Oesophagogastric Cancer Flashcards
Are males of females more likely to get oesophageal cancer?
Males
What are the 2 types of oesophageal cancer?
Squamous cell carcinoma (SCC) and adenocarcinoma (AC)
Where is squamous cell carcinoma most commonly seen?
Seen in the eastern world and developing countired
Where is adenocarcinoma most commonly seen?
Seen in the western world - incidence has markedly increased especially in caucasians
At what age does the incidence of oesophageal cancer in the UK increase?
From the age of 35
What are some risk factors for adenocarcinoma?
Males Obesity Smoking Diet low in fruit and veg GORD
Describe the pathology/evolution of Barrett’s and cancer?
Squamous oesophagus Chronic inflammation Barretts metaplasia Low grade dysplasia High grade dysplasia Invasive adenocarcinoma
How would you diagnose oesophageal cancer?
New onset dysphagia >55y - endoscopy
Mucosal abnormality mandates at least 6 biopsies
Once carcinoma diagnosed patient must be staged
How would you go about staging oesophageal cancer?
CT chest, abdo and pelvis
PET-CT
Endoscopic ultrasound
Describe TNM staging?
T refers to how far the primary tumor has grown into the wall of the esophagus and into nearby organs.
N refers to cancer spread to nearby lymph nodes.
M indicates whether the cancer has metastasized (spread to distant organs)
How can you treat squamous cell carcinoma?
Localised SSC treated with radical chemoradiotherapy
No surgery
How might you treat adenocarcinoma?
If no metasteses then could surgically resect
Chemo
What is the most common cause of gastric cancer?
Most common cause is H.Pylori
How is gastric cancer diagnosed?
Endoscopy
How could you treat gastric cancer?
if no metastases then you could perform surgery with curative intent
Chemo - poor results
