Gastric and Oesophageal cancer: clinical Flashcards Preview

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Flashcards in Gastric and Oesophageal cancer: clinical Deck (20):
1

What are the signs and symptoms of oesophageal cancer?

Dysphagia
Odynophagia (painful swallowing)
Haematemesis
Regurgitation
Dysphonia
Weight loss
Adenopathy
Effusion
Hepatomegaly
Paraneoplastic syndrome:
Hypercalcaemia
Inappropriate hormone production

2

What are the signs and symptoms of gastric cancer?

Dyspepsia
Emesis
Anorexia
Dysphagia
Early satiety
Upper GI haemorrhage
Weight loss
Abdominal mass
Jaundice
Paraneoplastic syndromes

3

What are important findings on examination for a patient with suspected oesophageal cancer?

Weight loss
Lymph nodes
Liver changes

4

What investigations are done in suspected oesophageal cancer?

Upper GI endoscopy and biopsy
Imaging studies :
Barium meal
CT (MRI) scan of chest and abdomen
Bronchoscopy

Fitness studies

5

What are important findings on examination of a patient with suspected gastric cancer?

Weight loss
Lymph nodes
Abdominal mass

6

What investigations are done in suspected gastric cancer?

Upper GI endoscopy and biopsy
Imaging studies:
Barium meal
CT (MRI) scan

7

What are alarm features in a patient's history?

>55 years of age
Dysphagia
Evidence of GI blood loss
Persistent vomiting
Unexplained weight loss
Upper abdominal mass
Anaemia

8

What is the curative treatment for oesophageal cancer?

Surgery- this is the only chance of a cure

9

How many patients are suitable for surgery in oesophageal cancer?
Which stages of tumour render the patient unsuitable for surgery?

About 50%
Tumours not suitable for surgery:
Stage T4 or M1 tumours
Long tumours
Tumours with cervical lymph nodes

10

What is the surgery for oesophageal cancer?

Removal of oesophagus and lymph nodes

11

What are contraindications to surgery for oesophageal cancer?

Direct invasion of adjacent structures:
e.g. Trachea or bronchus
Aorta
Pericardium
Lung
Fixed cervical lymph nodes
Widespread metastases
Poor medical condition

12

What are other forms of treatment for oesophageal cancer?

Radiotherapy:
radical especially the cervical oesophagus
Palliative

Intubation/stents

Canalisation:
Dilatation, laser, Diathermy, alcohol
PDT

Terminal care

13

What is surgery used for in gastric cancer?
How is the surgery carried out?
What can be removed as well as the primary cancer?

For improved survival
For palliation of symptoms
The surgery is via an abdominal operation
Involved adjacent organs can be removed

14

What are contraindications for gastric cancer surgery?

Widely metastatic disease
Malignant ascites
Brief life expectancy

15

What procedure is used in surgery for proximal and distal lesions in the stomach?

Total gastrectomy for proximal lesions
Partial gastrectomy for distal lesions

16

Apart from surgery, what other treatments are available for gastric cancer?

Radiotherapy
Chemotherapy
Intubation of proximal lesions

17

What is the prognosis for oesophageal cancer?

The majority of patients die within one year.
5 year survival is 11%.

18

What are adverse prognostic factors for oesophageal cancer?

Oesophageal obstruction
Tumour longer than 5cm
Metastatic disease

19

What is the 5 year survival for gastric cancer?

15%

20

What are adverse prognostic factors for gastric cancer?

Metastatic disease
Short history
Advanced age
Proximal lesion
Locally advanced lesion
Superficial gross appearance

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