Nutrition for a Patient Undergoing Radiation and Chemotherapy

Case Study – Nutrition for a Patient Undergoing Radiation and Chemotherapy
Case Overview
At the start of radiation therapy (XRT), Mr. Allen’s weight was171.5 lbs and his height was 5 feet 6.5 inches. His BMI, 27,
put him in the overweight classification. However, his usual bodyweight (prior to this condition) had been 183 lbs.
The primary goal of medical nutrition therapy is to identifynutritional risk and implement strategies to minimize the
impact of treatment side effects on food intake that may contributeto weight loss and nutrient deficiencies.
• On the 5th day of XRT, Mr. Allen complained of dysgeusia(decreased taste sensation).
• On the 19th day of XRT, he reported decreased appetite secondaryto constipation. He was following a soft diet
that included the oral supplement Boost plus TID. His weight losswas a total of 3.5 lbs. He began stool softeners
and was started on Megace, an appetite stimulant.
• On the 23rd day of XRT, the patient reported that he chokes onplain water but not oral supplements. His weight
was stable since day 19, indicating no further weight loss.
• On the 28th day of XRT, the patient complained of increased painwith swallowing, continued taste change, and
decreased PO intake. He also lost an additional 3 lbs. He wasinstructed to increase the frequency of liquid
codeine to ease the pain of swallowing.
• By day 38 of XRT, the patient had been treated for dehydrationtwice. His soft diet continues with thickened
juices and oral supplements. His weight has decreased another poundsince day 28. His total weight loss since
the beginning of XRT was 7.5 lbs. His weight at the end of XRT was164 lbs. and his BMI was 26.
Questions
1. Beginning with dysgeusia, list the issues that contributed toMr. Allen’s decreased food intake.
2. For each issue from #1, list possible interventions that youwould recommend to minimize the negative effects
on his food intake.
3. What is the most meaningful way to evaluate his weight loss? Dothe necessary calculations: consider his UBW
and his weight at the beginning and end of his 8 weeks oftreatment. How would you classify his nutritional
status based on his weight loss?

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