Cancer Flashcards
(25 cards)
Incidence of GI cancers. (3)
Bowel cancer is 4th most common
5/ top 20 are GI - bowel, pancreas, oesophagus, stomach, liver.
Describe three classifications of dysphagia. (3)
Extraluminal - external compression eg heart
Intralumial - things getting stuck
Luminal - benign or malignant growths
Describe the red flags of dysphagia. (5)
Anaemia Loss of weight Anorexia Recent onset of rapidly progressing symptoms Masses / Malaena Spells ALARM
Describe the types of cancers found in the GI tract. (3)
Most are columnar - adenocarcinoma
Oesophagus is squamous - squamous cell carcinoma - unless Barrett’s oesophagus occurs to columnar - then adenocarcinoma.
Describe the commonest cancer that presents with dysphagia. (3)
Oesophageal.
Severe and progressive dysphagia
Risk factors: smoking, Barrett’s.
Give 5 causes of epigastric pain.
Peptic ulcers, pancreatitis, oesophageal varices, carcinoma,
Describe Mallory-Weiss syndrome. (1)
Haematemesis from the friction of common vomiting.
Describe gastric cancer. (7)
Adenocarcinoma typically in antrum or cardia. Presents similarly to peptic ulcers, often with a palpable mass.
Risk factors: smoking, FH, high salt diet, H pylori.
Survival poor unless screened for, but we don’t do that here.
Describe gastric lymphoma. (3)
MALT tissue. Similar presentation to adenocarcinoma, but better prognosis. B
Heavily assocaited with H pylori.
Describe GI stromal tumours (1)
Incidental finding of sarcoma.
Describe the red flags associated with jaundice. (3)
Hepatomegaly with irregular border
Unintentional weight loss
Ascites
Describe the primary malignancy of the liver. (2)
Hepatocellular carcinoma, assocaited with cirrhosis.
Describe the secondary malignancy of the liver. (3)
Metastatic due to haematogenous spread through portal system. Breast, bowel, pancreas common.
Describe pancreatic cancer. (5)
Head: jaundice
Body/tail: more vague - altered metabolism
Prognosis poor because detection hard.
Risk factors: FH, smoking, male, old, chronic pancreatitis.
Describe obstruction as a key symptom that indicates distal GI malignancy. (6)
SI - nausea and vomiting
LI - constipation
Benign causes: volvulus, hernias, diverticular disease.
Red flags: unintentional weight loss, unexplained abdo pain.
Describe PR bleeding as a key symptom that indicates distal GI malignancy. (9)
Haematochezia or malaena?
Benign: haemorrhoids, anal fissure, infective gastroenteritis, IBD, diverticular Disease.
Red flags: 50-60 years old, iron deficiency anaemia, unexplained weight loss, changes in bowel habit, tenesmus.
Describe tenesmus. (2)
Rectal cancer giving the constant urge to deficate.
Describe changes in bowel habit as a key symptom that indicates distal GI malignancy. (5)
Changes from normal FOR THE PATIENT
Benign: thyroid disorder, IBD, IBS, medications
Red flags: iron deficiency anaemia, PR blood loss, unexplained weight loss.
Describe large bowel cancer. (5)
Adenocarcinoma
Risk factors: FH, IBD, polyposis syndromes (HNPCC and FAP), sedentary lifestyle, high fat diet.
Screening: fecal occult blood samples.
Describe the differences between cancer of the right side of the colon (ascending) and the left sode (descending). (7)
Both present with weight loss and masses in the iliac fossa.
Right side: anaemia, occult bleeding, unlikely to become obstructed, late change in bowel habits, advanced at presentation.
Left side: rectal bleeding, tenesmus, obstruction, early changes in bowel habit, less advanced at presentation.
Describe cancer of the small bowel. (10)
Rare
5 types: stromal, lymphoma, adenocarcinoma, sarcoma, carcinoid tumours.
Risk factors: IBD, coeliac disease, FAP, diet.
Symptoms: weight loss, abdo pain, bloody stools.
Describe the diagnosis of GI cancers. (4)
Blood tests - anaemia, tumour markers
CT/MRI
Endoscopy / colonoscopy - got for everything but SI, can biopsy.
Capsule endoscopy - good to visualise SI but can’t biopsy.
Describe the staging of GI cancers. (2)
TNM for most things
Duke’s staging for colorectal.
Describe the treatments of GI cancers. (3)
Chemotherapy / new-aduvent chemo - reduces size for possible removal.
Radiotherapy - often palliative symptom reduction
Surgical resection.
