Oesophageal Carcinoma

Question 1

What is it?

Answer 1

Cellular changes and neoplasm in the Oesophageal Epithelium

Question 2

Where does it occur?

Answer 2

It can occur anywhere in the oesphagus, but 20% occurs in the upper part, 50% in the middle and 30% in the lower oesophagus

Question 3

What type of carcinoma is more common in the proximal oesophagus?

Answer 3

Squamous Cell

Question 4

What type of carcinoma is more common in the distal oesophagus?

Answer 4

Adenocarcinoma

Question 5

Is there any pre-cancerous phase?

Answer 5

Yes, it is called Barret’s Oesophagus, a type of carcinoma in situ

Question 6

Is this cancer common?

Answer 6

<9 per 100,000 per year

Question 7

Who does it affect?

Answer 7

More commonly affects males 5:1

Question 8

Risk factors (10)

Answer 8

Diet, alcohol, smoking, achalasia (muscles in lower oesophagus fail to relax), plummer vinson syndrome, obesity, low vitamin A & C, reflux oesophagitis, nitrosamine exposure, barret’s oesophagus

Question 9

Signs and Symptoms (7)

Answer 9

Dysphagia, retrosternal chest pain, weight loss, hoarseness, cough, anorexia, lethargy

Question 10

Investigations (5)

Answer 10

Oesophagoscopy and biopsy, ultrasound, CT, MRI

Question 11

What staging does it use?

Answer 11

TNM

Question 12

Treatment (4)

Answer 12

Radical oesophagectomy, chemotherapy, radiotherapy, palliative stenting

Question 13

Is there a good prognosis?

Answer 13

Survival rates are poor with or without treatment