Question

Steve Palmer has been undergoing chemotherapy for liver cancer. In the past 3 months, Mr. Palmer has lost 25 pounds from his pre-cancer weight of 190 lbs. He is 6 ft 2 inches tall. He reports decreased appetite, nausea, vomiting, and dry mouth. He reports feeling full quickly and extreme fatigue. His oncologist refers him to you for suggestions on increasing his food intake. • Use your textbook to respond to the following questions (provide your responses in the Assignment Worksheet section on page 3) • Submit the Week 8 Assignment via Blackboard by clicking on the “Week 8 Assignment” link. • Include the proper file naming convention: SCI115_wk8_assn_jsmith_mmddyyyy. Grading: Gradable items in assignment Points Identify the main objectives for nutrition intervention in cancer patients 15 Calculate nutrient needs for protein, calories, and fluid 10 Discuss dietary suggestions for decreased appetite and nausea 5 Discuss dietary suggestions for xerostomia 5 Adhere to Writing Guidelines (see below). 5 Total Points 40

What are Mr. Palmer's protein and energy requirements? What are his fluid requirements? Please calculate the nutrient needs for protein, calories, and fluid for Mr. Palmer. List 3 dietary suggestions to address decreased appetite and nausea. List 3 dietary suggestions to address dry mouth (xerostomia)

Answer 1

According to the given situation, Mr. Palmer is experiencing a condition called hypermetabolism and has a protein requirement of more than 60 gm a day. To gain his lost weight during the chemotherapy, he must have calory intake of more than 3000 kcal per day. To compensate the effect of chemotherapy, he must have around 8-10 glass of water or other fluid everyday.

To calculate the protein needs, we will convert the weight of Mr. Palmer from pounds to kg by dividing it with 2.2

Hence, weight = 190 - 25 = 165lbs = 165/2.2 = 75kg

Now, recommended protein intake would be 75 x 0.8 = 60gm a day. (Since 0.8gm/kg/day is recommended)

Similarly for a cancer patient trying to gain weight, the recommended calories = 75 x 40 = 3000 kcal

(Since 40kcal/kg/day is recommended for weight gain)

And in the same way recommended fluid intake would be (75 x 35) / 28.3 = 2625 / 28.3 = 92.75 ounces of fluid.

Decreased appetite and nausea after chemotherapy shows the symptoms of cachexia or cancer anorexia-cachexia syndrome (CACS). Rather than taking 3 large proper meal in a day, Mr. Palmer should take frequent high-calorie and high-protein smack like canned tuna, chicken item, egg, cheese, peanut butter and other dairy items. He should also take starchy food like potato, pasta, oats and other cereals.

To address dry mouth (xerostomia) he should prefer liquid meal like juices and milkshakes. A high protein diet also cure dry mouth. He should have moist and tender meat item and avoid dry food items like toast, bread and pastries. Mashed potatoes, ice-cream, canned fruits and soups can also help with dry mouth