Prepared by: Tan, Elaine Joy D.

BSN 4B

Esophageal Cancer
usually begins in the cells that line the inside of the esophagus.

can occur anywhere along the esophagus, but in people in the United States, it occurs most often in the lower portion of the esophagus.

More men than women get esophageal cancer. More common in Asia and parts of Africa.

Stages of Esophageal Cancer

Stage 0. Abnormal cells are found only in the inner layer of the esophagus. Stage I. This cancer occurs only in the top layer of cells lining your esophagus.

Stage II. The cancer has invaded deeper layers of your esophagus lining and may have spread to nearby lymph nodes. Stage III. The cancer has spread to the deepest layers of the wall of your esophagus and to nearby tissues or lymph nodes. Stage IV. The cancer has spread to other parts of your body.

Stages of Esophageal Cancer

Types of Esophageal Cancer

Adenocarcinoma of the esophagus: -this type is usually found in the lower part of the esophagus, near the stomach. In the United States, adenocarcinoma is the most common type of esophageal cancer.

Squamous cell carcinoma of the esophagus: -this type is usually found in the upper part of the esophagus. This type is becoming less common among Americans. Around the world, however, squamous cell carcinoma is the most common type.

 Age 65 and above More common in men than women Smoking Alcohol drinker Acid Reflux (that may lead to Barretts esophagus)

Risk Factors

Signs and Symptoms

Pain when swallowing Chest pain Weight loss Heart burn Hoarseness of voice

Diagnostics
Barium Swallow Endoscopy Biopsy

Barium Swallow test

Endoscopy

Biopsy

Treatment
o Surgery

Esophagectomy (removal of a portion of the esophagus)

Esophagogastrectomy (removal of a portion of your esophagus and stomach)

Esophagectomy & Esophagogastrectomy

o Chemotherapy o Radiation therapy

o Combined radiation and chemotherapy

Nursing Interventions
Provide emotional support. Keep the head of the bed elevated at least 30 degrees to prevent reflux and pulmonary aspiration.

Monitor the skin turgor and mucous membranes to detect dehydration.

If the patient is having problems swallowing saliva, keep a suction catheter with an oral suction at the bedside at all times.

When appropriate, discuss expected preoperative and postoperative procedures, including information about xrays, intravenous (IV) hydration, wound drains, NG tube and suctioning, and chest tubes. Immediately after surgery, implement strategies to prevent respiratory complications.

Kidney Cancer
cancer that originates in the kidneys. In adults, the most common type of kidney cancer is renal cell carcinoma. Young children are more likely to develop a kind of kidney cancer called Wilms' tumor.

Stages of Kidney Cancer

Stage I. At this stage, the tumor can be up to 2-3/4 inches (7 centimeters) in diameter. The tumor is confined to the kidney. Stage II. A stage II kidney cancer is larger than a stage I tumor, but is still confined to the kidney.

Stage III. At this stage, the tumor extends beyond the kidney to the surrounding tissue and may also have spread to a nearby lymph node.
Stage IV. Cancer spreads outside the kidney, to multiple lymph nodes or to distant parts of the body, such as the bones, brain, liver or lungs.

Stages of Kidney Cancer

Types of Kidney Cancer

Renal Cell Carcinoma - is a type of kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products.

Wilms Tumor - rare kidney cancer that primarily affects children. Also known as nephroblastoma, Wilms' tumor is the most common cancer of the kidneys in children. Wilms' tumor most often affects children ages 3 to 4 and becomes much less common after age 5. Wilms' tumor most often occurs in just one kidney, though it can sometimes be found in both kidneys.

Risk factors
Smoking Obesity High blood pressure Long term dialysis Occupation Gender (Male)

Signs and Symptoms

Hematuria Lump or mass on the affected side Pain Weight loss

Fever

Diagnostics
Physical exam Blood tests Urine tests Intravenous Pyelogram (IVP) CT Scan Ultrasound test Biopsy

Intravenous Pyelogram (IVP)

o Surgery (Nephrectomy) Radical Nephrectomy -removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area also may be removed.

Treatment

 Simple Nephrectomy - removes only the kidney. Some people with Stage I kidney cancer may have a simple nephrectomy. Partial Nephrectomy - removes only the part of the kidney that contains the tumor.

Radical Nephrectomy

Simple Nephrectomy

Partial Nephrectomy

o Arterial Embolization - type of local therapy that shrinks the tumor. Sometimes it is done before an operation to make surgery easier. When surgery is not possible, embolization may be used to help relieve the symptoms of kidney cancer.

o Biological Therapy - type of systemic therapy. It uses substances that travel through the bloodstream, reaching and affecting cells all over the body. Biological therapy uses the body's natural ability (immune system) to fight cancer.

o Chemotherapy o Radiation therapy

Nursing Interventions
Administer prescribed analgesics as needed by the patient. Prepare for indicated. nephrectomy as

Provide symptomatic treatment for adverse effects of chemotherapeutic drugs.

Monitor the patients degree of pain and assess the effectiveness of analgesics.
Stress the importance of compliance with any prescribed outpatient treatment. Encourage the patient to express his anxieties and fears and remain with him during periods of severe stress and anxiety.

Thank You & God Bless !!!