Discuss the nutritional problems of cancer therapy and their dietary management.

1. 1 · Open in two lines. Cancer treatments damage fast-growing normal cells too, such as those lining the mouth and gut. This causes eating problems and weight loss.
2. 2 · Problems from surgery. Head and neck: chewing and swallowing. Stomach: early fullness, dumping. Intestine and pancreas: malabsorption, diarrhoea, diabetes.
3. 3 · Problems from chemotherapy and radiotherapy.
   • Chemotherapy: nausea, vomiting, mouth ulcers, taste changes, diarrhoea, low counts.
   • Radiotherapy: dry mouth, sore throat, swallowing pain, enteritis.
4. 4 · Draw a problem-solution table. [Two columns: problem (nausea, ulcers, dry mouth, taste change, diarrhoea) and food fix]
5. 5 · Dumping syndrome and food safety. Small dry meals, fluids apart, no sugar; well-cooked food and boiled water in neutropenia.
6. 6 · Sample menu. A soft, bland, high-protein menu for a patient with mouth ulcers.
7. 7 · Close in one line. Managing each side effect keeps the patient eating and able to finish treatment.

Scoring tip: Organise by treatment (surgery, chemotherapy, radiotherapy), then give a problem-fix table; it makes a long answer easy to mark.