Oesophago-gastric cancer Flashcards Preview

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Flashcards in Oesophago-gastric cancer Deck (22):
1

What happens to the cells of the lower oesophagus with reflux disease and why?

The squamous epithelium turn to columnar cells to try and resist the acidic environment

2

What can occur with persistant reflux and what can this cause?

Barratts oesophagus leading to adenocarcinoma

3

What causes squamous cell carcinoma?

excessive use of smoking or alcohol

4

Name the 3 changes in cells leading to adneocarcinoma

Metaplasia, dysplasia, adenocarcinoma

5

How does gastric adenocarcinoma arise as?

Presence of H Pylori combined with other genetic factors

6

Where do Gastro Intestinal stomal tumours develop

In the wall of the stomach - not the lining of the epithelium

7

Name the 3 types of gastric cancer

Adenocarcinoma
Lymphoma
GISTs

8

What are the 3 types of Junctional Cancers and what type of cancers are they?

Oesophageal
True junctional
Gastric
All adenocarcinomas

9

What are the signs and symptoms of oesophageal cancer

Dysphagia
Odynophagia
Haematemesis, Regurgitation, dysphonia
Weight loss
Adenopathy, pleural effusions, hepatomegaly (metastasis)
Paraneoplastic syndrome
Lymphadenopathy in the superclavicular junction around the carotid arteries

10

What are the signs and symptoms of gastric cancer?

Dyspepsia - abdo pain, emesis, anorexia, dysphagia
Upper GI haemorrhage
Weight loss
Abdo mass
Jaundice (if metastasis)
Paraneoplastic syndromes

11

How can we diagnose oesophageal cancer

Weight loss
Lymph nodes
Liver

Upper GI endoscopy AND BIOPSY!
Barium meal
CT or MRI of chest and abdo
Endoscopic ultrasound for patients who are likely to rquire surgery

12

What does an Endoscopic ultrasound show?

The lymph node location and state

13

How can we diagnose gastric cancer

Weight loss
lymph nodes
Abdominal mass
Upper GI endoscopy AND BIOPSY
Barium meal
CT scan

14

What are the alarm features of GI cancer

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

15

WHat is the life expectancy when GI cancer has metastasised

1- 3 months on average

16

What is the treatment for oesophageal treatment?

Palliation of oesophageal obstruction and improve survival
Only chance of cure is surgery
Removal of oesophagus and lymph nodes

17

Who is not suitable for surgery for oesophageal cancer

50% of patients
Not T4 or M1 diagnosis
Not long tumours
Not cervical lymph node patients

18

What are the contraindications to surgery for oesophageal cancer

Direct invasion of adjacent structures (trachea or bronchus)
Fixed cervical lymph nodes
Widespread metastases
Poor general health

19

What are the other forms of treatment for oesophageal cancer?

Palliative Radiotherapy
Intubation / stents
Canalisation - dilation
Photo-dynamic therapy
Alcohol injections (dry up cells)
Terminal care

20

What is the treatment options for gastric cancer?

SUrgery - palliation of symptoms
improved survival
via an abdo op
remove involved organs
Radiotherapy
Chemotherapy
Intubation of proximal lesions

21

What is the prognosis of oesophageal cancer?

11% 5 year survival rate for all patients
Patients who have surgery have a much higher survival rate

22

What is the prognosis of gastric cancer?

15% 5 year survival rate for all patients (higher than oesophageal)
Particularly in young and old
Young females - the tumours are particularly agressive as they feed on female hormones - surgery does not improve survival rate

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