Barrett's esophagus (BE), a common condition, is the only known precursor to esophageal adenocarcinoma (EAC). There is uncertainty about the best way to manage BE as most people with BE never develop ...EAC and most patients diagnosed with EAC have no preceding diagnosis of BE. Moreover, there have been recent advances in knowledge and practice about the management of BE and early EAC. To aid clinical decision making in this rapidly moving field, Cancer Council Australia convened an expert working party to identify pertinent clinical questions. The questions covered a wide range of topics including endoscopic and histological definitions of BE and early EAC; prevalence, incidence, natural history, and risk factors for BE; and methods for managing BE and early EAC. The latter considered modification of lifestyle factors; screening and surveillance strategies; and medical, endoscopic, and surgical interventions. To answer each question, the working party systematically reviewed the literature and developed a set of recommendations through consensus. Evidence underpinning each recommendation was rated according to quality and applicability.
This article is co-authored by a patient with oesophageal adenocarcinoma and his physician, who performed oesophagectomy. The patient relates his pre-operative preparation and post-operative ...experience. The physician comments on the alarming increase in the incidence of this cancer, risk factors, and treatment. As illustrated by the patient’s report, the physician also discusses the importance of maintaining adequate nutrition, cardiorespiratory fitness, and a positive psychological attitude.
Abstract
B
arrett's esophagus (
BE
), a common condition, is the only known precursor to esophageal adenocarcinoma (
EAC
). There is uncertainty about the best way to manage
BE
as most people with
BE
...never develop
EAC
and most patients diagnosed with
EAC
have no preceding diagnosis of
BE
. Moreover, there have been recent advances in knowledge and practice about the management of
BE
and early
EAC
. To aid clinical decision making in this rapidly moving field,
C
ancer
C
ouncil
A
ustralia convened an expert working party to identify pertinent clinical questions. The questions covered a wide range of topics including endoscopic and histological definitions of
BE
and early
EAC
; prevalence, incidence, natural history, and risk factors for
BE
; and methods for managing
BE
and early
EAC
. The latter considered modification of lifestyle factors; screening and surveillance strategies; and medical, endoscopic, and surgical interventions. To answer each question, the working party systematically reviewed the literature and developed a set of recommendations through consensus. Evidence underpinning each recommendation was rated according to quality and applicability.
Advanced nursing practice has developed in the UK since the late 1980s and there is a growing number of these nurses in various healthcare settings - so far, however, none is employed directly by a ...care home. In 2017, the Scottish veterans' charity Erskine appointed an advanced nursing practitioner (ANP) for two of its care homes. The ANP works in partnership with the homes' nurses and the local GP practice, treating and assessing some without GP input. The model is that of shared care, with GPs focusing on their role as expert generalists. Having an ANP on site speeds up residents' assessment and treatment. This article describes the initiative, its aims, processes and outcomes so far.
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