Cancer of Esophagus Cancer of Stomach Cancer of Liver Cancer of Pancreas

Definition Also known as Esophageal Also known as Gastric cancer- a It is the growth and spread of It is a disease in which malignant
cancer- a cancer that cancer that develops from the unhealthy cells in the liver. cancer cells form in the tissues of the
occurs in the esophagus. A lining of the stomach. Begins in the cell of the pancreas.
long, hollow tube that runs liver.the liver is a football- Begins in the tissue of the pancreas. It
from your throat to your sized organ that sits in the is an organ in the Abdomen that lies
stomach upper right portion of the behind the lower part of the stomach.
-usually begins in the cells abdomen, beneath the Pancreas releases enzymes that aid
that line inside of the diaphragm and above the digestion and produces hormones that
esophagus stomach.most common help manage your blood sugar. Most
Hepatocellular carcinoma common Pancreatic ductal
adenocarcinoma
-2nd most GI cancer and 4th leading
cause of death
Risk Factors -having gerd Nutritional factors (GERD) -Chronic infection with -smoking
-smoking Social (Smoking and HBV/HCV Cirrhosis -diabetes
-being obese Alcohol intake) -certain inherited liver -chronic inflammation of the pancreas
-diet Obesity disease -family history
-alcohol Environmental factors -diabetes -familial adenomatous polyposis
-(occupational and infectious -Excessive alcohol -obesity
diseases related factors) consumption -diet
Genetic and Medical factors -smoking -BRCA -2
-age 50—60 y.o -older age,after 65
-genetic
Sign and Symptoms -difficulty Difficulty or pain when swelling -Weight loss -abdominal pain that radiates at the
swallowing(dysphagia) Weight loss -Loss of appetite back
-weight loss Pain in the chest, behind the -Upper abdominal pain -jaundice
-chest pain, pressure or breastbone -Nausea and vomiting -light-colored stools
burning Coughing -General weakness and -dark-colored urine
-worsening indigestion or Hoarseness fatigue -itchy skin
heartburn Indigestion and heartburn -white, chalky stools -blood clots
-coughing or hoarseness -Jaundice -fatigue
-Abdominal swelling -weight loss
Prevention -quit smoking -Nutritional measures
-drink alcohol in (diets high in fiber, fruits &
moderation vegs., lower in red meat.
-eat more fruits and -Dietary measures
vegetables (proper preparation and storage
-maintain a healthy weight of food, limitation of foods that
-treat GERD are salted, smoked and grilled.
-Smoke cessation
-use of NSAID’s and eradication
of H.Pylori infections.
-Reduce risk of cirrhosis -stop smoking
-Get vaccinated against -maintain a healthy weight
hepatitis B. -choose a healthy diet.
-Take measures to prevent
hepatitis C by knowing the
health status of any sexual
partner, use a sterile needle
if doing IV.

Diagnosis -Endoscopy Examination of histopathology -Blood test -UTZ,CT scan, MRI, PET scans
-Biopsy of tissue obtained during -annual UTZ,CT scan,MRI,PET -Endoscopic Retrograde Cholangio-
-Bronchoscopy endoscopy or by assessment of scan. Pancreatography(ERCP)
-Endoscopic UTZ and gastric brushing or washing. -Serum AFP(greater than -FNA Biopsy
mediastinoscopy EGD- 400mcg/dl in the absence of -Intraoperative ultrasonography
esophagogastroduodenoscopy Hep) -Percutaneous transhepatic
-most sensitive and specific cholangiography
diagnostic test for gastric
cancer.
CT Scan-(chest, abdomen,
pelvis)
-to evaluate tumor extent,
nodal involvement and distant
metastasis.
-laparoscopy can be used in
combination with CT scan and
EUS for more accurate
assessment of serosal
infiltration, peritoneal seeding
and hepatic metastasis
PET-
Staging Stage0 Tis N0 M0 Stage 0 Tis N0 M0 Stage 1 T1 N0 M0 Stage 0 Tis N0 M0
Stage 1 T1 N0 M0 Stage 1A T1 N0 M0 Stage ll T2 N0 M0 Stage1A T1 N0 M0
 Stage llA T2 N0 M0 Stage 1B T1 N1 M0 Stage lllA T3a N0 M0 Stage 1B T2 N0 M0
T3 N0 M0 T2a N0 M0 Stage lllB T3b N0 M0 Stage llA T3 N0 M0
Stage llB T1 N1 M0 T2b N0 M0 Stage lllC T4 N0 M0 Stage llB T1-3 N1 M0
T2 N1 M0 Stage ll T1 N2 M0 Stage lVA Any T N1 M0 Stage lll T4 Any N M0
Stage lll T3 N1 M0 T2a N1 M0 Stage lVB Any T N1 M0 Stage Lv Any T Any N M1
T4 Any N M0 T2b N1 M0 Stage lVC Any T Any N M1
Stage lV Any T Any N M1 T3 N0 M0
Stage lllA T2a N2 M0
T2b N2 M0
T3 N1 M0
T4 N0 M0
Stage lllB T3 N2 M0
Stage lV T4 N1-3 M0
T1-3 N3 M0
Any T Any N M1

Tumor Marker CEA and CA 19-9, CA 125 CEA, CA 19-9 and CA 72-4 Alpha- Fetoprotein CA 19-9 & CEA
Surgery -esophagectomy EMR(Endoscopic Mucosal -Lobectomy -Pancreaticoduodenectomy
-esophagogastrectomy Resection) -Liver transplant -Partial Pancreatectomy
-gastronomy with local excision -Total Hepatotectomy
and gastrectomy. -Cryosurgery
-Gastroduodenostomy (billroth
I)
-Gastrojejunostomy (billroth ll)
Radiation Therapy Primary treatment for -can be used as adjuvant or neo -External Beam Radiation Intraoperative Radiation Therapy
clients with obstructing adjuvant (2500-3000cGy) (IORT)
tumor: intraluminal -used intraperatively for stage2- -Intravenous or Intraarterial RT+5FU or Gemcitabine
brachytherapy 4 injection of antibodies with
radioactive isotopes.
Nursing cae: health
teaching about
bleeding/dysphagia,
esophagitis, fatigue
Chemotherapy Agents commonly used: Current standard use: 5FU and Floxuridin (FUDR), 5FU 5FU
5FU, cisplatin, Cisplatin Doxorubicin, Cisplatin, Gemcitabine
Menthotrexate, Paclitaxel, Mitomycin C Cisplatin
Mitomycin, Vindesine