Cancer conditions Flashcards
When is it appropriate to refer someone for an upper GI endoscopy in relation to suspicions of gastric/oesophageal cancer?
When someone has dysphagia
When someone is over 55 and has new onset dysphagia with weight loss and abdo pain/ reflux/ dyspepsia
What symptoms will someone with oesophageal cancer present with?
Weight loss Dysphagia Odonyphagia Hoarsening of the voice Post prandial cough
Who is most likely to get oesophageal cancer?
Males
People who live in the Western world
What are some causes of oesophageal cancer?
Barret's oesophagus GORD Smoking Alcohol Family history Previous history of GI cancer
What investigations should you do if you suspect someone has oesophageal cancer?
Urgent upper GI endoscopy
Upper GI ultrasound to stage it
Whole body CT if radical treatment is needed
How is oesophageal cancer managed
Radiochemotherapy if not metastasised/earlier stage
Surgical resection
Expansive stent for immediate relief from dysphagia
What are the types of oesophageal cancer?
Squamous cell carcinoma
Adenocarcinoma
What is lymphoma?
Cancer of the lymphatic system
What are the types of lymphoma?
Hodgkin’s and non-Hodgkin’s
How do Hodgkin’s and non-Hodgkin’s lymphoma differ?
They affect different types of lymphocytes
In Hodgkin’s lymphoma Reed- Stenberg cells are present
What type of cell is found in Hodgkin’s lymphoma?
Reed- Stenberg cells
What symptoms will someone with lymphoma classically present with?
Fever Malaise Weight loss Lymphadenopathy Fatigue Night sweats
Who is more at risk of lymphoma?
Those who smoke
Those who drink
What investigations would you order if you suspect someone has lymphoma? What would you expect to see
FBC: WBC may be low or high, platelets may be low
Biopsy- excision or central
PET CT
CXR
How is lymphoma managed?
Rituximab with chemotherapy if advanced/ metastasised
Radical radiotherapy if local or early stage
CNS prophylaxis may be offered
Stem cell transplant may be offered
What treatment is given for advanced lymphoma?
Rituximab in combination with chemotherapy
What is the most common type of gastric cancer?
Adenocarcinoma
What symptoms will someone with gastric cancer present with classically?
Weight loss
Dysphagia
Abdominal pain
Lymphadenopathy
Who is more likely to get gastric cancer?
Men
50-70 years
Smokers
Those with family hx
What are some causes of gastric cancer?
Pernicious anaemia
H pylori
Diet low in fibre/ fruits and veg
When should you do an urgent 2 week referral for someone if you suspect gastric cancer?
If you find an abdominal mass that you suspect may be cancer
If someone has dysphagia
If someone is over 55 and has new onset dysphagia with weight loss, reflux or abdo pain
What investigations should be done if you suspect someone has gastric cancer?
Upper GI endoscopy
Upper GI ultrasound for staging
CT abdomen and pelvis for staging
Bloods- FBC look for anaemia, LFTs incase their are mets, inflammatory markers, cancer markers
How is gastric cancer managed
If early stage/not suitable for surgery= chemoradiation
Surgical resection with peri op chemo and post op chemoradiation
Palliative chemoradiation and gastrectomy if best
What are some complications of gastric cancer?
Gastric outlet obstruction
Gastric bleeding
Malnutrition
What are the 2 things that need to be done once a cancer is diagnosed?
It needs to be graded and staged
What is the grade of a cancer?
How histologically different it is to the normal cells it originated from
What is the stage of a cancer?
How far the cancer has spread anatomically
What is the general prognosis for oesophageal cancer?
Quite poor
Usually patients present with late stage disease with lymph node involvement and mortality is high- many of them are not even fit for surgery
When should you do a 2 week referral for suspected breast cancer
When someone over the age of 30 presents with a breast lump (that is pain or not painful)
When someone over the age of 50 presents with a breast lump and discharge/retraction or other concerning changes in one nipple only
When someone presents with skin changes that suggest breast cancer
When someone over 30 presents with an unexplained lump in the axilla
When is mammography offered in the NHS and how often?
To all women over the age of 50 every 3 years
