disease slide

1. By : Asifa Bukhari
Program Coordinator PRN –SWCON
Mph, B.ScN, RM, RN

2.  What Are the Symptoms of Esophageal
Cancer?
 What Are Risk Factors for Esophageal Cancer?
How Is Esophageal Cancer Diagnosed?
 What Are the Stages of Esophageal Cancer?
 How Is Esophageal Cancer Treated?

3.  Esophageal cancer occurs when cancer cells
develop in the esophagus.
 cancer starts at the inner layer of the
esophagus and can spread throughout the
other layers of the esophagus and to other
parts of the body (metastasis).

4.  There are two main types of esophageal
cancer.
1. One type is squamous cell carcinoma
Squamous cells line the inner esophagus,
2. The other type is called adenocarcinoma,
This is cancer that develops from gland cells.
Adenocarcinoma of the esophagus, squamous
cells that normally line the esophagus are
replaced by gland cells.

5.  Difficulty or pain when swallowing
 Weight loss
 Pain in the chest, behind the breastbone
 Coughing
 Hoarseness
 Indigestion and heartburn

6. There are a number of factors Which include:
 Smoking or other use of tobacco
 Heavy alcohol use
 Gastro esophageal reflux disease (GERD),
Barrett's esophagus

7.  Barium swallow X-ray,
 Endoscopy
 Endoscopic ultrasound
 Biopsy
 Computed tomography (CT) scans,
 Positron emission tomography (PET) scan,
 Thoracoscopy and laparoscopy, may be
performed to determine if the cancer has
spread,

8.  The stages of esophageal cancer are given a number (I through IV)
 Stage 0 . Abnormal cells (not yet cancer) are found only in the
layer of cells that line the esophagus.
 Stage I . Cancer cells are found only in the layer of cells that line
the esophagus.
 Stage II . The cancer has reached the muscle layer or the outer
wall of the esophagus. In addition, the cancer may have spread to
1 to 2 nearby lymph nodes (small glands that are part of the
immune system).
 Stage III . The cancer has reached deeper into the inner muscle
layer or the connective tissue wall. It may have spread beyond the
esophagus into surrounding organ and/or has spread to more
lymph nodes near the esophagus.
 Stage IV . This is the most advanced stage. The cancer has spread
to other organs in the body and/or to lymph nodes far from the
esophagus.

9.  What treatments you receive for esophageal
cancer are based on the type of cells involved
in your cancer, your cancer's stage, your
overall health and your preferences for
treatment.

10.  Surgery to remove the cancer can be used
alone or in combination with other
treatments.
 Surgery to remove very small tumors. If your
cancer is very small, confined to the
superficial layers of your esophagus and
hasn't spread,

11.  surgery to remove a portion of the
esophagus (esophagectomy). During
esophagectomy, the surgeon removes the
portion of your esophagus that contains the
cancer,
 Surgery to remove part of your esophagus
and the upper portion of your stomach
(esophagogastrectomy). During
esophagogastrectomy, the surgeon removes
part of your esophagus, nearby lymph nodes
and a larger part of your stomach.

12.  Esophageal cancer surgery carries a risk of
serious complications, such as infection,
bleeding and leakage from the area where the
remaining esophagus is reattached to the
stomach. esophageal obstruction and
difficulty swallowing (dysphagia) can include:
 Treatments for complications
 Relieving esophageal obstruction.
 Providing nutrition.

13.  Chemotherapy (Chemotherapy is drug treatment that
uses chemicals to kill cancer cells.)
 Radiation therapy (Radiation therapy uses high-
energy beams, such as X-rays and protons, to kill
cancer cell)
 Combined chemotherapy and radiation (Combining
chemotherapy and radiation therapy may enhance the
effectiveness of each treatment.)
 Targeted drug therapy(targeted drug treatments can
cause cancer cells to die.)
 Immunotherapy (immunotherapy is a drug treatment
that helps your immune system to fight cancer)

15.  Colorectal cancer, also known as bowel
cancer, colon cancer, or rectal cancer, is any
cancer that affects the colon and the rectum.

16.  It is not clear exactly why colorectal cancer
develops in some people and not in others.

17. family history of colorectal cancer
older age
high animal protein, saturated fats, diet and calories
low in fiber diet
high alcohol consumption
having had breast, ovary, or uterine cancer
having ulcerative colitis,
Crohn’s disease
irritable bowel disease (IBD)
Obesity
smoking
lack of physical activity
polyps in the colon or rectum
Most colon cancers develop within polyps (adenoma)

18.  changes in bowel habits
 Diarrhea or constipation
 bowel does not empty properly after a bowel
movement
 blood in feces
 stools look black
 bright red blood coming from the rectum
 Abdomen pain bloating
 feeling of fullness in the abdomen
 Fatigue or tiredness
 unexplained weight loss
 unexplained iron deficiency in men,
 or in women after menopause

20.  Stage 0: This is the earliest stage, when the cancer is still
within the mucosa, or inner layer, of the colon or rectum. It
is also called carcinoma
 Stage 1: grown through the inner layer of the colon or
rectum but has not yet spread beyond the wall of the
rectum or colon.
 Stage 2: grown through or into the wall of the colon or
rectum, but it has not yet reached the nearby lymph nodes.
 Stage 3: invaded the nearby lymph nodes, but it has not
yet affected other parts of the body.
 Stage 4: The cancer has spread to other parts of the body,
including other organs, such as the liver, the membrane
lining the abdominal cavity, the lung, or the ovaries.
 Recurrent: The cancer has returned after treatment. It
may come back and affect the rectum, colon, or another
part of the body.

21. The stage of a cancer defines how far it has
spread. Determining the stage helps chose the
most appropriate treatment.
In 40 percent of cases, diagnosis occurs at an
advanced stage, when surgery is likely the best
option.

22.  Fecal occult blood test (blood stool test)
 Stool DNA test
 Flexible sigmoidoscopy
 Barium enema X-ray
 Colonoscopy
 CT colonography
 Imaging scans(Ultrasound or MRI scans )

23.  Treatment will depend on several factors,
including the size, location, and stage of the
cancer, Treatment options include
chemotherapy, radiotherapy and surgery.

24.  Chemotherapy involves using a medicine or
chemical to destroy the cancerous cells. It is
commonly used for colon cancer treatment.
Before surgery, it may help shrink the tumor.
 Drugs that may be used for colorectal cancer
include
 Bevacizumab (Avastin) and
 Ramucirumab (Cyramza).

25.  Radiation therapy uses high energy radiation
beams to destroy the cancer cells and to. It
may be used before surgery in an attempt to
shrink the tumor.
 Both radiation therapy and chemotherapy
may be given after surgery to help lower the
chances of recurrence.

26.  This is the most common treatment. The affected
malignant tumors and any nearby lymph nodes
will be removed, to reduce the risk of the cancer
spreading.
 The bowel is usually sewn back together, but
sometimes the rectum is removed completely
and a colostomy bag is attached for drainage.
The colostomy bag collects stools. This is usually
a temporary measure, but it may be permanent if
it is not possible to join up the ends of the
bowel.
 If the cancer is diagnosed early enough, surgery
may successfully remove it. If surgery does not
stop the cancer, it will ease the symptoms.

27.  Regular screenings:
 People who have had colorectal cancer before,
 who are over 50 years of age,
 who have a family history of this type of cancer,
 or who have Crohn’s disease,
 Nutrition: Follow a diet with plenty of fiber, fruit,
vegetables, and good quality carbohydrates, good quality
fats, such as avocado, olive oil, fish oils, and nuts.
 minimum of red and processed meats. saturated fats
 Exercise: Moderate, regular exercise has been lowering a
person’s risk of developing colorectal cancer.
 Bodyweight: Being overweight or obese raises the risk of
many cancers, including colorectal cancer.