Chapter 19- Esophageal Cancer Flashcards
GERD or reflux disease is a common cause of adenocarcinoma of the esophagus, or cancer of the lower third of the esophagus. GERD also increases the risk of what disease which is characterized by inflamed tissue of the lower esophagus
Barrett’s esophagus
Barrett’s esophagus is associated with a__ to __ fold increased risk of adenocarcinoma of the esophagus or cancer of the lower third of the esophagus
30 to 60 fold increased risk
GERD and Barrett’s esophagus are more often diagnosed in individuals with ______.
Obesity
GERD is over twice as common in people who are obese
What foods should patients with GERD avoid?
Alcohol, chocolate, Citrus juice, tomato based products, peppermint, coffee, and onion
while also adopting a low-fat eating habits and consuming smaller volumes of food at Meal Time
What type of surgery involves the surgical removal of cancerous tissue within the esophagus, the nearby lymph nodes, and possibly part of the stomach. The remaining part of the esophagus is then connected to the stomach. What is this type of surgery called?
Esophagectomy
What type of surgery involves the surgical removal of the cancerous tissue within the esophagus, nearby lymph nodes, and the TOP portion of the stomach. the remaining stomach is then pulled up and connected to the remaining portion of the esophagus on occasion the surgeon uses a small section of the colon to reconnect the esophagus to the stomach. This surgery is often required when the esophageal cancer has advanced and spread to the upper portion of the stomach. What is this surgery called?
Esophagogastrectomy
Whenever an Esophagectomy or a Esophagogastrectomy is formed the chance for experiencing DUMPING SYNDROME increases. Dumping syndrome can occur early, 10 to 30 minutes after eating, or late one two three hours after eating. In either case an anti-dumping diet should be followed. What does an anti-dumping diet consist of?
An anti-dumping diet should limit foods high in CONCENTRATED SUGARS. Foods high in SOLUBLE fiber, like oats, barley, peeled fruit and cooked vegetables. Lactose free foods maybe better tolerated. Avoid fried and greasy Foods. Drink liquids 45 minutes before or 1 hour after meals but not during meals. Eat 5 to 6 small meals daily. Eat slowly and chew Foods till liquid. Eat protein sources with each meal.
What are the symptoms of early dumping syndrome?
Fullness, nausea, vomiting, abdominal cramps, bloating, diarrhea, lightheadedness, desire to lay down
What are the symptoms of late dumping syndrome which occurs 1 to 3 hours after eating?
Hunger, perspiration, tremors, difficulty concentrating
What percentage of malnutrition esophageal patients have?
78.9% prevalence of malnutrition
What kind of weight loss do esophageal patients experience?
90% lose greater than >5% of the body weight
16% lose >15% of the body
What are the estimated energy goals for esophageal patients?
30-35 kcal/kg
What are the estimated protein needs of esophageal cancer patients without renal issues?
- 0- 1.2g/kg if stable and not stressed
1. 2 -1.6g/kg if stressed and losing weight and lean body mass
What is the preferred way to provide enteral feedings to esophageal patients and why?
JEJUNOSTOMY tube feedings are preferred to gastric feedings because they allow early post-operative feeding beyond the anastomosis and do not interfere with post-operative gastric healing
What are the fluid needs for esophageal patients?
<10kg : 100mL/kg
11-20kg : 1000mL + 50mL/kg for each kg >10kg
> 20kg : 1500mL + 20mL/kg for each kg >20kg
Body surface area method: 1500 mL/m2
