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Chapter 29
CHAPTER 29 – NUTRITION, CANCER, AND HIV INFECTION
CHAPTER SUMMARY
Cancer and HIV infection are conditions that affect multiple systems, which can interfere with nutrition
status. The development of cancer is influenced by a combination of factors: genetics, health of the
immune system, environmental factors, and dietary factors. Dietary factors include cancer initiators,
promoters, anti-initiators and anti-promoters. Cancer cachexia, a common occurrence in patients with
cancer, can devastate nutritional status. Anorexia and inadequate nutrient intake in people with cancer
have various causes. For example, cancer patients often suffer from fatigue, pain, or stress. Additionally,
cancer therapies, such as surgery, chemotherapy, bone marrow transplants, and radiation therapy can
further decrease nutrient intake by causing nausea, vomiting, stomatitis, mouth blindness, and food
aversions. When a cancer patient does eat, nutrients are often lost due to malabsorption, vomiting,
diarrhea, and inadequate digestion. Proper nutrition therapy can be used to help cancer patients maintain
their strength and prevent wasting. Dietary considerations should be tailored to the specific type and
severity of cancer, side effects of treatment and the individual’s nutrition status. Ethical issues need to be
considered when providing medical nutrition therapy in cases of terminal illness.
AIDS (acquired immune deficiency syndrome) develops from infection with HIV (human
immunodeficiency virus) which attacks the immune system and disables the body’s defenses against
other diseases. HIV infection progresses in stages, gradually destroying CD4+ T cells. Consequences of
HIV in the early stages of infection range from fatigue, skin rashes, oral lesions and infection versus
wasting, recurrent bacterial pneumonia, and infections of the central nervous system in the final stages.
Treatments aim to slow the course of the infection, control associated symptoms, and alleviate pain.
Anorexia and inadequate nutrient intake are common in clients with HIV infection. Severe emotional
distress, thrush, respiratory infection, medication side effects, fatigue, and dementia all contribute to the
problem. As the disease progresses, a person with AIDS may experience severe wasting. Nutrition
therapy focuses on providing adequate amounts of energy and protein and correction of metabolic
complications. If the client is unable to meet the nutrient needs through oral diet, tube feeding and TPN
can be used to prevent nutrition complications and weight loss.
Highlight 29 focuses on illness, mental health and nutrition.
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