Rosa is a 62-year-old woman who has three adult daughters and eight grandchildren. Recently she was diagnosed with breast cancer (estrogen-receptor and progesterone-receptor negative and HER/2 neu positive). Surgery, followed by concurrent chemotherapy and biotherapy and then radiation therapy to her breast are planned for treatment of her disease. Anticipated side effects of her cancer therapy include treatment-related fatigue, mouth sores, nausea, vomiting, diarrhea, and peripheral neuropathy. She is 5’6“ tall, weighs 168 lb, and has a history of hypercholesterolemia and hypertension that has been managed with dietary measures. She currently does not engage in regular physical activity other than helping to care for her grandchildren but is motivated to make changes in her lifestyle to improve her fitness and overall health. She also is attracted to the use of multiple vitamins/ minerals and dietary supplements and complementary and alternative therapies for managing treatment-related side effects, reducing her cancer recurrence risk and managing her hypercholesterolemia and hypertension.
Nutrition Diagnostic Statement 1
Altered GI function related to prescribed cancer treatment as evidenced by anticipated nausea, vomiting, diarrhea, and mouth sores.
Nutrition Diagnostic Statement 2
Physical inactivity related to lack of a regular exercise plan as evidenced by patient reports of no exercise.
Nutrition Diagnostic Statement 3
Food- and nutrition-related knowledge deficit related to medical nutrition therapy related to cancer treatment and secondary prevention as evidenced by patient requesting more information.
Nutrition Care Questions
• What diet and nutrition recommendations would you give Rosa to prepare her for upcoming cancer treatment?
• List some dietary strategies Rosa may try if she experiences the following: fatigue, intermittent queasiness, mouth sores, and diarrhea.
• Is Rosa at her ideal body weight? If not, what suggestions would you recommend? Consider her lifestyle, hypertension, hypercholesterolemia, and planned cancer treatment.
• What guidance should be provided with regard to the appropriate use of vitamin and mineral supplements and ways to evaluate alternative therapies?