Master in medical and surgical nursing Esophagus cancer Presented by Qassim j. oddaa Master in medical and surgical nursing

Esophageal cancer  is cancer arising from the esophagus - the food pipe that runs between the throat and the stomach. The main Symptoms often include difficulty in swallowing and weight loss

The two main sub-types of the esophagus cancer are 1-Esophageal squamous-cell carcinoma (ESCC) more common in the developing world, Squamous-cell carcinoma arises from the epithelial cells that line the esophagus. Causes of the squamous-cell type include tobacco, alcohol, very hot drinks, poor diet, and chewing

The two main sub-types of the esophagus cancer are Esophageal adenocarcinoma (EAC) less common types also occur arises from glandular cells present in the lower third of the esophagus, . The most common causes of the adenocarcinoma type are smoking tobacco, obesity, and acid reflux

Sings and symptoms Narrowing of the esophagus due to the physical presence of the tumor Difficulty in swallowing Pain when swallowing   Weight loss  Reduced appetite and malnutrition   Pain behind the breastbone 

Signs and symptoms Nausea and vomiting Regurgitation of food and coughing. Vomiting of blood. Upper airway obstruction  pain region around the stomach  Feels heartburn. Hoarse-sounding

Causes of esophagus cancer Poor oral hygiene Tobacco (smoking or chewing) and alcohol. Chewing betel nut (areca) is an important risk factor in Asia. Physical trauma may increase the risk include the drinking of very hot drinks. obesity. The long-term erosive effects of acid reflux as gastroesophageal reflux disease or GERD Chronicesophagus  inflammatory  Helicobacter pylori   gastric cancer

Diagnosis test of esophagus  barium swallow or barium meal, the diagnosis is best made with an examination using an endoscope. This involves the passing of a flexible tube with a light and camera down the esophagus and examining the wall, and is called an esophagogastroduodenoscopy.  Biopsies taken of suspicious lesions are then examined histologically for signs of malignancy.

Diagnosis Computed tomography (CT) of the chest, abdomen and pelvis can evaluate whether the cancer has spread to adjacent tissues or distant organs (especially liver and lymph nodes).

Stage of esophagus cancer Any stage of cancer classify according T.N.M which include T: Tumore invasion N:Lymph node M: distant metastasis Stage one – cancer only in esophagus not metastasis to other part involve out layer Stage two – cancer not metastasis to other part but involve out, middle and inter layer Stage three – cancer metastasis to lymph node Stage four – cancer metastasis to lymph node and near parts such as stomach

Treatment of esophagus cancer 1- Surgery Esophagectomy is the removal of a segment of the esophagus; as this shortens the length of the remaining esophagus, some other segment of the digestive tract is pulled up through the chest cavity and interposed.

Treatment of esophagus cancer 2- Chemotherapy and radiotherapy Chemotherapy depends on the tumor type, giving every three weeks Radiotherapy is given before, during, or after chemotherapy or surgery, and sometimes on its own to control symptoms. In patients with localised disease but contraindications to surgery,

Treatment of esophagus cancer Laser therapy is the use of high-intensity light to destroy tumor cells while affecting only the treated area. This is typically done if the cancer cannot be removed by surgery. The relief of a blockage can help with pain and difficulty swallowing. 4- Photodynamic therapy, a type of laser therapy, involves the use of drugs that are absorbed by cancer cells; when exposed to a special light, the drugs become active and destroy the cancer cells.

Complication of esophagus cancer Aspiration pneumonia Pleural effusion Airway obstruction Death Metastasis to stomach

Typhoid fever also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms. Symptoms may vary from mild to severe and usually begin six to thirty days after exposure. Often there is a gradual onset of a high fever over several days.

Clinical feature Fever bradycardia malaise headache cough A bloody nose (epistaxis) Abdominal pain Delirium  Rose spots appear on the lower chest and abdomen

Diagnosis of typhoid fever Blood test  Bone marrow aspiration    Stool cultures  Widal test (demonstration of antibodies against Salmonella antigens )

Treatment of typhoid fever Treatment underlying causes such as fever and loss appetite Keep taking the prescribed antibiotics for as long period Wash the hands carefully with soap and water after using the bathroom, and do not prepare or serve food for other people. Perform a series of stool cultures to ensure that no Salmonella Typhi bacteria remain in the body.

Complications of typhoid fever Hepatosplenomegaly Intestinal haemorrhage  peritonitis . Encephalitis Respiratory diseases such as pneumonia and acute bronchitis Cholecystitis, endocarditis, and osteitis Dehydration