What are the key steps for effective cancer screening and recovery?

Cancer, Recovery and Nutritional Needs ! We are all quite aware of Cancer and the consequences. Cancer is not easy and so is recovery from the deadly disease. There are more than 200 types of cancers . Social media and health articles have made it easy for the population to understand what causes cancer. Diagnosing the disease plays a major role because as early as we diagnose cancer, the better the recovery and survival rates.

As I said there are more than 200 types of cancers and there are many reasons why a human is prone to this disease. Few of them being:

1. Genetically modified cells which is a genetic mutation where the genetic coding is modified and there is decreased cell death. As the cell has a cycle of 52 divisions and differentiation, after this cycle there must be apoptosis, which is cell death and there will be a cell renewal. All this is regulated by the genetic coding. Cancer can be an outcome when there is T-cell deficiency, combined sever immunodeficiency disorders (CISD), and other deletions and innate immunity defects.

2. Lifestyle changes like consuming more processed foods, pickled foods, packaged foods, smoking which makes the most cases in cancer, alcohol which is another trigger for cancer.

3. Family history of tumours and cancers can also lead to cancerous risks.

4. Usage of certain chemicals, preservatives, prolonged plastic exposure, people who work in industrial exposure, cities that are exhausted with more polluted chemical releases from industrial waste.

Can we prevent cancer from reaching our bodies?

As we have already discussed, cancer can be in the family, genetic mutation

s that are not always externally stimulated. And sometimes, external factors like lifestyle and environment play the role of the stimulants that can trigger a healthy cell and also a cell that is prone to mutations. Regularly getting health check ups is encouraged especially in case there are family histories of cancer.

Cancer screening markers

What are the Cancer screening markers?

• PSA - prostate specific antigen

• CA-125 - Ovarian and some other cancers

• CEA - Carcinoembryonic antigen (Colorectal, breast, and other cancers)

• AFP - Alpha-Fetoprotein (Diagnosis of germ cell cancers, liver cancer)

• HCG - Human chorionic gonadotropin (germ cell cancers)

• Calcitonin - (thyroid cancer)

• CA 15-3

• CA 27-29

• CA 19-9

• BCL 2 gene rearrangement

• Beta 2 microglobulin - B2M

• BRCA 1 & BRCA 2

Early cancer screening is always deemed an essential part of health check-ups. Early diagnosis helps in a faster treatment and recovery options.

What are the signs and symptoms of Cancer ?

# Fatigue # weightloss # swelling or lumps # pain # decreased immunity # strange marks on the body/rashes # temperature changes # lack of appetite # nausea/vomiting/diarrhoea # night sweats

Diagnosing Cancer !

Cancer is diagnosed by various blood tests, sputum cultures, scans and X-rays, endoscopy, tumour markers, gene testing, hormone levels, cytokine/inflammatory markers etc.

It all starts with stage 1-initiation, where we rarely find symptoms. Stage 2 is the promotional stage where the cancer cells start to divide. Stage 3 is the progression stage where the cancer is spread to the body parts. Stage 4 is the advance stage of the malignancy.

Treatment

If the cancer is benign which means there is no risk of cells dividing and spreading, a watchful waiting is generally suggested by the Doctor. After observing the cultures and biopsy, certain medications are given. A surgery to remove the tumour can also be part of the treatment that is generally followed. Some benign tumours might not require medication. So watchful waiting is very important here.

If the cancer is malignant, this will be diagnosed by the blood tests and the scans. Also the symptoms will be much more intense. A malignant tumour’s treatment will be decided after the physician understands at what stage of cancer the individual is progressing into. Once, the stage is known medication and treatment is given accordingly. Surgery, Chemotherapy, corticosteroids, radiation therapy, hormonal therapy are the regular treatments.

Recovery and Nutrition

Now after all the hardwork and stress, the individual would want to recover as soon as possible. It is stressful for the individual and the family that goes through all the clinical procedures. Many people lose hope during their recovery, moral support from the medical team and the family is essential during these tough times.

Clinical Symptoms During Recovery

During recovery, the individual goes through pain and discomfort. Mental and physical pain will be evident. Depression is also seen with loss of appetite and loss of confidence. Lack of movement can be troublesome for some individuals. Radiation around the head and neck area might cause dysphagia, which means there will be swallowing difficulties with pain. The fear of pain can make them resistant to eating. Medications will curb the appetite, and gut sensitivity increases.

Loss of weight along with muscle loss is observed. Blood glucose levels are also impaired initially. Stress impacts blood pressure. There will be an over load on the kidneys and the liver, to metabolize, synthesize, and excrete the drugs and medicines out of the system . The recovery stage is mostly catabolic (energy expenditure), and hence the individual will always find themselves fatigued and weak.

Supplementary Nutrition

Now, supplementary nutrition comes to rescue immediately after the treatment or surgery. If the individual doesn’t co-operate for the recovery or is not in a position to consume anything orally or is not in a conscious state of mind, supplementary nutrition finds its place to save many adverse consequences.

The initial stage of recovery sees a catabolic stage in the body where the blood glucose levels are spiked due to stress and impaired hormonal function. The body recognises this stage as starvation and starts glycogenolysis and gluconeogenic responses. Also, during recovery, the primary source of energy for the body would come from fats and amino acids. Hence, supplementary nutrition is initiated as early as possible to inhibit the catabolic responses.

PARENTERAL NUTRITION

Intravenous or parenteral nutrition is only preferred after the blood glucose levels, sodium, and electrolyte levels are monitored and the patient is stable (normotensive & glucose homeostasis). Mostly in case there is dehydration and electrolyte loss (diarrhoea and vomitings), the individual will be stabilized and then parenteral nutrition/feeding is provided.

ENTERAL NUTRITION

Enteral nutrition is the most common supplementary nutrition that is chosen as it is safer concerning reduced infections. Enteral nutrition is given either via gastro-enteral feeds like Naso-gastric tube, naso-jejunal tube, PEG (percutaneous endoscopic gastrostomy), gastrostomy, jejunostomy, esophagsotomy.

Enteral feeding is safer and economical.

The nutritional emulsions would generally include glucose, amino acids, and lipids as macronutrients. Fiber, Omega 3, Vitamin E, glutamine, arginine, electrolytes, and trace minerals will be added according to the individual needs. Also, the enteral formulas are divided into elemental, semi-elemental, polymeric, standard, and enhancing formulas.

The patients will be given continuous feeding, bolus feeding, or intermittent feeding depending upon their physical movement and metabolic condition.

Recovery is a lengthy process, and lots of patience and cooperation from the individual and the family is needed. In-patient care and nutrition will be taken care of by the Dietitians. Once the individual is discharged, at-home nutrition becomes a struggle, especially when the individual doesn’t cooperate. At times, depression hits and recovery is delayed. visible weight loss is generally seen in some cases after the patient is discharged. Regular monitoring of blood glucose, blood pressure, creatinine, electrolyte levels is important.

Physical activity, mental health counseling, and balanced nutrition, together play an important role in recovery and healing.

Author Manisha B K Clinical Nutritionist & Therapist Founder – NUtreboot