Esophageal Cancer: Final Project
Esophageal Cancer –Final Project
Deborah Denise Kane
Virginia College C-18
PRN 1325
Esophageal Cancer
Esophageal cancer is a malignant cancerous tumor that forms in the tissue lining the esophagus; the esophagus is a muscular tube that moves food from the mouth to the stomach. It is more common in male patients over the age of 60, who were or are heavy smokers or tobacco users, heavy drinkers, and are overweight. It is thought to affect African Americans more in the United States than Caucasians. The mortality rate for African Americans continues to be higher than that of Caucasians. In 2012 there have been 17,460 new cases and an estimated 15,070 death so far. There are two major types of esophageal cancer: squamous cell carcinoma …show more content…
and andenocarcinoma. These two types can be determined by looking at them under a microscope.
Squamous cell carcinoma is the most common type of esophageal cancer worldwide. This type of cancer starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. Normally this cancer is caused by heavy alcohol consumption and smoking but there have been other documented risk factors. South Central Asia is known as the “esophageal cancer belt” due to the over abundant cases known in both males and females. Andenocarcinoma is the most common type known in the United States and Western Europe. It’s the fastest most increasing cancer in the United States. This type starts in the glandular cells in the lower part of the esophagus and may occur at or near the junction of the esophagus and the stomach, known as the gastro-esophageal junction. Normally this type is caused by acid reflux and often linked to obesity.
These two types are the most common, but there are several other types such as, lymphoma, melanoma, sarcoma, small cell, choriocarcinoma and spindle cell carcinoma. Although they are rare they have been seen in patients and are most often caused by the spreading of cancer from various other body parts; like the lungs, liver or breast and spread into the esophagus via the lymph or blood systems.
Esophageal cancer has few, if any signs or symptoms’ in its early stages. However as the cancer grows the most common symptoms may include; * Difficulty or painful swallowing * Weight loss and loss of appetite * Blood in stool * Feeling very tired * Heartburn or GERD * Pain in the throat or back * Hoarseness or coughing
There are several different tests that can be performed to determine what exactly the cause of your symptoms is.
The Barium Swallow test where a patient swallows a liquid mixture while at an x-ray machine. The barium is opaque to the x-ray therefore allowing narrowing in the esophagus to be shown in pictures. The Endoscopy is a medical instrument that consists of a narrow flexible tube with a light and camera at the end in which it is used to look into the esophagus. It may also be equipped with a small attachment to take a sample or biopsy of the esophageal tissue. A biopsy is the removal of cells or tissue for the examination by a pathologist. The patient is usually slightly sedated. Next there is the PET scan or the Positron Emission Tomography Scan this is where the patient is given a dose of glucose that is altered so it is radioactive. Tumor cells require much more sugar in the form of glucose for energy than normal cells in the body. After receiving the glucose the patient usually is instructed to wait about an hour, this giving the cells in the body time to absorb large amounts of glucose before the scan. The PET scanner is able to locate where in the body there is an excess of radioactive glucose and where there are likely to be tumor cells. The radioactivity rapidly decays, so that it does not cause any lasting effects on the …show more content…
patient.
If your doctor orders a biopsy and the test comes back as a positive for cancer the next step would be to determine at what extent or stage of the disease you are in to help choose the best treatment. Staging is a careful attempt to find out how deeply the cancer invades the walls of the esophagus, whether the cancer invades nearby tissue and whether the cancer has spread and if so, to what parts of the body. Sometimes staging cannot be completed until surgery is performed and nearby lymph nodes have been examined. There are four stages to be categorized in if you are diagnosed with esophageal cancer * Stage 0- abnormal cells are found only in the inner layer of the esophagus. It’s called carcinoma in situ. * Stage 1- the cancer has grown through the inner layer of the submucosa * Stage 2- is one of the following- * The cancer has grown through the inner layer of the submucosa, and the cancer cells have spread to the lymph nodes * The cancer has invaded the muscle layer. Cancer cells may be found in the lymph nodes * The cancer has grown through the outer layer of the esophagus
* Stage 3- is one of the following- * The cancer has grown through the outer layer, and cancer cells have spread to lymph nodes * The cancer has invaded nearby structures, such as the airways. Cancer cells may have spread to the lymph nodes * Stage 4- Cancer cells have spread to distant organs, such as the liver, lungs and or breast.
People who have been diagnosed with esophageal cancer have several treatment options, such as, surgery, radiation therapy, chemotherapy, or a combination of these treatments.
The treatment is determined by the cellular type of cancer, the stage of the disease, the general condition of the patient and if other diseases are present. Surgery would include but not be limited to an esophageal stent that may be inserted to widen the esophagus and place a metal tube or stent to hold the esophagus open. A nasogastric tube may be necessary to continue feeding the patient while treatment for the tumor is given. An esophagectomy is a minimally invasive surgery used to remove part of or the entire esophagus. After the esophagus is removed it is rebuilt from part of the stomach or large intestine. There’s also laser therapy, its use of high intensity light destroys tumor cells and only treats the affected area. This is typically done if the cancer cannot be removed by surgery. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells and depends on the tumor type, and may be given after surgery to reduce the risk of reoccurrence. Chemotheraputic agents such as cisplatin (Platinol), paclitaxel (taxol), and fluorouracil (5-FU) are currently used in combination with radiation before and after surgery. Radiotherapy which uses high powered energy beams to kill cancer cells and can be given before, during or after chemotherapy or surgery and sometimes on its own to control
symptoms. There are always risks with any type of treatment and with radiotherapy the development of an esophagotracheal fistula, aspiration from the fistula and edema are common.
If the tumor is located in the upper third portion of the esophagus then radiation is most likely used. If it is located in the lower third then it is usually resected surgically.
As a nurse or care giver for a patient with esophageal cancer or any other disease or illness you should take into consideration the patient and family. Concerns about treatments, managing side effects, hospital stays, and medical bills are common. Patients may also worry about caring for their family, keeping a job, or continuing daily activities; here's where you can help. You should provide supportive care, information on symptom and pain management, information about the type of cancer or disease, stage of cancer, treatment, prognosis, and even help in planning home care needs. Patient teaching would include stopping smoking, stop drinking, and eating a well-balanced diet, following medication instructions and being available for follow up appointments are also very important. Help to identify a great support group for the patient to join this will help to ease the shock, anxiety, depression, fear, and even help the patient to stay compliance with all their treatment options.
Several nursing diagnosis can be associated with esophageal cancer, let’s take Ineffective breathing related to; incision pain, manifested by esophageal cancer. With this specific diagnosis you as a care giver need to be able to monitor the respiration pattern effectively and be able to identify when the patient is in distress. Help the patient by giving them effective breathing exercises to ease the discomfort of the incision pain, as in holding a pillow against the chest.
Esophageal Cancer or EC is a very devastating and aggressive disease. Although some patients can be cured, the treatment is still considered debatable. It decreases the quality of life and is lethal in a significant number of cases. Because the disease is well advanced before most show any signs or symptoms of the disease the mortality rate is high. The 5 year survival rate is less than 20%. The only good prognosis of this disease is early detection.
Reference Page
Esophageal cancer. (2012, August 30). Retrieved from http://www.bing.com/health/article/mayo-MADS00500/Esophageal-cancer?q=esophageal cancer&qpvt=esophageal cancer
Kockrow, C. (2012, September 3). Adult health gastrointestinal disorders.
ADAM. (2012, August 30). Esophageal cancer. U.S. Library of Medicine, Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001328/
Medicine net esophageal cancer signs and symptoms. (n.d.). Retrieved from http://www.medicinenet.com/esophageal_cancer/article.htm
Esophageal cancer Pre-Test 1. Presenting signs and symptoms of esophageal cancer may include a. Weight loss b. difficulty swallowing c. Hoarseness d. A,B,& C 2. Which of the following is linked to esophageal cancer a. Smoking b. Drinking milk c.Eating Mexican food d. Living in the South 3. When a patient is given a dose of glucose that is altered so it is radioactive, what type of test is being performed? a. PTE b. PET c. CAT d. endoscopy 4. _________________________starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. 5. An ________________________is a minimally invasive surgery used to remove part of or the entire esophagus. 6. The _______________________ is a muscular tube that moves food from the mouth to the stomach. 7. Barium Swallow __________ 8. Esophageal stent __________ 9. Radiotherapy _____________ 10. laser therapy ______________ a. a metal tube is inserted into the esophagus. b. uses high intensity light destroys tumor cells and only treats the affected area. c. high powered energy beams used to kill cancer cells. d. test where a patient swallows a liquid mixture while at an x-ray machine.
Esophageal cancer Post-Test 1. Presenting signs and symptoms of esophageal cancer may include
a. Weight loss b. difficulty swallowing c. Hoarseness d. A,B,& C 2. Which of the following is linked to esophageal cancer b. Smoking b. Drinking milk c.Eating Mexican food d. Living in the South 3. When a patient is given a dose of glucose that is altered so it is radioactive, what type of test is being performed? b. PTE b. PET c. CAT d. endoscopy 4. _________________________starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. 5. An ________________________is a minimally invasive surgery used to remove part of or the entire esophagus. 6. The _______________________ is a muscular tube that moves food from the mouth to the stomach. 7. Barium Swallow __________ 8. Esophageal stent __________ 9. Radiotherapy _____________ 10. laser therapy ______________ a. a metal tube is inserted into the esophagus. b. uses high intensity light destroys tumor cells and only treats the affected area. c. high powered energy beams used to kill cancer cells. d. test where a patient swallows a liquid mixture while at an x-ray machine.
Deborah Denise Kane
Virginia College C-18
PRN 1325
Esophageal Cancer
Esophageal cancer is a malignant cancerous tumor that forms in the tissue lining the esophagus; the esophagus is a muscular tube that moves food from the mouth to the stomach. It is more common in male patients over the age of 60, who were or are heavy smokers or tobacco users, heavy drinkers, and are overweight. It is thought to affect African Americans more in the United States than Caucasians. The mortality rate for African Americans continues to be higher than that of Caucasians. In 2012 there have been 17,460 new cases and an estimated 15,070 death so far. There are two major types of esophageal cancer: squamous cell carcinoma …show more content…
and andenocarcinoma. These two types can be determined by looking at them under a microscope.
Squamous cell carcinoma is the most common type of esophageal cancer worldwide. This type of cancer starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. Normally this cancer is caused by heavy alcohol consumption and smoking but there have been other documented risk factors. South Central Asia is known as the “esophageal cancer belt” due to the over abundant cases known in both males and females. Andenocarcinoma is the most common type known in the United States and Western Europe. It’s the fastest most increasing cancer in the United States. This type starts in the glandular cells in the lower part of the esophagus and may occur at or near the junction of the esophagus and the stomach, known as the gastro-esophageal junction. Normally this type is caused by acid reflux and often linked to obesity.
These two types are the most common, but there are several other types such as, lymphoma, melanoma, sarcoma, small cell, choriocarcinoma and spindle cell carcinoma. Although they are rare they have been seen in patients and are most often caused by the spreading of cancer from various other body parts; like the lungs, liver or breast and spread into the esophagus via the lymph or blood systems.
Esophageal cancer has few, if any signs or symptoms’ in its early stages. However as the cancer grows the most common symptoms may include; * Difficulty or painful swallowing * Weight loss and loss of appetite * Blood in stool * Feeling very tired * Heartburn or GERD * Pain in the throat or back * Hoarseness or coughing
There are several different tests that can be performed to determine what exactly the cause of your symptoms is.
The Barium Swallow test where a patient swallows a liquid mixture while at an x-ray machine. The barium is opaque to the x-ray therefore allowing narrowing in the esophagus to be shown in pictures. The Endoscopy is a medical instrument that consists of a narrow flexible tube with a light and camera at the end in which it is used to look into the esophagus. It may also be equipped with a small attachment to take a sample or biopsy of the esophageal tissue. A biopsy is the removal of cells or tissue for the examination by a pathologist. The patient is usually slightly sedated. Next there is the PET scan or the Positron Emission Tomography Scan this is where the patient is given a dose of glucose that is altered so it is radioactive. Tumor cells require much more sugar in the form of glucose for energy than normal cells in the body. After receiving the glucose the patient usually is instructed to wait about an hour, this giving the cells in the body time to absorb large amounts of glucose before the scan. The PET scanner is able to locate where in the body there is an excess of radioactive glucose and where there are likely to be tumor cells. The radioactivity rapidly decays, so that it does not cause any lasting effects on the …show more content…
patient.
If your doctor orders a biopsy and the test comes back as a positive for cancer the next step would be to determine at what extent or stage of the disease you are in to help choose the best treatment. Staging is a careful attempt to find out how deeply the cancer invades the walls of the esophagus, whether the cancer invades nearby tissue and whether the cancer has spread and if so, to what parts of the body. Sometimes staging cannot be completed until surgery is performed and nearby lymph nodes have been examined. There are four stages to be categorized in if you are diagnosed with esophageal cancer * Stage 0- abnormal cells are found only in the inner layer of the esophagus. It’s called carcinoma in situ. * Stage 1- the cancer has grown through the inner layer of the submucosa * Stage 2- is one of the following- * The cancer has grown through the inner layer of the submucosa, and the cancer cells have spread to the lymph nodes * The cancer has invaded the muscle layer. Cancer cells may be found in the lymph nodes * The cancer has grown through the outer layer of the esophagus
* Stage 3- is one of the following- * The cancer has grown through the outer layer, and cancer cells have spread to lymph nodes * The cancer has invaded nearby structures, such as the airways. Cancer cells may have spread to the lymph nodes * Stage 4- Cancer cells have spread to distant organs, such as the liver, lungs and or breast.
People who have been diagnosed with esophageal cancer have several treatment options, such as, surgery, radiation therapy, chemotherapy, or a combination of these treatments.
The treatment is determined by the cellular type of cancer, the stage of the disease, the general condition of the patient and if other diseases are present. Surgery would include but not be limited to an esophageal stent that may be inserted to widen the esophagus and place a metal tube or stent to hold the esophagus open. A nasogastric tube may be necessary to continue feeding the patient while treatment for the tumor is given. An esophagectomy is a minimally invasive surgery used to remove part of or the entire esophagus. After the esophagus is removed it is rebuilt from part of the stomach or large intestine. There’s also laser therapy, its use of high intensity light destroys tumor cells and only treats the affected area. This is typically done if the cancer cannot be removed by surgery. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells and depends on the tumor type, and may be given after surgery to reduce the risk of reoccurrence. Chemotheraputic agents such as cisplatin (Platinol), paclitaxel (taxol), and fluorouracil (5-FU) are currently used in combination with radiation before and after surgery. Radiotherapy which uses high powered energy beams to kill cancer cells and can be given before, during or after chemotherapy or surgery and sometimes on its own to control
symptoms. There are always risks with any type of treatment and with radiotherapy the development of an esophagotracheal fistula, aspiration from the fistula and edema are common.
If the tumor is located in the upper third portion of the esophagus then radiation is most likely used. If it is located in the lower third then it is usually resected surgically.
As a nurse or care giver for a patient with esophageal cancer or any other disease or illness you should take into consideration the patient and family. Concerns about treatments, managing side effects, hospital stays, and medical bills are common. Patients may also worry about caring for their family, keeping a job, or continuing daily activities; here's where you can help. You should provide supportive care, information on symptom and pain management, information about the type of cancer or disease, stage of cancer, treatment, prognosis, and even help in planning home care needs. Patient teaching would include stopping smoking, stop drinking, and eating a well-balanced diet, following medication instructions and being available for follow up appointments are also very important. Help to identify a great support group for the patient to join this will help to ease the shock, anxiety, depression, fear, and even help the patient to stay compliance with all their treatment options.
Several nursing diagnosis can be associated with esophageal cancer, let’s take Ineffective breathing related to; incision pain, manifested by esophageal cancer. With this specific diagnosis you as a care giver need to be able to monitor the respiration pattern effectively and be able to identify when the patient is in distress. Help the patient by giving them effective breathing exercises to ease the discomfort of the incision pain, as in holding a pillow against the chest.
Esophageal Cancer or EC is a very devastating and aggressive disease. Although some patients can be cured, the treatment is still considered debatable. It decreases the quality of life and is lethal in a significant number of cases. Because the disease is well advanced before most show any signs or symptoms of the disease the mortality rate is high. The 5 year survival rate is less than 20%. The only good prognosis of this disease is early detection.
Reference Page
Esophageal cancer. (2012, August 30). Retrieved from http://www.bing.com/health/article/mayo-MADS00500/Esophageal-cancer?q=esophageal cancer&qpvt=esophageal cancer
Kockrow, C. (2012, September 3). Adult health gastrointestinal disorders.
ADAM. (2012, August 30). Esophageal cancer. U.S. Library of Medicine, Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001328/
Medicine net esophageal cancer signs and symptoms. (n.d.). Retrieved from http://www.medicinenet.com/esophageal_cancer/article.htm
Esophageal cancer Pre-Test 1. Presenting signs and symptoms of esophageal cancer may include a. Weight loss b. difficulty swallowing c. Hoarseness d. A,B,& C 2. Which of the following is linked to esophageal cancer a. Smoking b. Drinking milk c.Eating Mexican food d. Living in the South 3. When a patient is given a dose of glucose that is altered so it is radioactive, what type of test is being performed? a. PTE b. PET c. CAT d. endoscopy 4. _________________________starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. 5. An ________________________is a minimally invasive surgery used to remove part of or the entire esophagus. 6. The _______________________ is a muscular tube that moves food from the mouth to the stomach. 7. Barium Swallow __________ 8. Esophageal stent __________ 9. Radiotherapy _____________ 10. laser therapy ______________ a. a metal tube is inserted into the esophagus. b. uses high intensity light destroys tumor cells and only treats the affected area. c. high powered energy beams used to kill cancer cells. d. test where a patient swallows a liquid mixture while at an x-ray machine.
Esophageal cancer Post-Test 1. Presenting signs and symptoms of esophageal cancer may include
a. Weight loss b. difficulty swallowing c. Hoarseness d. A,B,& C 2. Which of the following is linked to esophageal cancer b. Smoking b. Drinking milk c.Eating Mexican food d. Living in the South 3. When a patient is given a dose of glucose that is altered so it is radioactive, what type of test is being performed? b. PTE b. PET c. CAT d. endoscopy 4. _________________________starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. 5. An ________________________is a minimally invasive surgery used to remove part of or the entire esophagus. 6. The _______________________ is a muscular tube that moves food from the mouth to the stomach. 7. Barium Swallow __________ 8. Esophageal stent __________ 9. Radiotherapy _____________ 10. laser therapy ______________ a. a metal tube is inserted into the esophagus. b. uses high intensity light destroys tumor cells and only treats the affected area. c. high powered energy beams used to kill cancer cells. d. test where a patient swallows a liquid mixture while at an x-ray machine.