a doctor who admitted her to the hospital. Her medical history revealed that she had suffered from pain in the upper abdomen for several months. These pains became more and more acute over time, accompanied by headaches, for which she used aspirin. Linda was pale, nervous and weak upon admission. She had lost 4kg in the past year and weighs 50kg now, for a height of 165 cm.

The initial treatment was: • Blood transfusions • Intravenous infusion of fluids. • Electrolytes and vitamin C • Drugs including: cimetidine, aluminum hydroxide and magnesium. • Triple antibiotic therapy. After leaving the hospital, after 2 weeks, the dietician discussed general nutritional needs with her. She advised her to consume her meals at fixed and regular times each day, in a relaxed atmosphere as much as possible, to eliminate coffee and snacks between meals and to take a daily multivitamin supplement with a meal. She also advised her to quit smoking and stay home to rest for 2 weeks before returning to work. She also received a general guide with a list of some foods and eating habits to avoid. After that, she was to return for a follow-up in a week.

1. After your assessment, what can you diagnose in Linda’s case? 2. What do you think would be the normal weight range? 3. Knowing that the list given for foods to avoid was a small list, in your opinion, what would be the foods mentioned? and why are they to be avoided? 4. What role does vitamin C have in her case? 5. What other vitamins and minerals are significant in this case? what role does each have? 6. Why are antibiotics given in the treatment of ulcers? 7. Will Linda have a problem when she eliminates coffee, cigarettes and alcohol? what are they and what is your rational concerning them? 8. Write a day menu as an example to illustrate.

Answer 1

1. According to assessmenmt linda having a cancer of stomach in progressive phase.

2.Normal weight range in 35 years of age is 50-64 kgs

3.She adviced to avaoid COFFEE and other junk food but according to me she should need to avaoid  meats such as bacon, sausage, and deli meats, which can increase the risk of  cancer.

It's also have to avoid processed foods including sweet candy, packaged snack foods, soda, and other sweetened beverages, which provide few nutritional benefits but have a higher risk to progress cancer in advance phase

4. Role of vitamin C in linda is :

Vitamin C, an important antioxidant, may inhibit carcinogenesis in the stomach by neutralizing reactive oxygen species that can damage DNA  or by inhibiting the formation of carcinogenic nitrosamines. Vitamin C also help in regression of precancerous stomach lesions.

Its anti-proliferative and pro-apoptotic action has been suggested in vitro. Because of its antioxidant activity, it protects cells against oxidative DNA damage caused by toxic effects of reactive oxygen species.

So vitamin C is very important in Linda for furthere progression of her condition

5. role of other vitamin and minerals :

person have stomach cancer often have problems getting enough vitamins and minerals. This may be because of a large tumour that makes it difficult to eat.Vitamin B12 is important in making red blood cells as well as keeping the nervous and digestive systems healthy. A person with stomach cancer may not get enough calcium from their food. Low calcium levels may lead to osteoporosis so Calcium is also important to prevent osteoporosis in women,Eating a healthy diet often doesn’t provide enough vitamins or minerals if the body is not able to absorb them properly from regular foods so outerly suppliments of vitamin D, vitamin E , Iron etc. are very important for the person who having cancer of stomach.

6. Helicobacter pylori infection is the s most important risk factor for gastric cancer so antibiotics are important to use in this kind of the patients also there is use of antacids is important to prevent heartburn and also peptic ulcer which can lead to further bacterial growth in lining of stomach wall.

7. Yes, Linda will have definately problem after she suddenly cut off smoking alcohol and coffee .

she will show withdrawl symptoms like vomiting, heartburn, acidity, severe headache etc.

also sudden after withdrawal from Alcohol can be particularly dangerous because it can include tremors, fear, hallucinations, and seizures. etc .Smoking withdrawal can have its side effects as well including intense cravings, tingling, sweating, nausea, headaches, sore throat, insomnia, concentration problems, anxiety, and irritation. Quitting nicotine can also lead to depression etc.Caffeine withdrawal symptoms include headache, fatigue, low energy, irritability, anxiety, poor concentration, depressed mood and tremors.

8. Balanced diet should be give to the patrient who having stomach cancer , lower fiber, softer fruits; cooked vegetables; and less fibrous lean proteins, such as fish instead of shellfish, eggs in place of steak, or smooth nut butters instead of raw nuts.

High protein diet is very important for Linda becouse it will help to maintain body weight and tissue repair. raw food also help for this kind of the patients.

take small and frequent amount of food , she should try peanut butter and crackers also olive oil food will help her out.

take soft milk shake and fruit juices.