Case Study - Nutrition for a Patient Undergoing Radiation and
Chemotherapy
Case Overview
At the start of radiation therapy (XRT), Mr. Allen’s weight
was 171.5 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 identify
nutritional risk and implement strategies to minimize the
Impact of treatment side effects on food intake that may contribute
to 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 secondary
to constipation. He was following a soft diet that included the oral supplement
Boost plus TID. His weight loss was 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 on plain 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 pain with swallowing, continued taste change, and decreased PO
intake. He also lost an additional 3 lbs. He was instructed to increase the
frequency of liquid codeine to ease the pain of swallowing.
• By day 38 of XRT, the patient had been treated for
dehydration twice. His soft diet continues with thickened juices and oral
supplements. His weight has decreased another pound since 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
to Mr. Allen’s decreased food intake.
2. For each issue from #1, list possible interventions that
you would recommend to minimize the negative effects on his food intake.
3. What is the most meaningful way to evaluate his weight
loss? Do the necessary calculations: consider his UBW and his weight at the
beginning and end of his 8 weeks of treatment. How would you classify his
nutritional status based on his weight loss?
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