Michael K GibsonMD and Arlene A ForastiereMD

Treatment of esophageal cancer (EC) remains a challenging endeavor that is best approached by a multidisciplinary team. Furthermore, significant controversy exists regarding the standard of care for this group of complex patients. Although this aggressive cancer remains difficult to treat and even more difficult to cure, recent advances in screening, diagnosis, treatment, and supportive care are resulting in progress (Polednak, 2003). The goal of this chapter is to provide up-to-date and concise guidance to the health care providers working together to better the outlook for patients with EC. After a brief review of epidemiology, the primary focus will be on treatment, be it with palliative or curative intent. Although supportive care is an integral part of treatment, another full chapter in this text is devoted to palliative care (see Chapter 22, "Palliation of Esophageal Cancer").

The chapter will be presented in the same sequential manner that clinicians use when they approach a referred patient who is already diagnosed. A review of initial broad considerations will be followed by more detailed discussions of staging—with particular emphasis on categorizing patients as either curable or not. Specifics of treatment will be stratified by the presenting stage, with the majority of discussion involving the controversial area of locally advanced (curable) disease. The chapter concludes with a few words about follow-up and recurrent disease.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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