Gastric Cancer

Question 1

Define gastric cancer

Answer 1

Malignancy of the gastric mucosa – mostly adenocarcinoma (rarely lymphoma,
leiomyosarcoma)

Question 2

What are the causes/risk factors of gastric cancer?

Answer 2

• Male
• H. pylori
• Atrophic gastritis
• Dietary nitrosamines e.g. cured meats, salted fish, pickled vegetables
• Smoking

Question 3

What are the symptoms of gastric cancer?

Answer 3

• Early satiety
• Epigastric discomfort
• Weight loss
• Anorexia
• Nausea & vomiting
• Haematemesis
• Melaena
• Anaemia (fatigue)

Question 4

What are the signs of gastric cancer?

Answer 4

• Abdominal tenderness
• Palpable epigastric mass
• Virchow’s node/Trosier’s sign
• Sister Mary Joseph node
(metastatic nodule on umbilicus)

Metastases
• Ascites
• Jaundice
• Hepatomegaly

Question 5

What investigations are carried out for gastric cancer?

Answer 5

• OGD + Biopsy - shows mass or ulcer. Biopsy allows for pathological diagnosis
• LFTs - hepatocellular dysfunction in liver metastasis
• FBC - anaemia
• Endoscopic Ultrasound - determines T and N
• CT Abdomen - hows extent of the lesion and metastatic lesions
• CXR and CT Chest - hows metastatic lesions
• CT/MRI Head - Shows metastatic lesions in the brain
• PET Scan - hot nodules in metastatic foci
• Bone Scan - bone metastases