Chapter 19: MNT for Esophageal CA

Question 1

What are the two types of cancer cells for esophageal CA?

Answer 1

Squamous cell (SCC) - in the upper 2/3 of the esophagus

Adenocarcinomas of the esophagus (AE) - lower third

Question 2

What are the common risk factors for Esophageal CA?

Answer 2

SCC - smoking and alcohol, infections of H Pylori and HPV

AE - GERD, Barrett’s esophagus, obesity

Question 3

What are the two common surgeries and describe them?

Answer 3

Esophagectomy - removal of CA within esophagus, nearby lymph nodes and possibly part of stomach. Remaining esophagus is connected to the stomach

Esophagogastrectomy - same as above with more top of stomach removed, pulling more of the stomach up. Sometimes part of the colon is needed as a tube to help connect the two. Usually used when its spread to part of the stomach.

Question 4

What is a common side effect of surgery for EC?

Answer 4

dumping syndrome

Question 5

How many patients can get surgery in western countries?

Answer 5

50%. Many are ineligible due to comorbidities or being diagnosed at an advanced stage

Question 6

what are the estimated needs for an EC patient? Protein?

Answer 6

30-35 kcal/kg

1-1.2 g/kg if not stressed/good wt, 1.2-1.6 g/kg if stressed/losing wt/LBM

Question 7

What is the EAL recommendation for interventions from the RD of EC? How often should they be seen?

Answer 7

pre-treatment evaluation and weekly visits for 6 weeks during chemoradiation treatment