Oesophageal Cancer Flashcards
Description: How common is oesophageal cancer?
3rd most common cancer of the alimentary tract, 5th in world Cancer Mortality Rank
Risk factors: In oesophageal cancer what are the risk factors for:
(a) Squamous cell carcinoma
(b) Adenocarcinoma
(a) Squamous cell carcinoma:
- Smoking
- Alcohol
- Dietary carcinogens
(b) Adenocarcinoma:
- Barrett’s Oesophagus
- Obesity
- Male sex
- Middle aged
- Caucasian
Pathology: State the local effects of oesophageal cancer (3)
- Obstruction
- Ulceration
- Perforation
Pathology: State the methods of spread of oesophageal cancer (3)
- Direct
- Lymphatic
- Blood
Pathology: State the sites of metastasis for oesophageal cancer (4)
- Liver
- Lungs
- Brain
- Bone
Pathology: Oesophageal cancer leads to local invasion of what structures? (3)
- Heart
- Aorta
- Trachea
(limits surgery)
Symptoms: State the symptoms of oesophageal cancer
- Progressive dysphagia
- Weight loss/anorexia
- Odynophagia
- Vocal cord paralysis
- Haematemesis
- Pneumonia (trachea-oesophageal fistula)
- Chest pain (retrosternal)
- Cough
THE SIGNS WERE NOT IN THE LECTURE
THE SIGNS WERE NOT IN THE LECTURE
Investigations: What investigations are done for oesophageal cancer to
(a) Confirm the diagnosis
(b) Stage the cancer
(c) Disease staging done by what classification?
(a) Confirm the diagnosis
- Endoscopy
- Biopsy
(b) To stage the cancer
- CT scan
- Endoscopic ultrasound
- PET scan
- Bone scan
(c) TNM
Treatment: How do we treat oesophageal cancer?
CURABLE:
- Surgical oesophagectomy (to remove oesophagus) +/- adjuvant (after) or neoadjuvant (before) chemotherapy
INCURABLE
- Combined chemotherapy and radiotherapy (for improved long term survival)
- Symptom palliation/improves survival: Chemotherapy, radiotherapy, endoscopic stenting and brachytherapy
- Patients require nutritional support
Complications: Complications for oesophageal cancer?
Probs death
Extra: What are the two histological types of oesophageal cancer and in what regions of the oesophagus is affected for each type?
- Squamous cell carcinoma: Proximal and middle third
- Adenocarcinoma:
Distal
Extra: Prognosis for oesophageal cancer is good/bad
Bad
Extra: Benign tumours for oesophageal cancer is common/rare
Rare
Extra: Oesophageal cancer normally presents early/late
Late (cancer would have already spread to the sites of metastasis)
