Gastric cancer Flashcards
define gastric cancer?
cancer of the stomach- most commonly adenocarcinoma
what are the rarer types of gastric cancer
Lymphoma
Leiomyosarcoma
Neuroendocrine
Squamous cell carcinoma
what are the risk factors for gastric cancer?
Smoked and processed foods, foods high in nitrosamines, high nitrates, high salt, pickling, low vitamin C
Smoking
Helicobacter pylori infection
Pernicious anaemia
Adenomatous polyps
Familial risk
summarise the epidemiology of gastric cancer?
COMMON cause of cancer death worldwide
Highest incidence in JAPAN (and Asia in general)
This is cos of smoked fish and h pylori
6th most common cancer in the UK
Usual age of presentation: > 50 yrs
what are the presenting symptoms of gastric cancer?
Often asymptomatic early
Early satiety
Epigastric discomfort
Haematemesis, melaena, symptoms of anaemia
Anaemia can be due to blood loss or of chronic disease
Systemic symptoms: weight loss, anorexia, nausea/vomiting
Dysphagia (in tumours of the gastric cardia)
Symptoms of metastases (e.g. ascites, jaundice)
summarise a typical presentation of gastric cancer?
FLAWS + epigastric pain + early satiety + haematemesis (N+V) + virchow’s or sister Mary Joseph’s N (lump in belly button)
what are the signs of gastric cancer on physical examination?
May be normal
Epigastric mass
Abdominal tenderness
Ascites
Signs of anaemia
Virchow’s Node (aka Troisier’s sign) – lymphadenopathy in left supraclavicular fossa
Sister Mary Joseph’s Nodule (metastatic node on the umbilicus)
Krukenberg’s Tumour (ovarian metastases)
what are the investigation for gastric cancer?
Upper GI endoscopy – with biopsy of all gastric ulc
what other investigations would you consider for gastric cancer?
Endoscopic USS - assess depth of gastric invasion and lymph node involvement (TNM staging of cancer after diagnoses)
CT/MRI/PET - for staging
Laparoscopy may be needed to determine if tumour resectable
Bloods - FBC (check for anaemia), LFTs
