Saturday, January 14, 2006

cancer, esophageal

Carcinoma is the most common cause of obstruction of the esophagus in the elderly. Symptoms develop very slowly. By the time difficulty in swallowing (dysphagia) is noticeable the cancer may have invaded surrounding tissues and lymphatics. Prognosis is generally poor. In the beginning, symptoms may be mild with only vague feelings of discomfort and difficulty in swallowing. As the disease progresses, solid foods become almost impossible to swallow and the patient resorts to a liquid diet. Weight loss occurs with progressive dysphagia.
Treatment of cancer of the esophagus depends on the extent of the lesion and evidence of metastasis. Radiation is used for inoperable lesions but, if possible, surgical resection of the esophagus is performed. If the patient is too ill to withstand surgery, a gastrostomy may be performed, permitting food to be introduced directly into the stomach through an opening in the abdomen. Sometimes this will be a temporary measure used until the patient's nutritional status has improved enough to permit surgery. Gastrostomy is a relatively minor procedure and can be performed even if the patient is very weak.
Scherer, J. C. Introductory Medical-Surgical Nursing, 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.

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