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Clinical Alimentary System > 1.3. Oesophageal Disease - Oesophageal Cancer > Flashcards

1.3. Oesophageal Disease - Oesophageal Cancer Flashcards

1
Q

What are the 2 Types of Oesophageal Cancer?

A
  1. Squamous Cell Carcinoma

2. Adenocarcinoma

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2
Q

Which part of the Oesophagus is Squamous Cell Carcinoma found?

A

The Proximal 2/3

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3
Q

Which part of the Oesophagus is Adenocarcinoma found?

A

The Distal 1/3

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4
Q

Is Oesophageal more common in Males or Females?

A

Males

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5
Q

What is the Median Age of presenting with Oesophageal Cancer?

A

65 - and decreasing

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6
Q

What precedes Oesophageal Squamous Cell Carcinoma?

A
  1. Dysplasia

2. Carcinoma in Situ

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7
Q

What precedes Oesophageal Adenocarcinoma?

A

Barrett’s Oesophagus

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8
Q

What are the predisposing factors of Squamous Cell Carcinoma?

A
  1. Excessive consumption of Alcohol
  2. Smoking
  3. Vitamin Deficiencies
  4. Achalasia
  5. Caustic Strictures
  6. Plummer-Vinson Syndrome
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9
Q

What are the predisposing factors of Adenocarcinoma?

A

The Risk Factors for GORD / Berrett’s Oesophagus:

  1. Being Male
  2. Caucasian
  3. Middle Aged
  4. Obese
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10
Q

What is the Pathology of Oesophageal Squamous Cell Carcinoma?

A

This is the Standard Cancer Pathology - A mutation, with the correct genetic susceptibility, leading to Dysplasia

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11
Q

What is the Pathology of Oesophageal Adenocarcinoma?

A

The Metaplasia in Barrett’s Oesophagus, continues to Dysplasia - leading to Cancer

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12
Q

What are the Clinical Signs of Oesophageal Cancer?

A
  1. Weight Loss
  2. Aspiration Pneumonia
  3. Vocal Cord Paralysis
  4. Haematemesis
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13
Q

Why does Weight Loss occur?

A
  1. Due to the presence of the Cancer

2. Due to the trouble eating, associated with the location of the Cancer

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14
Q

Why does Aspiration Pneumonia potentially occur?

A

Due to the potential presence of a Tracheo-Oesophageal Fistula

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15
Q

Why does Vocal Cord Paralysis potentially occur?

A

Due to the Potential Invasion / Compression of the Vocal Cords

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16
Q

What is Haematemesis?

A

Blood in Vomit

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17
Q

Why does Haematemesis occur?

A

Due to the Bleeding associated with the Cancer

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18
Q

What would a patient with Oesophageal Cancer present with?

A
  1. Dysphagia
  2. Odynophagia
  3. Chest Pain
  4. Vomiting
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19
Q

What is Dysphagia?

A

The Feeling of having trouble swallowing

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20
Q

What is Odynophagia?

A

The feeling of Pain on Swallowing

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21
Q

What causes the Symptoms in Oesophageal Cancer?

A

The presence of the Abdominal Mas infiltrating and compressing the surrounding Lumen / Structure

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22
Q

What investigations are needed in Oesophageal Cancer?

A
  1. Upper G.I. Endoscopy with Biopsy
  2. CT/PET Scan
  3. Endoscopic Ultrasound
23
Q

What is the purpose of the Upper G.I. Endoscopy with Biopsy?

A
  1. To view and assess the severity of the tumour

2. The Grade the cancer

24
Q

What is the purpose of the CT/PET scan?

A

This is used for Staging Purposes - looking for Metastases

25
Q

Where needs to be scanned in the CT/PET scan?

A
  1. Chest
  2. Abdomen
  3. Pelvis
26
Q

What is the purpose of the Endoscopic Ultrasound?

A

To assess the surrounding structures - for Staging Purposes

27
Q

What staging Criteria is used?

A

TNM

28
Q

What are the Different “T” stages in Oesophageal Cancer?

A
  1. T1a
  2. T1b
  3. T2
  4. T3
  5. T4
29
Q

What does “T1a” refer to?

A

A Tumour which has invaded the Lamina Propria

30
Q

What does “T1b” refer to?

A

A Tumour which has invaded the Sub-Mucosa

31
Q

What does “T2” refer to?

A

A Tumour which has invaded the Muscularis Externa

32
Q

What does “T3” refer to?

A

A Tumour which has invaded the Oesophageal Adventitia

33
Q

What does “T4” refer to?

A

A Tumour which has invaded the Adjacent (Surrounding) Structures

34
Q

What are the Different “N” stages in Oesophageal Cancer?

A
  1. N0

2. N1

35
Q

What does “N0” refer to?

A

No Regional Lymph Node Metastases

36
Q

What does “N1” refer to?

A

Regional Lymph Node Metastases

37
Q

What are the Different “M” stages in Oesophageal Cancer?

A
  1. M0

2. M1

38
Q

What does “M0” refer to?

A

No Metastases

39
Q

What does “M1” refer to?

A

Metastases

40
Q

What is the only Cure of Oesophageal Carcinoma?

A

An Oesophagectomy

41
Q

What is an Oesophagectomy?

A

The Surgical Removal of the Oesophagus, and the Stomach is stretched to reach the Upper Oesophageal Sphincter

42
Q

What is used alongside the Oesophagectomy?

A

Chemotherapy

43
Q

What are the 2 times Chemotherapy can be used?

A
  1. Adjuvant

2. Neoadjuvant

44
Q

What is Adjuvant Chemotherapy?

A

Chemotherapy after the Operation, to remove anything which might be left

45
Q

What is Neoadjuvant Chemotherapy?

A

Chemotherapy before the Operation, to reduce the size of the tumour

46
Q

What are some palliative care options?

A
  1. Endoscopic Stenting
  2. Endoscopic Argon Plasma Coagulation
  3. Percutaneous Endoscopic Gastrostomy (PEG)
  4. Chemotherapy
  5. Radiotherapy
47
Q

What is the function of the Endoscopic Stenting?

A

To reduce the Symptom of Dysphagia

48
Q

What is the function of Endoscopic Argon Plasma Coagulation?

A

To reduce the Symptom of Bleeding (Haematemesis)

49
Q

What is the function of a Percutaneous Endoscopic Gastrostomy?

A

To allow feeding to take place if the Tumour is too large that it obstruct the whole passage to the Stomach

50
Q

What is the function of Palliative Chemotherapy / Radiotherapy?

A

This is just done to reduce the Symptoms

51
Q

How common are Benign Oesophageal Tumours?

A

Very Rare

52
Q

In Western Europe / USA. which type of Oesophageal Carcinoma is most common?

A

Adenocarcinoma

53
Q

In the rest of the World, other than Western Europe / USA,. which type of Oesophageal Carcinoma is most common?

A

Squamous Cell Carcinoma

Clinical Alimentary System (64 decks)

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