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Admitting Diagnosis Ca of the DuodenumW F is divorced and lives alone in a private dwelling He has worked as a city bus driver for the past 10 yrs and plans to return to his job when he is able W F also works part time as a carpenter with a friend doing custom carpentry after his day job endsW F received support by regular visits from his girlfriend and family located in the city Other family members live elsewhere but were in contact with himW F was a packday smoker for approximately 30 yrs and is currently trying to quit he also usually has 2 beer or glasses of wineday after work with supper WF has had an appendectomy as well as nasal surgery 1991 to correct his snoring difficultiesIn the summer of 1995 W F experienced heartburn epigastric pain and was diagnosed Dx with having an active duodenal ulcer and treated with Histamine H2 receptor blocking agent Ranitidine to reduce gastric acidity and alleviate the ulcer The symptoms eased but persisted so in August 1996 the Dr booked WF for a gastroscopy and a biopsy was taken from the lesion At this time a Dx of Adenocarcinoma moderately differentiated was madeThe occurrence rate of cancer of the small intestine in Canada is approximately 17100000 Adenocarcinoma of the small intestine is said to form less than one percent of all intestinal carcinomas but is the most common small intestinal malignancy 1 Epidemiological studies have shown that there are many different possible causative agents for the development of cancer They include viruses a wide variety of chemicals both ionizing and ultraviolet radiation and even inherited forms of tumors such as retinoblastoma 1 The common element amongst all the causative factors is that they cause damage to or alteration of the DNA in the cells leading to improper reproduction of the genetic information in the next cell generation 1Most normal cells are differentiated a
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