Chapter 18: Gastric & esophageal Flashcards
T/F: Squamous cell esophageal cancer is found within the upper 2/3 of the esophagus
True
Adenocarcinoma is the lower 1/3
How is cancer at the GE junction treated?
Like esophageal cancer
______ esophageal cancer is most common in the world and amongst black people in the US
Squamous
Treatment of esophageal & gastric cancers are based on ____________
Resectability
What are the 3 options to create a new esophagus?
Stomach
Small intestine
Large intestine
Is HPV associated more with squamous cell or adenocarcinomas of the esophagus?
Squamous
Adenocarcinoma is mostly obesity & GERD
When does esophagitis typically occur during concurrent chemoRT for esophageal cancer
weeks 3-6
What are 5 MNT tips for esophageal stent?
- Liquids for a couple of days and then very soft/moist foods
- Chewing thoroughly
- Cabonated beverage if food doesn’t pass
- Sitting upright for 30-60 minutes after eating
- Small bites
T/F: Malnutrition has been reported in >75% esophageal cancer patients and toxicities are especially prevalent w/ sarcopenic obesity
True
_______ is the most common symptom of esophageal cancer
Dysphagia
Formula recommendations for j tube feedings post-esophagectomy
Standard. Energy-dense can also be trialed and typically well tolerated
T/F: ERAS is traditionally recommended post-esophagectomy
FALSE
Really the only cancer it’s not recommended with d/t risk for anastomosis leak and aspiration risk . This is the traditional approach but some newer studies are demonstrating safety/benefit
How long should you remain upright post-op esophagectomy before going to bed?
2-3 hours
The removal of ________ during esophagectomy is often the cause of reflux
lower esophageal sphincter
Why do strictures sometime form post-esophagectomy?
Anastomotic complications (leaks & strictures)
In advanced cases of esophageal cancer, post-surgical malabsorptive may be an issue. There is some evidence that _____________ may provide benefit
PERT
4 signs of dumping syndrome
- Bloating
- Abdominal cramping
- Nausea
- Diarrhea
Differences in early versus late dumping syndrome
Early - 10-30 minutes post-prandial. Nausea, vomiting, abdominal cramping, bloating, diarrhea. 75% of cases.
Late - hunger, perspiration, difficulty concentrating
(low BG signs). 1-3 hours post-prandial. 25% cases
7 tips for dumping syndrome
- Limit concentrated sweets
- Avoid lactose foods if needed
- Avoid fried & greasy foods
- Eat foods w/ protein & complex carbs, soluble fiber
- Separate liquids from meals by 30 minutes before or afte
- Eat 5-6 small meals/day
- Chew food until liquified
Gastric cancer is the most prevalent in _________ (country)
Korea (salty foods)
Gastrointestinal stromal cancers (GISTs) occur in the stomach but the most common type of gastric cancer is ___________
Adenocarcinoma
Gastric adenocarcinomas are typically described as ______ or _______, but could have mixed features of both
Intestinal
Diffuse
Define linitis plastica
Rigid/thick stomach wall possibly d/t infiltration by diffuse adenocarcinomas
What is the difference between intestinal and diffuse adenocarinomas of the stomach?
Intestinal - well-differentiated
Diffuse - poorly differentiated
