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Esophageal Cancer PowerPoint Presentation

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Slide 1 - Esophageal Cancer By: Lindsay Rupert
Slide 2 - Description of patient Name: Nick Seyer Age: 58 Ht: 6’3” Current wt: 198 lbs. Usual body weight: 230 lbs. Chief complaint: heartburn for “a long time” and problems swallowing during the past 4 or 5 months. Occasionally food seems to “hang up” in his throat. He points to the upper portion of his neck, directly beneath his chin.
Slide 3 - Assessment Nick Seyer Age 54, 198 lbs., 6’3” BMI=24.9 kg/m2 Percent UBW= 198 /230 x 100 = 83% Family hx: Liver cancer, mother-died age 58 Smoker: Yes Drinker: 1-2 beers daily Low lab values: albumin, prealbumin, total protein
Slide 4 - Patient: Nick Seyer On set of disease: Dysphagia x 3-4 months; odynophagia x 5-6 months Takes these meds: TUMS, Alka-Seltzer, and Pepcid Has sunken eyes, dry mucous membranes, no inflammation Some signs of muscle wasting. No edema. Lungs: clear Abdomen: tenderness
Slide 5 - 24-hour recall AM: 1 packet of instant oatmeal; sips coffee Lunch: 6 oz. tomato soup with 2-4 crackers Dinner: Macaroni and cheese-homemade ½ c. Bedtime: 1 scoop of chocolate ice cream Not vit./mineral intake
Slide 6 - Diagnosis Diagnosed with Stage IIB (T1, N1, MO) adenocarcinoma of the esophagus These stages identify how severe a person’s disease is and how far along the disease has progressed. T1 indicates: Tumor invades lamina propria submucosa. It is only in the lining of the esophagus. N1 indicates: Cancer has extended to nearby lymph nodes. MO indicates: No distant metastasis.
Slide 7 - Adenocarcinoma of the Esophagus Primarily appears in the lower esophagus and an important predisposing factor is the “Barrett’s Esophagus.” There is a malignant tumor originating in the epithelial cells of glandular tissue. Factors that contribute to this: smoking, drinking, a diet low in fruits/vegetables, and a family history.
Slide 8 - Diagnosis Inadequate caloric intake related to esophageal cancer as evidenced by 24-hour recall. Inadequate protein intake related to esophageal cancer as evidenced by muscle wasting, and loss of weight. Pt. receives transhiatal esophagectomy Used to treat pts. with malignant esophageal cancers. This reconstructive surgery is done through the abdomen and neck. An incision is made on the abdominal wall and a small incision is placed in the left of the neck. Newly shaped stomach will function as the esophagus used to.
Slide 9 - Energy needs Energy needs: 2,700 kcal/day to gain weight. Protein needs: 135 grams, or 540 kcal/day. Fluid needs: 2,700 cc.
Slide 10 - Enteral nutrition therapy Receiving Isosource HN at 75 mL/hr. Energy: 2,700 kcal/day 1,800 mL/day Protein: 90 g. protein/day
Slide 11 - Intervention Goals and Intervention: Increase calories and protein to adequate levels each day. Provide Mr. Seyer’s with a list of foods that are high in calories and protein. Encourage him to keep eating. Make him as comfortable as possible as cancer progresses.
Slide 12 - Terminal illness An illness that is active and malignant; it cannot be cured. Patient experiencing many different emotions: Anger Denial Depression Acceptance These factors influence his eating patterns.
Slide 13 - Nutrition Support/Therapy Increase calories and protein. Pt. will receive radiation therapy as an outpatient. Side effects of radiation therapy: Dehydration Mucositis Xerostomia Odynophagia Altered taste perceptions Dysphagia Diarrhea Nausea
Slide 14 - Monitoring/Evaluation Monitor and evaluate patient’s: Weight Calories delivered via feeding tube Hydration status Ability to swallow Output status
Slide 15 - References A Prospective Study of Major Dietary Patterns and the Risk of Cancer. (2001). Cancer epidemiology, biomarkers & prevention, 10(12), 26-34.  Beckles, M. A., Spiro, S. G., Colice, G. L., & Rudd, R. M. (2003, January). Initial Evaluation of the Patient With Lung Cancer. Chest, 123(1), 975-1045.    Cancer of the esophagus information. (2011). Retrieved April 2, 2011, from Cancer of the Esophagus website: http://www.canceroftheesophagus.info/  Heymsfield, S. B., & McManus, C. B. (2006). Tissue components of weight loss in cancer patients. A new method of study and preliminary observations.  Isosource 1.5 CAL. (2011). Retrieved April 4, 2011, from Nestle Nutrition website: http://www.nestlenutrition.com  Lab Tests. (2011, March 22). Retrieved April 2, 2011, from American Association for ClinicalChemistry website: http://www.labtestsonline.org  Nelms, M., Sucher, K., Lacey, K., & Roth, S. L. (2011). Nutrition Therapy and Pathophysiology (2nd ed.). New York City: Brooks/Cole.  Nutrition Implications of Cancer Therapies. (2011). Retrieved April 4, 2011, from National Cancer Institute website: http://www.cancer.gov/   Orringer, M. B., Marshall, B., & Iannettoni, M. D. (1999). Transhiatal Esophagectomy: Clinical Experience and Refinements. General thoracic surgery, 3(391), 230.   Terminal illness. (2010, November 5). Retrieved April 2, 2011, from Mayo Foundation for Medical Education and Research website: http://www.mayoclinic.com
Slide 16 - Questions? Thank you for your time!