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gi cancer Flashcards

1
Q

what are the two types of oesophageal cancer?

A
  1. adenocarcinomas
  2. squamous cell carcinoma
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2
Q

where do adenocarcinomas occur?

A
  • lower 2/3 of oesophagus
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3
Q

where do squamous cell carcinomas occur?

A
  • upper 2/3 of oesophagus
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4
Q

what are the risk factors for adenocarcinomas?

A
  • barretts oesophagus
  • obesity
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5
Q

who is more likely to get adenocarcinomas?

A
  • males
  • 60-70
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6
Q

what are the risk factors for squamous cell carcinomas?

A
  • smoking
  • alcohol
  • nitrous amines
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7
Q

who is more likely to get squamous cell carcinomas?

A

males
60 - 70

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8
Q

describe the pathology behind oesophageal cancers

A
  1. oesophagus lined by squamous epithelium
  2. stomach lines by columnar glandular epithelium
  3. oesophagus epithelium undergoes metaplasia to stomach epithelium
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9
Q

what are the early symptoms for oesophogeal cancers?

A

no symptoms
only presents when advanced

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10
Q

what are the later symptoms for oesophageal cancers?

A

Anaemia
Loss of weight
Anorexia
Recent sudden symptoms worsen
Melena/ haematemesis
Swallowing progressive difficulty
( if swallowing is NON progressive then suggests achalasia)
REMEMBER IT USING ALARMS

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11
Q

What is melena?

A

passage of black tarry stools

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12
Q

how are oesophageal cancers diagnosed?

A

-OGD (oesophago Gastro Duodenoscopy - basically endoscopy) + biopsy
- with barium swallow
-CT/PET
-for staging

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13
Q

how are oesophageal cancers treated?

A

-if medically fit- chemo/ radio + surgery
- if unfit- palliative care

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14
Q

what are gastric cancers?

A

stomach cancers

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15
Q

what are most gastric cancers?

A

adenocarcinomas ( 95%)

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16
Q

what do most gastric cancers involve?

A

most involve pyloris of stomach

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17
Q

what are type 1 Gastric cancers?

A
  • well differentiated
  • better prognosis
  • more common
18
Q

what are type 2 gastric cancers?

A
  • undifferentiated
  • signet ring carcinomas
  • worse prognosis
19
Q

who are more likely to get gastric cancers?

A
  • Eastern Europe + Asia
  • smoking
  • males
  • falling incidence
20
Q

what are the causes of gastric cancers?

A
  • H Pylori
  • smoking
  • CDH-1 mutation ( mutated cadherin gene- 80% risk)
  • pernicious anaemia- autoimmune chronic gastritis
21
Q

what are the symptoms of gastric cancer?

A
  • severe epigastric pain
    · Anaemia
    · Weight loss
    -Progressive dysphagia ·
    Tired all the time
22
Q

what are the signs of gastric cancer?

A

Jaundice
↳ liver metastases
Krukenburg tumour
↳ ovarian metastases
Lymph node spread
↳ virchows node - supraclavicular
↳ Sister Mary Joseph node
↳ umbilical

23
Q

how are gastric cancers diagnosed?

A

-Gastroscopy + biopsy
· CT/MRI for staging
· PET for metastases

24
Q

how are gastric cancers treated?

A
  • surgery ( gastroectomy) + ECF chemo regimen
25
Q

why is there a low chance of small intestine carcinomas?

A

-as SI is tumour resistant
- most adenocarcinomas

26
Q

what are the risk factors for small intestine carcinomas?

A
  • chronic SI disease
  • crohns, coeliac
27
Q

how are small intestine carcinomas diagnosed and treated?

A

same as gastric

28
Q

what does colorectal polyps and cancer affect?

A
  • large bowel cancer
29
Q

what are colorectal polyps and cancer usually?

A
  • usually adenocarcinomas
30
Q

what is the pre cursor for adenocarcinomas?

A

adenoma

31
Q

what do adenocarcinomas usually metastases to?

A

liver and lung

32
Q

describe the activity of adenocarcinomas

A

mostly spontaneous and benign but can progress to cancer

33
Q

who does colorectal polyps and cancer affect?

A

-60-65
- 3rd most common cancer
- males

34
Q

describe the pathology behind colorectal polyps and cancer

A

· Normal epithelium–>
adenoma–>colorectal adenocarcinoma-> metastatic colorectal adenocarcinomas

35
Q

what are the risk factors for colorectal polyps and cancer?

A
  1. Familial adenomatous polyposis
  2. hereditary non polyposis colorectal cancer
  3. adenomas/ polyps
  4. alcohol/ smoking/ UC
36
Q

how does familial adenomatous polyposis increase risk of colorectal polyps and cancer?

A

-Autosomal dominant condition
-APC gene mutation -> 1000s of duodenal polyps
- inevitably will get colorectal cancer

37
Q

how does hereditary non polyposis colorectal cancer increase risk of colorectal polyps and caner?

A

Autosomal dominant condition
MSH-1 mutation : DNA mismatch repair gene
rapidly increases progression of cancer

38
Q

what are the symptoms of colorectal polyps and cancer?

A
  • mostly in distal colon
  • LLQ pain
  • bloody mucus stools
  • tenesmus
39
Q

how are colorectal polyps and cancer diagnosed?

A
  1. FIT test (faecal immunological test) ↳ screening for micro blood particles in poo
  2. Colonoscopy + biopsy
  3. classification -> T N M staging
40
Q

how are colorectal polyps and cancer treated?

A

surgery and chemo

GI (20 decks)

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