13. Cancer of the Gut Flashcards

1
Q

Where can you get cancer in the digestive system?

A

Pretty much everywhere

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2
Q

Define cancer

A

A disease caused by an uncontrolled division of abnormal cells in a part of the body

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3
Q

Define primary cancer

A

Arising directly from the cells in an organ

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4
Q

Define secondary cancer

A

Spread from another organ, directly or by other means (blood or lymph)

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5
Q

Where can secondary tumours commonly form?

A

Liver, lung and brain

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6
Q

Where are squamous epithelial cells found?

A

Upper 2/3 of oesophagus, rectum

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7
Q

Where is glandular epithelium found?

A

Throughout the gut

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8
Q

What cancers do squamous cells form?

A

Squamous cell carcinomas

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9
Q

What cancers do glandular epithelium form?

A

Adenocarcinomas - most cancers of the GI tracts

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10
Q

List two neuroendocrine cells?

A

Enterochromaffin cells

Interstitial cells of Cajal

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11
Q

What cancers do enterochromaffin cells form?

A

Carcinoid tumours

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12
Q

What cancers do interstitial cells of Cajal form?

A

Gastrointestinal stromal tumours

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13
Q

What cancers does smooth muscle form?

A

Leiomyoma/Leiomyosarcomas

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14
Q

What cancers does adipose tissue form?

A

Lipomas

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15
Q

What is dysphagia?

A

Difficulty swallowing

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16
Q

How is oesophagus divided into?

A

Thirds: Cervical oesophagus, middle and lower oesophagus

17
Q

As you go down the oesophagus how does the structure of the muscle change?

A

Increased smooth muscle less skeletal muscle

18
Q

What are the two types of oesophageal cancer that can arise?

A

Adenocarcinoma

Squamous cell carcinoma

19
Q

Where does adenocarcinomas arise?

A

Lower 1/3 of oesophagus

20
Q

What is associated with adenocarcinoma?

A

Acid reflux

21
Q

Where does squamous cell carcinomas arise?

A

Upper 2/3 of the oesophagus

22
Q

What is associated with squamous cell carcinoma?

A

Acetaldehyde pathway - alcohol stresses squamous cells

23
Q

Describe the progression from acid reflux to cancer

A

Oesophagitis (inflammation) -> Barrett’s (metaplasia) -> Dysplasia -> Carcinoma (neoplasia)

24
Q

What does chronic exposure to acid in the oesophagus cause?

A

Injury, ongoing inflammation, cytokine drive eventually leading to cancer

25
Q

What are the risk factors for bowel cancer?

A
Family history
Specific inherited conditions
Uncontrolled Ulcerative Colitis
Age 
Previous polyps
26
Q

What mutation in the normal epithelium of the bowel results in a hyperproliferative epithelium

A

APC mutation

27
Q

What does a hyperproliferative epithelium develop to?

A

small adenoma

28
Q

What mutation converts small adenoma to large adeoma?

A

K-ras mutation

29
Q

What mutation converts the large adenoma to colon carcinoma?

A

p53 mutation and loss of 18q

30
Q

How is the pathology of cancer controlled?

A

Not a single gene but a sequence of genetic errors

31
Q

What are the sequence of errors that leads to cancer?

A

APC, K-ras, p53 and 18q

32
Q

What are the symptoms of bowel cancer?

A

Asymptomatic (caecum) (incidental symptoms)
Change in bowel habit (Diarrhoea + constipation0
Blood in stool
Acute intestinal obstruction

33
Q

What are the symptoms of pancreatic cancer?

A

No specific symptoms

‘Silent killer’

34
Q

What is Virchow’s triad for pancreatic cancer?

A

70% - pain
10% - anorexia
10% - weight loss

35
Q

Define ascites?

A

Fluid in the abdominal cavity

36
Q

What are the late symptoms of pancreatic cancer?

A

Weight loss
Jaundice
Ascites
Obstructed gall baldder