Presentation on Esophageal Carcinoma .pptx

This is presentation on esophageal carcinoma that is included in adult health nursing of BSN 2nd Year

1. Esophageal Carcinoma

2. Esophageal cancer Esophageal cancer is cancer of the esophagus. There are various subtypes, squamous cell cancer and adenocarcinoma . Squamous cell cancer arises from the cells that line the upper part of the esophagus. Adenocarcinoma arises from glandular cells that are present at the junction of the esophagus and stomach.

3. Etiology Squamous cell esophageal cancer is caused by smoking and alcohol consumption. Barrett's esophagus, a complication of  GERD, increases the risk for adenocarcinoma of the esophagus. Other risk factors for adenocarcinoma of the esophagus include: Male gender Obesity Smoking The most important risk factor is exposure to asbestos and metal and low level of fresh fruits and vegetables.

4. Pathophysiology Esophageal cancer arises in the mucosa of the esophagus. It then progresses locally to invade the sub mucosa and the muscular layer, and may invade contiguous structures such as the tracheobronchial tree, the aorta, or the recurrent laryngeal nerve. Metastasis typically occurs to the peri -esophageal lymph nodes, liver, and lungs. The pathophysiological mechanisms of many causes are not yet fully Known .

5. Risk factors Alcohol : Tobacco Smoking exposes the body to a large number of carcinogens. Gastroesophageal reflux disease. Human papillomavirus (HPV) Radiation therapy for other conditions in the mediastinum

6. Clinical manifestations Backwards movement of food through the esophagus and possibly mouth ( regurgitation ). Chest pain unrelated to eating. Difficulty in swallowing solids or liquids. Heartburn. Weight loss. Odynophagia (painful swallowing). Hematemesis.

7. Diagnostic Tests Barium swallow: identify irregular mucosal patterns or narrowing of lumen Esophagoscopy : allow direct visualization of tumor and biopsy Chest xray , CT scans, MRI: determine tumor metastases Complete Blood Count: identify anemia Serum albumin: low levels indicate malnutrition Liver function tests: elevated with liver metastasis

8. Treatments: dependent on stage of disease, client’s condition and preference Early (curable) stage: surgical resection of affected portion with anastomosis of stomach to remaining esophagus; may also include radiation therapy and chemotherapy prior to surgery More advanced carcinoma: treatment is palliative and may include surgery, radiation and chemotherapy to control dysphagia and pain

9. Nursing diagnosis Acute pain related to: fistula, surgery, tumor. Impaired swallowing R/T blockage of esophagus by mass. Fatigue related to cachexia (weight loss that cannot be reversed nutritionally). Imbalanced nutrition Less than body requirements related to dysphasia. Risk for aspiration related to dysphagia.

10. Nursing Interventions Give analgesics to relive from pain. Put up NPO sign and advise staff of patients about NPO status to insure that patient does not aspirate. Be alert to signs and symptoms of aspiration since aspiration is very serious and can cause death. Weight client weekly to help evaluate nutritional status, making sure the client is adequately nourished. Advise the patient for upright position to prevent regurgitation of fluids.