1 Esophageal Cancer

2 Y One of the most lethal tumors Y Starts at the lining and spreads outward Y Squamous cell carcinoma Y Adenocarcinoma

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4 Esophageal Cancer Y United States: 4 per 100,000 males Y Twice as high in males as in females Y Northern China: 130 per 100,000 males

5 Risk Factors Y Tobacco use Y Heavy alcohol use Y Older age Y Being male Y Being African-American Y Having Barrett’s esophagus

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7 Symptoms Y Early stages often has no symptoms Y Painful or difficult swallowing Y Weight loss Y Pain behind the breastbone Y Hoarseness and cough Y Indigestion and heartburn

8 Tests Y Chest x-ray Y Barium swallow ›Esophagram Y Esophagoscopy Y Biopsy

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11 Treatment/Prognosis Y Depend on ›stage of cancer ›size of tumor ›patient’s general health Y When found very early, better chance of recovery Y Often in advanced stage at diagnosis

12 Staging Process Y Bronchoscopy Y Chest x-ray Y Laryngoscopy Y CT scan Y Thoracoscopy Y Laparoscopy Y PET scan

13 Treatment Y Surgery Y Chemotherapy plus radiation therapy with or without surgery Y External or internal radiation as palliative therapy

14 Untreated Heartburn Y Esophagitis Y Esophageal bleeding & ulcers Y Barrett’s esophagus Y Strictures Y Esophageal cancer

15 Barrett’s Esophagus Y Can lead to cancer!! Y People with regular or daily heartburn for more than 5 years may be at risk Y Endoscopy Y Proton pump inhibitor medications ›Nexium Protonix Prevacid ›Prilosec Aciphex

16 Barrett’s Esophagus Because of the cancer risk, people Because of the cancer risk, people with Barrett’s esophagus are with Barrett’s esophagus are surveyed for esophageal cancer surveyed for esophageal cancer regularly regularly

17 Strictures Damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus Damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus

18 Hiatal Hernia Y A portion of the stomach pushes thru a tear-shaped hole where the esophagus and stomach join Y Most common cause is an increase pressure on the abdominal cavity

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20 Symptoms of Hiatal Hernia Y None Y Heartburn Y Bitter or sour taste in back of the throat Y Bloating and belching Y Discomfort or pain in stomach or esophagus Y Vomiting

21 Lifestyle Changes Y Weight Y Portion size Y Wait 3 to 4 hours before lying down Y Elevate head of bed by 6 inches Y No smoking Y Over-the-counter medications

22 Foods to Avoid Y Onions Y Chocolate Y Peppermint Y High-fat foods Y Alcohol Y Caffeinated beverages and foods ›coffee, tea, colas, chocolate