Common malignancies of the GI tract Flashcards
Types of oesophageal cancer
Squamous (proximal 2/3)
Adenocarcinoma (distal 1/3)
Presentation of oesophageal cancer
Progressive Dysphagia
Odynophagia
Weight Loss
Long history of reflux
Oesophageal cancer often presents late
Risk factors for oesophageal adenocarcinoma
Barrats oesophagus
Chronic gastro-oesphageal reflux
Smoking
Types of gastric cancer
Adenocarcinoma
Can be at the gastro-oesophageal junction or the stomach
Cancers can present as polyps, ulcers of diffuse spread of neoplasia (linitis plastica)
Lymphoma also common in the stomach (B-cell, non-Hodgkins). Responds well to chemotherapy
Risk factors for gastric cancer
Diet (major cause)
H. pylori infection (chronic ulcers)
Chronic gastritis
Smoking
Alcohol
Blood group A
Common symptoms of gastric cancer
Dyspepsia
Bleeding
Gastric outlet obsrucion (projectile vomiting)
Most common cause of cancer in the liver
Metastasis (secondary spread from elsewhere)
Primary liver cancer is rarer, caused by alcohol and liver infections (hepatitis)
Presentation of pancreatic cancer
Painless obstructive jaundice
Abdominal pain
Weight loss
Recently diagnoses diabetes (<2 years)
Dukes’ classification of cancer
A – confined to bowel wall
B – spread through bowel wall
C – involves lymph nodes;
C1 – apical node clear
C2 – apical node involved
D – distant spread
TNM staging of cancer
Tumour size
T1 – superficial to muscle
T2 – into muscle but not through bowel wall
T3 – Through bowel wall
T4 – Perforated, or involving serosa or locally spreading
Lymph Nodes
N1 – 1-3 local nodes
N2 – 4+ local nodes
Metastasis
M1 – Distant spread
Types of small bowel cancer
Primary cancers rare, secondaries more common
Carcinoma - very rare but can occur
Lymphoma - various types can occur. In particular, EATCL (enteropathy associated T cell lymphoma) occurs as complication of long-standing coeliac disease
Endocrine - carcinoid tumours
Risk factors for colorectal cancer
Diet - red meat, low fibre, low fruit and vegetable and dairy
Obesity
Low physical activity
Alcohol
Genetic: FAP, HNPCC
IBD
Type 2 diabetes
Presentation of colorectal cancer
Altered bowel habits
PR bleeding (fresh - left sided, altered - right sided)
Iron deficiency anaemia
Anorexia
Weight loss
Distribution of colorectal cancers
Rectum (27%)
Sigmoid colon (20%)
Caecum (14%)
