Oesophageal Cancer Flashcards
what is oesophageal cancer
The two main histological types are squamous cell carcinoma and adenocarcinoma
they are usually mucosal lesions
what is the more common type of oesophageal cancer
squamous cell carcinoma
-usually seen in the top 2/3rd of the oesophagus
where can adenocarcinomas be seen
lower third of the oesophagus
what are adenocarcinomas associated with
GORD and obesity
what does recurrent reflux cause
metaplastic formations of mucin-producing glandular tissue - BARRETS OESOPHAGUS
this can develop into neoplasia
what are the risk factors for oesophageal carcinoma
SMOKING
high alcohol intake
achalasia
Zenker diverticulum
oesophageal web
high intake of hot beverages
increased dietary intake of nitrosamines
how does oesophageal carcinoma present
progressive dysphagia from solids to liquids
how does oesophageal carcinoma differ from motility disorders
they usually present with dysphagia of solids and liquids from the start
other presenting symptoms of oesophageal carcinoma
Weight loss is the second most common symptom, due to a combination of anorexia and dysphagia.
Regurgitation
Cough
Choking after food
Voice hoarseness - local pharyngeal nerve
Odynophagia (painful swallowing)
Weight loss
Fatigue (due to iron deficiency anaemia)
why does dysphagia occur in oesophageal cancer
Dysphagia only really occurs when there is obstruction of more than two-thirds of the lumen. Hence, patients often present late. Patients may also have pain on swallowing (odynophagia)
what are some signs of metastatic disease
Supraclavicular lymphadenopathy
Hepatomegaly
Hoarseness
Signs of bronchopulmonary involvement
what investigations will be done for suspected oesophageal carcinoma
endoscopy- biopsy
oesophagogastroduodenoscopy
imaging- barium swallow and CXR
staging - CT chest and abdomen
how to treat oesophageal carcinoma
oesophagectomy
chemotherapy
prognosis
Oesophageal cancer remains one of the most lethal of all malignancies. Without aggressive treatment, the cancer tends to obstruct the oesophagus and cause severe dysphagia. In addition to local progression causing pain, the disease tends to metastasise widely to the lungs, liver, and bone.
