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Alimentary system > 14. Cancer of the gut > Flashcards

14. Cancer of the gut Flashcards

1
Q

Cancer

A

Uncontrolled division of abnormal cells in a part of the body.

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2
Q

What are Primary and Secondary cancers?

A

Primary: arise directly from the cells in an organ.

Secondary(metastases): spread from another organ, directly or by other means (blood or lymph).

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3
Q

Where do adenocarcinomas and squamous cell carcinomas arise from?

A

A: metaplastic columnar epithelium
SCC: Normal oesophageal squamous epithelium

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4
Q

What parts of the oesophagus is effected by adenocarcinomas and squamous cell carcinomas?

A

A: Lower 1/3 of oesophagus
SCC: Upper 2/3 of oesophagus

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5
Q

What are adenocarcinomas and squamous cell carcinomas associated with?

A

A: Related to acid reflux, repeated damage to epithelium, also obesity, tobacco smoking and alcohol
SCC: Acetaldehyde pathway (alcohol), tobacco smoking/ chewing, ingestion of caustic substances

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6
Q

Distribution of prevalence of adenocarcinomas and squamous cell carcinomas

A

A: more developed world, 10X more frequent in men
SCC: Less developed world

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7
Q

What are the symptoms of oesophageal cancer?

A 
Usually don't appear until >50% of circumference of oesophagus is cancerous 
Difficulty/ pain when swallowing
Weight loss (lack of nutrition)
Pain in breast bone and stomach
Feeling of reflux
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8
Q

What are the late stage symptoms of oesophageal cancer?

A

Nausea, vomiting and regurgitation of food

Vomiting blood

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9
Q

Clinical investigations for oesophageal cancer

A 
Endoscopy
CT scan to check for metastases 
Endoscopic ultrasound (determine level of invasion)
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10
Q

Treatment for oesophageal cancer

A

Surgery: removal of tumour/ part of the oesophagus

Chemotherapy and radiotherapy

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11
Q

Describe the progression from reflux to oesophageal cancer

A

Chronic exposure to acid causes injury, ongoing inflammation and cytokine drive
Oesophagitis
Barrett’s (metaplasia: expression of columnar)
Dysplasia
Carcinoma

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12
Q

Causes of colorectal cancer

A 
Old age
Diet (red/ processed meat)
Alcohol
Obesity
Tobacco smoking
Lack of physical activity.
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13
Q

How is screening for colorectal cancer performed in the UK?

A

Faecal sample

tests for presence of blood

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14
Q

What are the risk factors for colorectal cancer?

A 
Family History
IBD (Crohns, ulcerative colitis) 
Specific inherited conditions
Familial adenomatous polyposis, Hereditary non-polposis colon cancer, Lynch Syndrome
Uncontrolled Ulcerative Colitis
Age
Previous Polyps
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15
Q

What is the major location of colon cancer?

A

Rectum

Sigmoid colon

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16
Q

List 7 symptoms of colon cancer

A 
Worsening constipation
Blood in the stool
Loss of appetite
Loss of weight
Nausea and Vomiting
Rectal bleeding
Anemia
17
Q

Clinical investigations for colon cancer

A 
Abdominal radiography (X-ray)
Plain computer tomography (CT)
Barium Enema
Colonoscopy
CT virtual colonoscopy
18
Q

Treatment for colon cancer

A

Surgery: removal of the tumour via colonoscopy/ laparotomy. May result in removal of large parts of the colon, resulting in a colostomy.
Chemotherapy and radiotherapy

19
Q

What GI cancer is referred to as “the silent killer”?

A

Pancreatic cancer

As often diagnosis is very late

20
Q

List 3 early symptoms of pancreatic cancer

A

Depression
Abdominal pain
Glucose intolerance

21
Q

List 4 advanced symptoms of pancreatic cancer

A

Weight loss
Jaundice
Ascites
Gall bladder obstructions

22
Q

Pathology of colon cancer

A

Sequence of genetic errors: APC, K ras, p53, 18q

Thus, inheritance is not simple mendelian (except FAP, HNPCC)

23
Q

Outcome of pancreatic cancer

A

Poor
Only 20% suitable for resection
Surgery curative in 20-25% of cases
1 year survival 18%

24
Q

Risk factors for pancreatic cancer

A

Smoking
Alcohol
Obesity
Genetics (MEN)

25
Q

Diagnosing colonic cancer:

Advantages and disadvantages of X-ray

A

A: Quick, cheap, easy
D: Not very specific or sensitive

26
Q

Diagnosing colonic cancer:

Advantages and disadvantages of CT scan

A

A: Quick, easy, see large lesions
D: No tissue, no therapy, may miss small lesions

27
Q

Diagnosing colonic cancer:

Advantages and disadvantages of Barium enema

A

A: Reasonable sensitivity and specificity
D: Time intensive, technically demanding, uncomfortable

28
Q

Diagnosing colonic cancer:

Advantages and disadvantages of colonoscopy

A

A: Safe, quick, very sensitive, able to obtain tissue
D: Bowel prep causes diarrhoea, small risk of perforation and dehydration

29
Q

Diagnosing colonic cancer:

Advantages and disadvantages of CT virtual colonoscopy

A

A: Easy, quick, good for lesions >6mm, reduced bowel prep
D: Unable to obtain tissue/ remove lesions

Alimentary system (15 decks)

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