Case Study Assignment

Mr. J Case Study

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Question One

Small cell lung cancer is a type of lung cancer whereby cancer cells form in the tissues of the lungs. It is less common and only constitutes about 15% of the total number of lung cancers. However, small cell lung cancer is more aggressive and spreads very fast to other body parts. Therefore, if diagnosed late, it is less likely to recover. The cause of small cell lung cancer is not yet known but it is speculated that it may be caused by precancerous changes in the lungs. 

Risk factors are the factors that increase the chance of contracting a disease. The main risk factor for small cell lung cancer is old age. That is associated with decreasing body immunity. Smoking is also another risk factor in small cell lung cancer. The more a person smokes, the more likely they are to contracting small cell lung cancer. Apart from smoking actively, passive smoking is also a risk factor for contracting it. Being exposed to dangerous chemical substances such as asbestos, chromium, nickel among others may also increase the chances of contracting small cell lung cancer (Malhotra & Boffetta, 2016). Being exposed to radiation waves from radiotherapy, radon, CT scans, or even atomic and nuclear bomb radiations are also risk factors. Other risk factors include using carotene supplements and living in an area with a lot of air pollution. 

Question Two

Radiation therapy uses waves with high energy to destroy cancer cells. Cancer cells have a higher multiplication compared to normal cells. Therefore, radiation makes breaks in the DNA thus limiting the growth speed of cancer cells. The reduced rate of multiplication by cancerous cells leads to their death when radiation therapy is carried out often. Some of the radiations used for radiation therapy include gamma rays, electron beams, x-rays, and protons (Vinogradskiy & Kavanagh, 2016). Since radiation can only be used in one place at a time, it is not effective in treating cancer that has spread widely around the body. 

On the contrary, chemotherapy is the use of medical interventions to kill cancer cells. Chemotherapy targets all cells that grow at a very high rate in a person’s body. Therefore, apart from cancer cells, it may also affect hair, intestines, and skin cells. Since it uses drugs, chemotherapy is effective to kill cancer cells all over the body. Chemotherapy can be used to control, ease symptoms, or/and cure cancer cells. It is may also be used before and after radiation and/or surgeries.

Question Three

Chemotherapy and radiation therapy have several nutritional side effects. Chemotherapy may affect a person’s ability to eat by resulting in a lack of appetite. Therefore, it reduces the level of nutrition in a person’s body. Chemotherapy also causes nausea and vomiting. It may also result in mouth sores and mucositis. Diarrhea and constipation are also nutritional side effects of chemotherapy. Radiation therapy nutritional side effects depend on the part of the body subjected to the radiation. Radiation therapy in the stomach area may lead to diarrhea, vomiting, and nausea. When radiation therapy is conducted on the neck, chest, or the head, it may result to dry mouth, difficulty when swallowing, throat pain, diarrhea, and the change in taste. 

Question Four

Mr. J has increased his weight significantly. Currently, he is overweight. If his weight continues increasing at the same rate, he has a risk of becoming obese. His body mass index pre-illness was 21.2, which is normal. Currently, his body mass index is 26.3 which indicates that he is overweight. That may have been caused by eating foods with high calories and lack of exercise (Shepshelovich & Schwartz, 2019). 

Another nutritional problem that Mr. J may be suffering from is difficult when swallowing. The nutritional problem may have been caused by his regular radiation therapy. The nutritional problem is evident as he has difficulty eating. 

Question Five

When calculating the energy requirements of a person, several factors should be considered. One of the factors that should be considered is the gender of the person, their age, their weight, and their level of physical activity. In this case. Mr. J is male and he is 70 years old. He currently weighs 200 lbs. The same information is used when calculating his energy and protein requirements. From the information availed, Mr. J requires 8,285kJ of energy and 64g/day daily (Daily Nutrient Requirements Calculator, n.d).

Question Six

To reduce his weight, Mr. J should take a lot of fruits and vegetables. That will increase his vitamins and fiber uptake. He should also focus on taking wholemeal grains and avoid intake of fatty foods. He should also avoid taking added sugar in his drinks. Mr. J should also consider starting a regular exercise program to reduce his weight.

Question Seven

Nutritional monitoring and evaluation aim is to ensure that there is progress in a patient. To investigate whether there is a change, Mr. J’s BMI should be calculated frequently. That will show whether his weight is decreasing. If his weight is decreasing, the nutritional intervention will be effective. If there is no change in his weight or there is an increase in his weight, it will indicate that the nutritional interventions are not effective. He should also be questioned about how he feels while eating to determine whether he still has difficulty eating.  

References

Daily Nutrient Requirements Calculator (n.d). Retrieved from https://www.eatforhealth.gov.au/node/1813927/done?sid=360410

Malhotra, J., & Boffetta, P. (2016). Risk factors for lung cancer worldwide. European Respiratory Journal, 48(3), 889-902.

Shepshelovich, D., & Schwartz, A. G. (2019). Body Mass Index (BMI), BMI change, and overall survival in patients with SCLC and NSCLC: a pooled analysis of the international lung cancer consortium. Journal of Thoracic Oncology, 14(9), 1594-1607.

Vinogradskiy, Y., & Kavanagh, B. (2016). Regional lung function profiles of stage I and III lung cancer patients: an evaluation for functional avoidance radiation therapy. International Journal of Radiation Oncology* Biology* Physics, 95(4), 1273-1280.