Cancers Flashcards

1
Q

What two cancers affect the oesophagus?

A

Oesophageal squamous cell carcinoma- most common type

Oesophageal adenocarcinoma- if they have a barretts oesophagus

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2
Q

What are the 2 major risk factors for oesophageal squamous cell carcinoma?

A

Smoking and obesity

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3
Q

What is the most common presenting complaint for oesophageal carcinoma and what are its red flags?

A
  • Dysphagia

Red flags: anaemia, loss of weight, anorexia, resent onset of progressive symptoms, masses, malaema

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4
Q

In what part of the stomach does gastric cancer normally occur and what is the most common type of cancer?

A

Adenocarcinoma, normally in antrum or cardia

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5
Q

What are the risk factors for gastric adenocarcinoma?

A

smoking, high salt diet, FHx, chronic inflammation (eg from H. Pylori infections)

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6
Q

Describe the presentation of someone with gastric adenocarcinoma?

A

Epigastic pain, similar to gastric ulcers.

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7
Q

What are the differentials for epigastric pain?

A

eosphagitis, peptic ulcer, perforated ulcer, ruptured AAA, pancreatitis

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8
Q

What are the red flags for epigastric pain?

A

malaena, haematemesis, anaemia

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9
Q

Other than adenocarcinoma, what other, more rare, gastric cancers may you get?

A

Gastric lymphomas of MALT tissue- most associated w/ H. Pylori and better prognosis
Gastrointestinal stromal tumours (sarcomas)- very rare and usually incidental findings rather than symptomatic

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10
Q

What is the most likely cause of liver cancer?

A

Usually a metastasis from breast, colon, prostate, gastric ect.
Primary hepatocellular carinoma is very rare

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11
Q

Liver cancer usually presents with intra hepatic jaundice. What are the red flags for jaundice?

A
  • Hepatomegaly w/ irrgular boarder
  • Ascities
    Painless (painful jaundice more likely inflammatory)
  • unintenional weight loss
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12
Q

What is the most common cancer of the pancreas, where in the pancreas does it most commonly occur?

A

Ductal adenocarcinoma

Head of the pancreas

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13
Q

What are the risk factors for pancreatic cancer?

A

FHx, smoking, male, old age, chronic pancreatitis

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14
Q

How may pancreatic ductal adenocarcinoma present?

A
  • post hepatic jaundice
  • acute on chronic pancreatitis
  • malabsorbtion
  • epigastric pain
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15
Q

Is small bowel cancer common?

A

No its very rare

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16
Q

What cancers of the small bowel can occur?

A

lymphoma, adenocarcinoma, sarcoma, carcinoid, carcinoma

17
Q

What are risk factors for small bowel cancer?

A

IBD, coeliac, famillial adenomatous polyposis, diet

18
Q

What are the symptoms of small bowel cancer?

A

weight loss, abdo pain, blood in stools, change in bowel habit, per rectal bleeding, obstruction symptoms (nausia, vomiting, constipation later)

19
Q

Is colorectal cancer common?

A

yes- 3rd most common cancer in the UK

20
Q

What type of cancer tends to affect the colon and where in the colon is most often affected?

A

Adenocarcinoma
50% are in rectum
30% are in sigmoid colon

21
Q

What symptoms arise from left sided colon cancers?

A
  • weight loss
  • abdo pain
  • bowel obstruction
  • tenesmus (feeling like you need to go when you dont)
  • mass in RIF
  • Early change in bowel habit
  • Less advanced at presentation
22
Q

What symptoms arise from right sided colon cancers?

A
  • weight loss
  • anaemia
  • occult bleeding
  • mass in RIF
  • more advanced at presentation
23
Q

Why are right sided colon cancers more advanced at presentation than left sided colon cancers?

A

the colon has a large lumen, contents are more liquid and the wall is more distensible on the right so symptoms due to blockage don’t occur till later

24
Q

What are the risk factors for colon cancer?

A

FHx, IBD, Familial adenomatous polyposis, high meat diet, sedentary lifestyle

25
What differentials are there for bowel obstruction?
Diverticular disease, colon cancer, volvulus, hernia
26
What are the differentials for per rectal bleeding?
haemorrhoids, anal fissures, gasteroenteritis, IBD, diverticular disease (bleeding), cancer
27
What are the differentials for changes in bowel habits?
thryoid disease, IBD, metformin/ other meds, irritable bowel syndrome, coeliac disease, lactose intolerance, cancer
28
How is GI cancer managed?
- TNM staging via biopsies and scans - Blood tests- faecal ocult blood and CAE125 tumour markers + RBCs (anaemia) - CT and MRI (staging) - Colonoscopy - Chemo and surgery - If palliative= radiotherapy