13. CCs in brief - carcinomas

Question 1

What risk factors are there for oesophageal carcinoma?

Answer 1

Diet (low fruit + veg)
Alcohol excess
Smoking
Achalasia
Reflux oesophagi's / Barrett's
Obesity

Question 2

How does oesophageal carcinoma present?

Answer 2

Dysphagia
Weight loss
Retrosternal chest pain
Hoarseness

Question 3

How common is oesophageal carcinoma?

Answer 3

<9 / 100 000
20% upper
50% middle
30% lower

Question 4

What risk factors are there for gastric carcinoma?

Answer 4

Pernicious anaemia
Blood type A
H. pylori
Adenomatous polyps
Atrophic gastritis
Lower social class
Smoking

Question 5

How does gastric carcinoma present?

Answer 5

Dyspepsia
Dysphagia
Weight loss
Vomiting
Anaemia
VIRCHOW'S NODE (large left supraclavicular node, Troisier's sign)

Question 6

How common is gastric carcinoma?

Answer 6

23 / 100 000

Question 7

What risk factors are there for pancreatic carcinoma?

Answer 7

Smoking
Alcohol
Diabetes
Chronic pancreatitis
High waist circumference
FH - 95% have mutation in KRAS2 gene

Question 8

How does pancreatic carcinoma present?

Answer 8

Head of pancreas: painless obstructive jaundice
Body and tail: epigastric pain, radiates to back and relieved on sitting forward
All my cause anorexia, cachexia, diabetes, acute pancreatitis

Question 9

How common is pancreatic carcinoma?

Answer 9

3% of all malignancy
UK incidence is rising
Average patient is 70 y/o male

Question 10

What risk factors are there for colorectal carcinoma?

Answer 10

Neoplastic polyps
IBD
Genetic predisposition eg FAP and HNPCC
Diet (low fibre, red meat)
Smoking
Alcohol
PMH of cancer

Question 11

How does colorectal carcinoma present?

Answer 11

DEPENDS ON SITE
Left-sided: bleeding, mucus, altered bowel habit / obstruction, tenesmus, mass
Right: cachexia, anaemia, abdo pain

Question 12

How common is colorectal cancer?

Answer 12

3rd most common cancer in UK
2nd most common cause of cancer deaths
75% 5YSR with diagnosis at stage 1
5% 5YSR with diagnosis at stage 4