Power Point Tatalaksana Nutridi Kanker Payudara

Ppt kanker

1. Understanding CANCER Before understanding the impact of nutrition on cancer, it is first important to understand the biochemical and physiological determinants of the disease. Cancers are as a results of the interaction of genetic, epigenetics and environment of the individual. Cancer is a chronic disease. 1

2. What is cancer? Healthy cells: balance between growth and programmed cell death is tightly regulated. Cancer cells are that grow and divide at an unregulated pace. 2

3. Environmental and Chemical CARCINOGENS People are continuously exposed exogenously to varying amounts of chemicals that have been shown to have carcinogenic or mutagenic properties. In the case of a solid tumour there is a 20-40 year interval from the time of exposure of an individual to a chemical or viral carcinogen until the clinical detection of a tumour. By the time a tumour is apparent, cancer cells have aquired the ability to divide where normal cells ought not, to invade adjacent cellular architectures, to metastasize and to kill the host. 3

4. Cancer is a preventable disease Only 5-10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90-95% have their roots in the environment and lifestyle. The lifestyle factors include smoking, diet, alcohol, obesity, infectious agents, environmental pollutants and radiation. Of all cancer-related deaths; 25-30% are due to tobacco, 30-35% diet, 15-20% infections, 10-20% obesity, 4-6% alcohol, 10-15% others, which includes environmental and radiation. 4

5. How diet can affect cancer? 5

6. Initiation – dietary carcinogens Aflatoxins (found in mouldy food) Heterocyclic amines (meat cooked at very high temperatures) N-nitroso compounds (in some spoiled foods, protein food, cured meat) Polycyclic aromatic hydrocarbons (PAH) (Products of combustion found in cooked foods, smoked foods and dark beer) These chemicals can start a cancer process by creating cancer cells (World Cancer Research Fund 1997; NRC 1982) 6

7. DIET – RED MEAT Heavy consumption of red meat is a risk factor for several cancers, especially those of the gastrointestinal tract, but also for colorectal, prostate, bladder, breast, gastric, pancreatic and oral cancer. The hetrocyclic amines produced during the cooking of meat are carcinogenic. Charcoal cooking and or smoke curing of meat produces harmful carbon compounds such as pyrolysates and amino acids which have a strong cancerous effect, Anand P et al, Cancer is a preventable disease that requires major lifestles changes. 2008 7

8. DIET: FATS AND SUGARS Saturated fatty acids, trans fatty acids and refined sugars and flour present in most foods have also been associated with various cancers (1) Epidemiologic studies suggested a postive association between dietary fat and colon cancer (2) Frequent consumption of sugar and hig sugar foods may increase the risk of pancreatic cancer by inducing frequent postprandial hyperglycemia, increasing insuling demand, and decreasing insulin sensitivity (3) (1) Anand P et al, Cancer is a preventable disease that requires major lifestles changes. 2008 (2) Reddy, B Dietary Fat and Colon Cancer. Chemistry and material science vol 27 no 10 807-813 (3) American Journal of Clinical Nutrition Vol 84 No 5 1171-1176 Nov 06 8

9. DIEtary tumour promoters: Excess Fat -  insulin,  estrogens, oxidative stress,  inflammation Excess Protein -  insulin,  IGF-1 Excess Calories -  insulin,  IGF-1,  Oxidative stress,  inflammation Excess Omega 6 EFA-  oxidative stress,  inflammation (Heber et al.2006) 9

10. METABOLIC tumour promoters: Insulin – promotes cancer cell proliferation and decreases apoptosis. Estrogens – induces cancer cell proliferation. Oxidative stress- can act as cancer initiator and promoter Inflammation – strong association between chronic inflammation and cancer ( mechanisms: promoting proliferation of cancer cells, formation of cancer blood vessels) IGF-1 – Potent growth factor for many lines (Heber et al.2006) 10

11. ALCOHOL Drinking as little as one pint of beer or one large glass of wine a day increases risk of breast cancer by more than 7%. (World Cancer Research Fund 2007; American Cancer Society 2007; Cancer Research UK 2009a) 11

12. Obesity/Excess BODY FAT AND CANCER 12

13. Dairy and cancer- POSSIBLE MECHANISMS Consumption of milk increases blood levels of IGF-1, which has been associated with increased prostate and breast cancer risk. (Chan et al.1998) 13

14. Tumour ANTI - promoters: Folic Acid – reducing likelihood of DNA damage Antioxidants – preventing oxidative damage and lipid peroxidation, which compound DNA damage in tumor promotion Phytochemicals – various mechanisms Low Fat Plant Based Diet – (various mechanisms) 14

15. PROMOTION - PROTECTION: Low Fat- High Fibre -  insulin,  estrogens,  IGF-1,  inflammation,  Down regulation of oncogenes,  upregulation of tumour supressor genes Adequate Protein -  insulin,  estrogens,  IGF-1,  inflammation,  Down regulation of oncogenes,  upregulation of tumour supressor genes Adequate Calories  insulin,  estrogens,  IGF-1,  inflammation,  Down regulation of oncogenes,  upregulation of tumour supressor genes Whole Plant Foods-  insulin,  estrogens,  IGF-1,  inflammation,  Down regulation of oncogenes,  upregulation of tumour supressor genes Omega 6: Omega 3 ratio 2:1  insulin,  estrogens,  IGF-1,  inflammation,  Down regulation of oncogenes,  upregulation of tumour supressor genes Physical activity  insulin,  estrogens,  IGF-1,  inflammation,  Down regulation of oncogenes,  upregulation of tumour supressor genes (Heber et al.2006, World Cancer Research Fund 2007) 15

16. Phytonutrients US National Cancer Institute : 5 is just the bare minimum. Men – at least 9 servings Women – at least 7 servings Children – at least 5 sevings 16

17. Phytonutrients-Flavonoids: Onions Kale Grape Citrus fruits Apple Pear Powerful inhibitors of many cancers including human breast cancer cells 17

18. Phytonutrients-Flavonoids: Broccoli, Brussel sprouts Cabbage Cauliflower Chinese cabbage Cress Turnip 18

19. Other Anti Cancer Nutrients Other anticancer substances: Sulphur compounds of garlic ( tumour growth inhibition; cancer formation inhibition) Folic acid (fruits and vegetables; DNA Protection) Beta sitosterol (fruits and vegetables; tumor growth inhibition) 19

20. Color CODE System OF Vegetables and fruits 20 Color Phytochemical Vegetable and Fruit Red Lycopene Tomatoes products, pinkgrapefruits, watermelon Red/Purple Anthocyanins polyphenols Berries, grapes, prunes Orange A, b-carotene Carrots, mango, pumpkin Orange/Yellow b-cryptoxanthin. Flavonoids Cantaloupe, peaches, oranges, papaya, nectarines Yellow/Green Lutein, zeaxanthin Spinach, avocado, honeydew, collard and turnip greens Green Sulforaphanes, indoles Cabbage, broccoli, brussels sprouts, cauliflower White/Green Allyl sulphides Leeks onion, garlic, chives

21. Guidelines for cancer prevention Choose a diet rich in a variety of plant based foods Eat plenty of vegetables and fruits Maintain a healthy weight and be physically active Select foods low in fat and salt Prepare and store food safety And always remember..... Do not use tobacco in any form 21

22. Lifestyle Changes to Reduce Breast Cancer Risk Reducing alcohol consumption Breastfeeding Avoiding obesity Being physically active 22

23. Recommendations for Cancer Survivors Limit total fat intake 15-20% of total calories. Monosaturated fats are preferred Aim for 10-12 daily servings of a variety of whole vegetables and fruits Consume 4-6 servings of whole grains daily. Breast cancer pts should eliminate or severely restrict alcohol intake Consider a Vitamin E supplement of 200 IU/day to replace deficit from rduced fat intake Excercise moderately (30 minute daily walk, for example) Maintain desirable body weight 23