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Oncology > Esophagus, Gastric, and Colon Cancer Lecture Powerpoint > Flashcards

Esophagus, Gastric, and Colon Cancer Lecture Powerpoint Flashcards

1
Q

Unlike the stomach, the esophagus is not surrounded by a ___, leading to some differences in the cancers

A

double layered serosa

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2
Q

3 constrictures of the esophagus

A

Cricoid cartilage level, aortic arch level, and esophageal hiatus

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3
Q

Vascular supply to the esophagus

A

3 different arteries, branches of inferior thyroid, thoracic aortic branches, and phrenic

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4
Q

Lymph nodes of the esophagus

A

Run longitudinally in the wall of the esophagus, with upper ones going to the cervical nodes and the lower going to the gastric or celiac nodes

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5
Q

Histology of the esophagus

A

Inner circular layer of muscle, outer longitudinal layer of muscle, mucosa composed of stratified squamous epithelium with transition to columnar epithelium lower down

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6
Q

Leiomyoma

A

Esophageal benign tumor of smooth muscle that occurs in the lower portion of the esophagus causing dysphagia, retrosternal distress, and pain

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7
Q

Esophageal polyps

A

Benign tumor 80% cervical with regurgitation into mouth being the common presenting symptom, can be surgically excised

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8
Q

Overwhelming majority of neoplasms in the esophagus are (benign or malignant)

A

malignant

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9
Q

Achalasia

A

Esophageal dismotility syndrome due to lack of parasympathetic ganglia in the GI system resulting in a lack of peristalsis

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10
Q

Barrett’s esophagus

A

Precancerous damage to the lower portion of the esophagus (GERD) where squamous cells have undergone metastasis into columnar, a precancerous condition with risk to develop into adenocarcinoma, responsible for the rising cases of adenocarcinoma in the western world opposed to squamous cell which is due to tobacco and alcohol

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11
Q

EGD (esophagogastroduodenoscopy)

A

Endoscopic procedure to visualize the esophagus to the duodenum

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12
Q

Dysphagia is ___ until proven otherwise

A

esophageal cancer

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13
Q

Esophageal cancer staging

A

CT scan

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14
Q

Esophageal cancer should indicate need for MRI for bronchoscopy. This is because…

A

…the esophagus doesn’t have a serosa so it can directly transmit to adjacent tissue

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15
Q

Esophageal cancer treatment (2) and prognosis

A
  • palliation thru resection or stents
  • neoadjuvant chemo therapy in case they become candidates for resection
  • 5 year survival <10-15%
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16
Q

Blood supply to stomach (4)

A

right and left hepatic arteries, and left and right gastroepiploic arteries

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17
Q

Gastric cancer prevalence and prognosis

A

Decreased in the US, most occur in the antral area, prognosis is terrible

18
Q

Risk factors for gastric cancer (2)

A
  • familial adenomatous polyposis (anywhere from colon deep)

- chronic atrophic gastritis

19
Q

Most common tissue type of stomach/esophagus cancer

A

Adenocarcinoma

20
Q

Gastric cancer ways of spreading

A
  • lymphatics
  • blood stream
  • peritoneal seeding
  • direct extension
21
Q

Bloomer’s shelf

A

finding felt on rectal exam that indicates if a tumor has metastasized to the pouch of douglas, usually metastasis of lung or stomach and sometimes palpable on rectal exam

22
Q

Gastric cancer symptoms (6)

A
  • anorexia and weight loss
  • dysphagia
  • early satiety
  • virchow’s node (left supraclavicular)
  • sister mary josephs node (periumbilical area)
  • massive hematemesis
23
Q

Gastric cancer diagnosis (2)

A

EGD

Upper GI series

24
Q

Gastric carcinoma therapy (1)

A
  • surgery (subtotal or total gastrectomy) with 6cm distal and 3cm proximal margins
  • radiation and chemo little benefit
25
Q

Gastrointestinal stromal tumor (GIST)

A

submucosal tumors that protrude into the lumen of the stomach that present with pain, dyspepsia, and GI bleeding

26
Q

GIST diagnosis, prognosis, treatment (2)

A
  • kit protein, CD34+
  • low mitosis likely benign, high mitosis likely malignant
  • surgical removal with clear margins and gleevec (chemo adjuvant)
27
Q

colon layers

A

3 layers of smooth muscle at the rectum, 2 deep to that in the colon, one is referred to as the tenae coli

28
Q

Largest risk factor for colon cancer and some others

A
  • family history in a 1st degree relative
  • serrated polyposis syndrome
  • ulcerative colitis
29
Q

Colon cancer symptoms (3)

A
  • nonspecific
  • change in bowel habits (alternating constipation and diarrhea)
  • bright red blood per rectum/hematochezia
30
Q

Intussusception

A

Bowel teloscoping in on itself

31
Q

Rectal bleeding always requires a…

A

…digital rectal exam

32
Q

Colon cancer imaging (1)

A

-colonoscopy

33
Q

What type of cancer is most common histologically in the colon?

A

Adenocarcinoma

34
Q

Carcinoembryonic antigen (CEA) levels

A

Elevation of the CEA is consistent with more frequent liver metastasis of the colon cancer in some cases

35
Q

colon cancer treatment (2)

A
  • resection

- chemotherapy in stage 3 or 4 depending on microsatellite instability

36
Q

Microsatellite instability

A

A series of 4 defective DNA mismatch pairs that if present are indicative of lynch syndrome which places at risk for colon cancer stage 3 or 4 and need for chemotherapy

37
Q

2 chemo agents used for rectal cancer

A
  • 5 fu

- cyclophosphamide

38
Q

incisors to EG junction distance

A

35-40cm

39
Q

Most stomach cancers are found in what part?

A

Antrum

40
Q

4 common types of gastric cancer

A
  • polypoid
  • ulcerative
  • superficiaal spreading
  • schirrhous linitis plastica
41
Q

Gastric carcinoma staging

A

Endoscopic inspection or CT

42
Q

2 most common locations for tumor distribution of colon cancers

A
  • cecum

- distal left or sigmoid

Oncology (14 decks)

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