Mod 5-1 Esophageal Cancer

Question 1

___% of esophageal malignancies are _______ ______ carcinomas.

Answer 1

80%; squamous cell

Question 2

What are the other remainder esophageal malignancies (other than the squamous cell carcinomas)?

Answer 2

Adenocarcinomas developed secondary to Barrett’s esophagus.

Question 3

Cancer of the esophagus effects men or women more?

Answer 3

Men

Question 4

What is the etiology of esophageal cancer?

Answer 4

• Unknown
• Alcoholism and smoking are primary risk factors

Question 5

What are the two sites that are most commonly affected by esophageal carcinoma?

Answer 5

• Middle third, where esophagus is crossed by left bronchus (most favored)
• Lower third

Question 6

What usually causes esophageal cancer in the lower third portion?

Answer 6

An upward extension of cancer of the stomach into the lower esophagus.

Question 7

What is the most common presenting clinical manifestation of esophageal cancer?

Answer 7

Dysphagia - progressive difficulty in swallowing

Question 8

When does dysphagia become noticeable in patients w/esophageal cancer?

Answer 8

• When the esophageal lumen has been reduced by 75%
• Difficulty typically present 2-4 months before seeking medical advice

Question 9

What does progressive dysphagia mean?

Answer 9

• Difficulty swallowing progresses from solids to liquid

Question 10

What are some other symptoms (other than dysphagia) of esophageal cancer

Answer 10

• Odynophagia (painful swallowing of food)
• Anorexia
• Weight loss
• Chest pain

Question 11

At what stage do symptoms of esophageal cancer appear?

Answer 11

Late in its course and by the time the cancer is diagnosed, it has frequently extended beyond its borders into and around the esophagus, including the local and regional lymph nodes.

Question 12

What is done if no extension has occured in esophageal cancer?

Answer 12

Surgical intervention may result in cure.

Question 13

If extensin is present in esophageal cancer, ___% of patients will be alive ___ years after diagnosis.

Answer 13

10; 5

Question 14

What is the earliest radiographic appearance of esophageal cancer?

Answer 14

Flat plaque-like lesion involving one wall of the esophagus.

Question 15

What happens as esophageal cancer progresses?

Answer 15

The mucosal wall is destroyed, the tumor circles the esophagus causing increasing stricture and difficulty with swallowoing.

Question 16

What happens as the tumor grows and the lumen of the esophagus decreases?

Answer 16

• The esophagus above the site enlarges to compensate for the stricturing of the cancerous area
• Aspiration becomes more frequent
• Aspiration pnemonia more frequent as well

Question 17

What can the extension of the tumor ot adjacent mediastinal structures lead to?

Answer 17

A fistula formation, especially between the esophagus and the respiratory tract.

Question 18

What modality is used to stage esophageal carcinoma?

Answer 18

CT

Question 19

What is the effect of esophageal cancer on readiographic technique?

Answer 19

none