Cancer Flashcards
Where are gastrointestinal cancers found?
Oesophageal Stomach Biliary system Pancreatic Colorectal - small intestine, large intestine, colon and anus
What are the two types of oesophageal cancer?
Adenocarcinoma
Squamous cell carcinoma
Where are adenocarcinomas found on oesophageal cancer?
Occurs in the columnar epithelium that lines the lower 1/3rd of the oesophagus.
What are adenocarcinomas related to and associated with in oesophageal cancer?
Related to acid reflux - repeated damage to the epithelium. Also associated with obesity, but due to unknown cause, tobacco smoking and alcohol consumption.
What are the details of development of adenocarcinoma - stages?
Normal epithelium Hyperplasia - abnormal proliferation of epithelial cells Development of adenomatous polyps Development of adenocarcinoma Metastasis
Where does squamous cell carcinoma occur?
Occurs in the squamous epithelium that lines the upper 2/3rds of the oesophagus.
What are the main causes of squamous cell carcinoma in oesophageal cancer
Main causes are tobacco smoking and chewing, alcohol consumption, and ingestion of caustic substances.
What is the link between squamous cell oesophageal carcinoma and alcohol
acetaldehyde metabolite, which damages the epithelial cells. This is more common in the Asian population, where mutations in the acetaldehyde dehydrogenase enzyme leads to build up of this metabolite, increasing the risk of cancer
What are the stages of development of a squamous cell carcinoma
Normal epithelium
Metaplasia - development of abnormal squamous cell
Dysplasia - proliferation of abnormal cells
Severe dysplasia - almost all cells are abnormal
Development of squamous cell carcinoma
Metastasis
What are early symptoms of oesphageal cancer?
Difficulty and pain when swallowing
Weight loss - due to lack of nutrition
Pain in the breast bone and stomach, or a feeling of reflux
What are early symptoms of oesphageal cancer due to?
Symptoms do not usually appear until a >50% of the circumference of the oesophagus is cancerous. This is due to the tumour narrowing the tube.
What are late symptoms of oesphageal cancer?
Nausea, vomiting, and regurgitation of food
Vomiting blood, due to trauma to the tumour
What are examples of clincal investigations used to test for oesophageal cancer?
Endoscopy, called an ‘oesophagogastroduodenoscopy’. Includes using a camera to observe the tumour, and a biopsy to evaluate the cells by histology
CT scan to check for metastasis
Endoscopic ultrasound - to determine level of invasion
What are treatment options for oesophageal cancer?
Surgery
In early stages, the tumour may be removed from the oesophageal wall
Oesophagectomy - removal of part of the oesophagus
Chemotherapy and radiotherapy
Where does colorectal cancer occur
Colon or rectum
What are the main causes of colorectal cancer?
The main causes are old age, and lifestyle factors including diet (link to consumption of red meat and processed meat), alcohol, obesity, tobacco smoking and lack of physical activity.
What is a screening option for colorectal cancer?
Faecal sample testing for presence of blood - offered every 2 years for those over 60 yrs old
What is the five year survival rate of colorectal cancer in europe?
60%
What are the risk factors of colorectal cancer?
Family History
Inflammatory bowel disease (Crohns, ulcerative colitis)
Specific inherited conditions
Familial adenomatous polyposis, Hereditary non-polposis colon cancer, Lynch Syndrome
Uncontrolled Ulcerative Colitis
Age
Previous Polyps
What are symptoms of colorectal cancer?
Worsening constipation Blood in the stool Loss of appetite Loss of weight Nausea and Vomiting Rectal bleeding Anemia
What are investigation options for colon cancer?
Abdominal radiograohy (X-ray Plain computer tomography (CT) Barium Enema Colonoscopy CT virtual colonoscopy
What are treatment options for colorectal cancer?
Surgery - removal of the tumour via colonoscopy or laparotomy. This may result in removal of large parts of the colon, resulting in a colostomy.
Chemotherapy and radiotherapy
Why do patients with GI cancer have a higher risk of malnutrition
Poor digestion
Malabsorption
What triad is associated with pancreatic cancer?
Silent killer with non specific symptoms Virchow’s triad - Pain 70% Anorexia 10% Weight loss 10%
