Week 5 - Gastric Cancer Flashcards
what is gastric cancer
- an adenocarcinoma of the stomach wall
- can occur in any portion of the stomach
what causes gastric cancer
- no specific causative agent `
what factors contribute to development of gastric cancer (5)
- genetics
- diet
- more prevalent in men
- H. pylori
- polyps
what diet can contribute to gastric cancer (5)
- smoked food
- spicy food
- salty food
- NSAID use
- alcohol
what are symptoms of gastric cancer (6)
- S&S anemia
- S&S of PUD
- S&S of indigestion
- weight loss, dysphagia, constipation (d/t epigastric distress)
what are S&S of anemia (5)
- pale
- weakness
- fatigue
- dizziness
- SOB
what are some S&S of indigestion (2)
- vague epigastric fullness
- feelings of early satiety after meals
what does NV, and hematemesis in gastric cancer indicate (2)
- gastric outlet obstruction
- or impending hemorrhage
what can be used to diagnose gastric cancer (5)
- xray
- endoscopic exam **
- upper GI barium studies
- blood chem studies
- tumour markers
what is the treatment of choice for gastric cancer
- surgical removal of the tumour
preop management of gastric cancer focuses on (5)
correction of:
- nutritional deficits
- treatment of anemia
- replacement of blood vol
- gastric decompression
- if in transverse colon and requires partial colon resection, prep the bowel
what is used to treat anemia in gastric cancer
- transfusion of packed RBC
describe prep for the bowel if gastric ca surgery involves the transverse colon and partial colon resection is required (3)
- low residue diet
- enemas
- use of ab to reduce intestinal bacteria
what is the surgical aim of treatment for gastric ca
- remove as much of the stomach as necessary to remove the tumour and a margin of normal tissue
what type of surgery can be done gastric cancer
- subtotal gastrectomy (Billroth 1 &2 = same as care discussed in PUD)
- total gastrectomy with esophagojejunostomy
what is a total gastrectomy with esophagojejunostomy
- removal of stomach
- with anastomosis of lower end of the esophagus to the jejenum
when is adjuvant therapy used for gastric ca
- if pt cannot physically withstand surery
- when surgical cure is not feasible
what adjuvant therapy is used w surgery
- chemo
- radiation
describe postop care for a subtotal gastrectomy for gastric ca
- similar to that with Billroth 1&2
describe postop care for a total gastrectomy with esophagojejunostomy (5)
- will have NG ( will have minimal drainage)
- will have chest tubes (bc enter thru chest wall)
- clear fluids initiated after several days, gradually work up to solid foods
- delayed postop wound healing (d/t poor nutrition)
- IV or oral replacement of vitamins
what is a pt at risk for post total gastrectomy (5)
- dumping syndrome
- postprandial hypoglycemia
- weight loss
- poor nutrition status
- vitamin deficiency
describe patient teaching after surgery for gastric cancer (3)
- same dietary measures as after PUD
- teach wound care
- teach abt comfort measures for pain & med regimen for analgesics
