278 - GI Cancer Flashcards
From which cells does pancreatic cancer most commonly arise?
Columnar cells (form the pancreatic ducts)
=> adenocarcinoma
What percentage of pancreatic cancer is metastatic at presentaiton?
85%
Treat with palliative chemotherapy
Currently, no great immunotherapy agents for pancreatic cancer
What is the most significant risk factor for esophageal cancer?
Barrett’s esophagus
Where in the esophagus is squamous vs. adenocarcinoma more likely?
- Squamous: upper 2/3 of esophagus
- Adenocarcinoma: lower 1/3 of esophagus
List 3 risk factors for cholangiocarcinoma
- Primary sclerosing cholangitis
- Infection (chlonorchis sinesins)
- Inflammation
What are the 2 curative therapies for HCC?
Liver transplant
Resection
List 4 symptoms of pancreatic cancer
- Weight loss
- Pain (epigastric, radiates to the back)
- Jaundice
- Nausea/vomiting
What symptom of cholangiocarcinoma can help differentiate it from pancreatic cancer?
Pruitis
Not always present; often presents similarly to pancreatic cancer
What is the only GI cancer in which radiation has a major role in treatment?
Cholangiocarcinoma
- Go straight to surgery if resecttable
- Neoadjuvant radiation can sterilize the surgical area
- Chemotherapy if metatstatic disease
In which cancers is HER2 testing important?
Adenocarcinomas
Esophageal/Gastric cancer
Breast cancer
What is the leading cause of the incidence in HCC in the western population
Increasing rates of Hepatitic C and Non-alcoholic fatty lifer disease
Both lead to chronic inflammation -> cirrhosis -> HCC
What is the most concerning risk factor for the increasing incidence in pancreatic cancer?
Increase in diabetes an dinsulin resistance
Increase in alcohol use -> chronic pancreatitis is also a concern
What is Barrett’s Esophagus?
(Histological changes)
Transformation of squamous -> columnar epithelium in the lower esophagus
Esophagus starts to look more like the stomach
