Flashcards in Upper GI cancer Deck (14)
What is Barrett's oesophagus?
An abnormal change (metaplasia) in the cells of the lower portion of the esophagus. When the normal stratified squamous epithelium lining of the esophagus is replaced by simple columnar epithelium with goblet cells (cells usually found lower in the gastrointestinal tract), Barrett's esophagus is diagnosed. The medical significance of Barrett's esophagus is its strong association with esophageal adenocarcinoma, a particularly lethal cancer.
Main cause = an adaptation to chronic acid exposure from reflux esophagitis.
Diagnosis = endoscopy and biopsy. clinical history and examination.
What is oesophageal cancer?
• more common in > 65 yrs • 7,000 new cases/year UK
• 35% female • Two aetiological subtypes: Squamous cell cancer and Adenocarcinoma
What are the causes of adenocarcinoma?
• Obesity & gastro-oesophageal reflux • Smoking & alcohol • Barrett’s oesophagus
What are the causes of squamous cell cancer?
• Diet Nitrosamines,
Vitamins A & C, riboflavin & protein • Smoking & alcohol
• Leukoplakia, achalasia, webs
What's the epidemiology of gastric cancer?
20 per 100,000 UK
> 65 years
poor socio-economic status
high incidence in far East
What are the causes of gastric cancer?
• Pernicious anaemia
• Previous gastric surgery
• Helicobacter infection
• Dietary factors, low fresh fruit
• Blood group A
• Family history (E-cadherin mutation)
What are the symptoms of oesophageal and gastric cancer?
• Chest pain
• Weight loss
• Lymph nodes
• Epigastric mass
How can you stage upper GI cancer?
• Computed tomography scan
• Endoluminal ultrasound scan
What's radical treatment for oesophageal cancer?
Primary chemotherapy & radiotherapy
Palliative care for malignant dysphagia?
Endoscopic stent placement
What are the complications of stent insertion?
What's radical treatment for gastric cancer?
Palliative care for gastric cancer?
Treat blood loss
Remove gastric outlet obstruction