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Cancer > Cancer of Oesophagus > Flashcards

Cancer of Oesophagus Flashcards

1
Q

State the incidence of Oesophageal Cancer.

A

80% develop over age of 60.

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2
Q

State a risk factor for Oesophageal Cancer.

A

1) Lifestyle factors e.g. obesity, smoking, alcohol, achalasia (muscular ring that closes off oesophagus from stomach).
2) Barrett’s oesophagus (reflux causing).
3) Radiotherapy

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3
Q

Define Metaplasia.

A

Occurs in Barrett’s oesophagus - when mature differentiated cell transforms into new mature cell type.

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4
Q

Define Dysplasia.

A

Occurs in Barrett’s oesophagus - when tissue develops a large number of immature cells to become

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5
Q

State a type of Carcinoma of the Oesophagus.

A

Adenocarcinoma. Squamous Carcinoma.

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6
Q

Define an Adenocarcinoma of the Oesophagus.

A

Lower oesophageal mucosa damaged by the reflux of acid and gastric content in hiatus hernia. Results in metaplasia (Barrett’s oesophagus), progresses to dysplasia and adenocarcinoma.

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7
Q

Where does a Squamous Carcinoma arise from in Oesophageal Cancer?

A

Arises from a Squamous Carcinoma.

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8
Q

Define Barrett’s Oesophagus.

A

Is the condition in which there is an abnormal (metaplastic) change in the mucosal cells lining the lower portion of the oesophagus. It’s caused by chronic inflammation.

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9
Q

State a symptom of Oesophageal Cancer.

A

Difficulty swallowing. Persistent heartburn. Weight loss. Pain in throat/behind the sternum. Regurgitation of food.

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10
Q

State an investigation of Oesophageal Cancer.

A

Oesophagoscopy - camera with a biopsy for staging. Blood tests (full blood count, urea and electrolytes, liver function tests). Staging CT scan (chest, abdomen and pelvis).

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11
Q

State a treatment for Oesophageal Cancer.

A

1) Endoscopic therapy for early cancer with mucosa - Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Resection (ESD).
2) Chemotherapy - neo-adjuvant chemotherapy before treatment (surgery), peri-operative chemotherapy.
3) Surgery - Oesophagectomy
4) Palliative for Advanced Cancer

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12
Q

State a type of chemotherapy.

A

Combination of 2 drugs. Combination of 3 drugs. Advanced Cancer.

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13
Q

Define Chemotherapy - combination of 2 drugs.

A

Cisplatin + Fluorouracil (SFU). Cisplatin + Capecitabine (CX).

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14
Q

Define Chemotherapy - combination of 3 drugs.

A

Epirubicin + Cisplatin + Capecitabine (ECX). Epirubicin + Oxaliplatin + Capecitabine (EOX).

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15
Q

Define Chemotherapy - advanced cancer.

A

Trastuzumab (herceptin) - if HER2 protein expression. Epirubicin + Cisplatin + Fluorouracil (ECF).

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16
Q

State an example of a Chemotherapy drug.

A

Carboplatin (Paraplatin). Paclitaxel (Taxol).

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17
Q

Define an Ivor-Lewis Oesophago-gastrectomy.

A

Middle and lower third of oesophagus removed.

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18
Q

Define what Palliative care for Advanced Cancer involves.

A

Radiotherapy/chemotherapy. Stenting if obstruction.

19
Q

Define T1 for Oesophageal Cancer.

A

Cancer in the mucosa/submucosa layer.

20
Q

Define T2 for Oesophageal Cancer.

A

Cancer involves the muscular layer.

21
Q

Define T3 for Oesophageal Cancer.

A

Cancer involves the serosa layer of the membrane.

22
Q

Define T4a for Oesophageal Cancer.

A

Cancer involves the pleura, pericardium and diaphragm.

23
Q

Define T4b for Oesophageal Cancer.

A

Cancer involves the trachea, vertebra and aorta.

24
Q

Define T4 for Oesophageal Cancer.

A

The cancer has grown into another body structure.

25
Q

Define N0 in Oesophageal Cancer.

A

No lymph nodes.

26
Q

Define N1 in Oesophageal Cancer.

A

1 or 2 nearby lymph nodes.

27
Q

Define N2 in Oesophageal Cancer.

A

3 to 6 nearby lymph nodes.

28
Q

Define N3 in Oesophageal Cancer.

A

7 or more nearby lymph nodes.

29
Q

Define M0 in Oesophageal Cancer.

A

No spread.

30
Q

Define M1 in Oesophageal Cancer.

A

Spread to other parts.

31
Q

What is meant by staging?

A

How much the carcinoma has spread?

32
Q

Define stage 0 of Oesophageal Cancer.

A

High grade dysplasia.

33
Q

Define stage 1A of Oesophageal Cancer.

A

Cancer of the submucosa layer.

34
Q

Define stage 1B of Oesophageal Cancer.

A

Cancer of the muscular layer.

35
Q

Define stage 2A of Oesophageal Cancer.

A

Cancer of the outside of the Serosa (membrane covering the oesophagus outside of muscles).

36
Q

Define stage 2B of Oesophageal Cancer.

A

Cancer involves the muscles and 1-2 lymph nodes.

37
Q

Define stage 3A of Oesophageal Cancer.

A

T4a, N0, M0 = Cancer involves the pleura, pericardium or diaphragm.
T3, N1, M0 = Cancer involves the serosa, 1-2 lymph nodes.
T1/2, N2, M0 = Cancer involves the muscles, nearby 3-6 lymph nodes.

38
Q

Define stage 3B of Oesophageal Cancer.

A

T3, N2 (3-6 lymph nodes), M0

39
Q

Define stage 3C of Oesophageal Cancer.

A

T4a, N1 or 2, M0 = Involves 6 lymph nodes pleura, heart or diaphragm
T4b, any N, M0 = Involves the trachea, vertebra or aorta and lymph nodes
Any T, N3, M0 = Involves more than 7 lymph nodes

40
Q

Define stage 4 of Oesophageal Cancer.

A

Distance metastases e.g. liver or lungs.

41
Q

State the prognosis or a Squamous Cell Carcinoma.

A

75% survival 1 year or more.

42
Q

State the prognosis or a Adenocarcinoma.

A

75% survival 1 year or more.

43
Q

State the prognosis of Cancer spread to lymph nodes.

A

21% live for more than 5 years.

44
Q

State the prognosis of Advanced Oesophageal Cancer (distant metastases).

A

Most live for 3 to 12 months.

Cancer (21 decks)

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