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Exams from other people > oesophagus > Flashcards

oesophagus Flashcards

1
Q

Oesophagus Cancer represents how many percent of all cancers?

A

2.2%

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2
Q

Oesophagus Cancer is the ___ leading cause of cancer death worldwide?

A

6th

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3
Q

After 5 years of having Oesophagus cancer what is your chance of survival after 5 years?

A

25%

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4
Q

At what age is your chance of getting oesophagus cancer highest and lowest?

A 
peak 60-70 years
under 25 (rare)
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5
Q

What are risk factors of getting Oesophageal cancer? (SCC)

A 
-Tobacco & Alcohol
• Diet
• Achalasia
• Head & Neck cancer
• Tylosis, Coeliac
disease & Lye
ingestion
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6
Q

What are risk factors of getting Oesophageal cancer? (adenocarcinoma)

A

Barrett’s oesophagus
• Chronic reflux
• Smoking
• Obesity

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7
Q

Causes of endemic oesophageal cancer?

A 
Endemic oesophageal cancer
• “Oesophageal cancer belt”
• Poor nutrition
• Low intake fruit and vegetables
• Drinking hot beverages
• No sex bias in endemic variety
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8
Q

Where does the Sub-mucosal Plexus drain to?

A

internal jugular, peri-tracheal, sub-carinal, perioesphageal,
peri-aortic, peri-cardial, lesser
curve of stomach

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9
Q

Where can cancer in the cervical oesophagus spread to?

A

– carotids, pleura, Rec laryngeal nerve, trachea

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10
Q

Which route of spread is the most common?

A

Sub-mucosal spread

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11
Q

Where can the middle third of the Oesophagus spread to?

A

bronchi, thoracic duct, aortic arch, azygos, (R)

pleura

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12
Q

Lower third can spread to?

A

pericardium, (L) pleura, descending aorta

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13
Q

Presenting symptoms of oesophageal cancer?

A 
Dysphagia
• Anorexia
• Weight loss
• Pain
• Vomiting
• Symptoms dependent on location of tumour
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14
Q

How is Oesophageal cancer diagnosed?

A

Biopsy confirmation, usually performed at
endoscopy
• Barium swallow (can suggest Dx)
• Endoscopy (define site and longitudinal
extent of lesion)
• Histology

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15
Q

Investigations into Oesophageal cancer can include…?

A 
CT scan (chest/abdo)
• Endoscopic ultrasound
• PET/CT
• FBE/U&Es/LFTs
• Panendoscopy
• Laparoscopy
• ECG &Respiratory function tests
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16
Q

What is an endoscopic ultrasound used to determine?

A

• Used to determine extent of invasion of

oesophageal wall

17
Q

Describe stage 1 of oesophageal cancer and the chance of survival after 5 years?

A

T0N0M0 60%

18
Q

Describe stage 2 of oesophageal cancer and the chance of survival after 5 years?

A

T2-3N0M0 31%

19
Q

Describe stage 3 of oesophageal cancer and the chance of survival after 5 years?

A

T3N1M0 20%

20
Q

Describe stage 4 of oesophageal cancer and the chance of survival after 5 years?

A

anyT,anyN, MI

4%

21
Q

Curative therapies for oesophageal cancer?

A 
Surgery
• Radiation therapy
• Combined modality therapy
 1) CT/RT (definitive or adjuvant)
 2) Neoadjuvant
22
Q

Reasons for disease being unresectable?

A

1) Distant metastases
2) Disease un-resectable
3) Medically unfit for surgery
4) Refuse surgery

23
Q

Goals of palliative treatment?

A
  • Restore or maintain swallowing
  • Manage pain
  • Prevent bleeding
24
Q

Candidates for palliation?

A 
• Local symptoms and distant metastatic
disease
• Poor Performance Status
• Inadequate respiratory function
• Very large tumours
25
Q

Acute effects of treatment?

A 
ACUTE EFFECTS
• Lethargy
• Skin erythema
• Dysphagia
• Odynophagia
• Risk of neutropaenic
sepsis
• Pericarditis
26
Q

Late effects of treatment?

A
  • LATE EFFECTS
  • Pulmonary fibrosis
  • Second malignancy
  • Hypothyroidism
  • Increased risk of IHD
  • Benign stricture
27
Q

Organs at risk and DVH tolerances?

A

– Lung, any >20Gy is destroyed
– Limit V20 (the volume receiving >20Gy) to 30-
35%
– Spinal cord limited to <46Gy @ 2 Gy fractions
– Cervical oesophagus may allow 50Gy/30

28
Q

Typical field arrangements for Oesophagus planning?

A

– Anterior,Posterior,(L) lateral,(R) lateral
– Anterior. Posterior and obliques
– for palliative treatment may use AP-PA fields

29
Q

Where would wedges usually be required for an Oesophagus plan?

A

– Wedges usually required in laterals

Exams from other people (6 decks)

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