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GASTRIC CARCINOMA PowerPoint Presentation

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Description : Check out this medical presentation on Hereditary Diffuse Gastric Cancer, which is titled "GASTRIC CARCINOMA", to know about stomach cancer, also known as gastric cancer.

Tags : Hereditary Diffuse Gastric Cancer, Gastric Carcinoma, stomach cancer, gastric cancer, gastric adenocarcinomas

Published on : May 18, 2021 | Views : 3954 | Downloads : 10

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Slide 1-

GASTRIC CARCINOMA
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Pathophysiology Adenocarcinoma characterized as intestinal or diffuse Spreads through stomach into the gastric wall to the Lymph nodes Liver Pancreas Transverse colon Omentum Peritoneum Ovaries Pelvic cul-de-sac Through portal vein into lungs, liver, and bone Advanced stage: stomach muscle
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Etiology H. pylori: 80 percent of gastric carcinomas result from H. pylori due to the result of free radicals Dietary nitrates (bacteria in stomach breaks down nitrites to compounds that are carcinogenic in animals) Hypochlorhydria: occurs in gastric atrophy and promotes bacterial growth in stomach Foods such as starch, pickled vegetables, salted fish and meat, smoked foods and salt People who smoke cigarettes or use alcohol are 3-5 times more likely
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Etiology cont. Epstein-Barr virus is now implicated as a cause Pernicious anemia Chronic atrophic gastritis Gastric polyp Achlorhydria Barrett’s esophagus Having had a Billroth 2 procedure Genetic factors include: First degree relatives Type A blood
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Incidence/Prevalence 3rd most common GI malignancy (after colorectal and pancreatic) 14th cause of cancer related death in U.S. 85-95% are caused by adenocarcinoma 15% are caused by Non-Hodgkin’s lymphoma & leiomysosarcomas
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Anatomy of the stomach
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location 37% in the proximal third of the stomach 30% in the distal stomach 20% in the midsection Remaining 13% in the entire stomach
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Onset Insidious (slowly developing) Usually discovered in advanced stages Men>Women Occurs between the ages of 50-70 Increased mortality in Japanese Costa Ricans Chileans Native Americans African Americans Scandinavians
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Assessment History: High risk foods Alcohol/tobacco use Treated for H. Pylori infection Gastritis, pernicious anemia, gastric surgery, polyps Immediate family dx gastric cancer Blood type
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Physical Assessment Early gastric cancer Indigestion Abdominal discomfort initially relieved with antacids Feeling of fullness Epigastric, back, or retrosternal pain NOTE: most people will show no clinical manifestations
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Physical Assessment cont. Advanced stage: Nausea/vomiting Obstructive symptoms Iron deficiency/anemia Palpable epigastric mass Enlarged lymph nodes Weakness/fatigue Progressive weight loss
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Labs Decreased hematocrit and hemoglobin Macrocytic or microcytic anemia (decreased vit.B12 and iron absorption) Stool positive for occult blood In Advanced stages: Hypoalbuminemia Bilirubin and alkaline phosphate will be abnormal Increased level of carcinoembryonic antigen
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Radiographic assessment Double contrast upper GI series C.T. Esophagogastroduodenoscopy (EGD) Endoscopic ultrasound (EUS) Other findings include Polypoid mass Ulcer crater Thickened fibrotic gastric wall
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Interventions Meds: chemotherapy Fluruorouracil (5-FU) Doxorubicin Mitomycin-C Cisplatin Etopide (best results when used in combination with each other) Side Effects include nausea/vomiting and bone marrow suppression
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Interventions cont. Radiation Used most commonly for pre-op Used in specific hospitals for intra-op Does not increase survival after operations Side Effects include skin integrity, fatigue, anorexia, and diarrhea
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Surgical Interventions Surgery is the preferred method of treatment Curative: Total gastrectomy Subtotal gastrectomy Palliative: To relieve patients pain and ease their suffering
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Nursing Interventions Teach: s/s of dumping syndrome Eat small, frequent meals No liquids with meals (one hour before or after) Increase protein, fat, and caloric intake Decrease carbohydrates Increase Iron, Vit B12, and folate Dressing changes Side effects of chemo/radiation Always provide emotional support
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Gastric Carcinoma
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Questions? True or False: Lab findings have shown stool positive for occult blood, decreased hematocrit and hemoglobin, and hypoalbuminemia in patients with gastric carcinoma True or False: Most people will show many signs and symptoms indicating gastric cancer True or False: People who have had gastritis are at a higher risk of developing gastric ca.
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Grading Criteria Joint effort by Elaine M. Lund and Monique Kolin