Short of breath
  Too tired
  The dwindles
  Weight loss
  Mom to be
  Very sociable
   Thanks To
 Mark W. Braun, MD

   Nutrition and Diagnosis-Related Care



Mrs. Wilma O'Dea is a 52 year-old, post menopausal woman who was diagnosed with breast cancer six months ago. An attorney, and now a judge, she has always been in good health. Mrs. O'Dea discovered the tumor herself as a small lump in the upper outer quadrant of her left breast during her routine breast self-exam . A mammogram revealed a discrete mass, and an excisional biopsy confirmed the diagnosis. Her primary cancer was 2.1 cm in greatest diameter, and there were 2 positive axillary lymph nodes. An abdominal CT and bone scan revealed no evidence of distant metastases.

Mrs. O'Dea's oncologist routinely refers her patients for a nutrition consultation as she knows how important adequate nutrition is to recovery. Click here for her completed SGA.

  • Although her weight hasn't changed, Mrs. O'Dea just doesn't feel well.
  • She just feels generally run-down and believes she's lost some muscle strength.
  • Also, she has questions about phytoestrogens and her breast cancer.

In general, recovering from a malignancy represents an anabolic state, with increased need for calories, protein and certain vitamins.

  • The release of tumor necrosis factor (TNF) by the immune system complicates matters as it causes appetite suppression.
  • Recovery from the cycles of chemotherapy also adds to the extra nutritional needs.
  • Her concern about estrogen-like substances in her diet is not unreasonable.

Let's consider Mrs. O'Dea's situation in more detail.

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