276 - GI Cancer Flashcards

1
Q

From which cells does pancreatic cancer most commonly arise?

A

Columnar cells (form the pancreatic ducts)

=> results in adenocarcinoma (most aggressive type)

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2
Q

What percentage of pancreatic cancer is metastatic at presentation?

A

85%

Treat with palliative chemotherapy

Currently, no great immunotherapy agents for pancreatic cancer

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3
Q

What is the most significant risk factor for esophageal cancer?

A

Barrett’s esophagus = acquired metaplasia of transition zone btwn squamous epithelium of esophagus and columnar cells of the stomach

other risk factors: tobacco, alcohol

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4
Q

Where in the esophagus is squamous vs. adenocarcinoma more likely?

A
  • Squamous: upper 2/3 of esophagus
  • Adenocarcinoma: lower 1/3 of esophagus
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5
Q

List 3 risk factors for cholangiocarcinoma

A
  • Primary sclerosing cholangitis
  • Infection
  • Inflammation
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6
Q

What are the 2 curative therapies for Hepatocellular Carcinoma?

A
  1. Liver transplant
    • when only one tumor <5 cm or up to 3 tumors that are all < 3cm
  2. Resection
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7
Q

List 4 symptoms of pancreatic cancer

A
  • Weight loss
  • Pain (epigastric, radiates to the back)
  • Jaundice
  • Nausea/vomiting
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8
Q

What symptom of cholangiocarcinoma can help differentiate it from pancreatic cancer?

A

Pruitis

Not always present; often presents similarly to pancreatic cancer

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9
Q

What is the only GI cancer in which radiation has a major role in treatment?

A

Cholangiocarcinoma

  • Go straight to surgery if resectable
  • Neoadjuvant radiation can sterilize the surgical area
  • Chemotherapy if metatstatic disease
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10
Q

In which cancers is HER2 testing important?

A

Adenocarcinomas:

  • Esophageal/Gastric cancer
  • Breast cancer
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11
Q

What is the leading cause of the incidence in HCC in the western population

A

Increasing rates of Hepatitic C and Non-alcoholic fatty liver disease

Both lead to chronic inflammation -> cirrhosis -> HCC

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12
Q

What is the most concerning risk factor for the increasing incidence in pancreatic cancer?

A

Increase in diabetes an insulin resistance

Increase in alcohol use -> chronic pancreatitis is also a concern

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13
Q

What is Barrett’s Esophagus?

(Histological changes)

A

Transformation of squamous -> columnar epithelium in the lower esophagus

Esophagus starts to look more like the stomach

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