Cancers Flashcards
What two cancers affect the oesophagus?
Oesophageal squamous cell carcinoma- most common type
Oesophageal adenocarcinoma- if they have a barretts oesophagus
What are the 2 major risk factors for oesophageal squamous cell carcinoma?
Smoking and obesity
What is the most common presenting complaint for oesophageal carcinoma and what are its red flags?
- Dysphagia
Red flags: anaemia, loss of weight, anorexia, resent onset of progressive symptoms, masses, malaema
In what part of the stomach does gastric cancer normally occur and what is the most common type of cancer?
Adenocarcinoma, normally in antrum or cardia
What are the risk factors for gastric adenocarcinoma?
smoking, high salt diet, FHx, chronic inflammation (eg from H. Pylori infections)
Describe the presentation of someone with gastric adenocarcinoma?
Epigastic pain, similar to gastric ulcers.
What are the differentials for epigastric pain?
eosphagitis, peptic ulcer, perforated ulcer, ruptured AAA, pancreatitis
What are the red flags for epigastric pain?
malaena, haematemesis, anaemia
Other than adenocarcinoma, what other, more rare, gastric cancers may you get?
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
What is the most likely cause of liver cancer?
Usually a metastasis from breast, colon, prostate, gastric ect.
Primary hepatocellular carinoma is very rare
Liver cancer usually presents with intra hepatic jaundice. What are the red flags for jaundice?
- Hepatomegaly w/ irrgular boarder
- Ascities
Painless (painful jaundice more likely inflammatory) - unintenional weight loss
What is the most common cancer of the pancreas, where in the pancreas does it most commonly occur?
Ductal adenocarcinoma
Head of the pancreas
What are the risk factors for pancreatic cancer?
FHx, smoking, male, old age, chronic pancreatitis
How may pancreatic ductal adenocarcinoma present?
- post hepatic jaundice
- acute on chronic pancreatitis
- malabsorbtion
- epigastric pain
Is small bowel cancer common?
No its very rare
What cancers of the small bowel can occur?
lymphoma, adenocarcinoma, sarcoma, carcinoid, carcinoma
What are risk factors for small bowel cancer?
IBD, coeliac, famillial adenomatous polyposis, diet
What are the symptoms of small bowel cancer?
weight loss, abdo pain, blood in stools, change in bowel habit, per rectal bleeding, obstruction symptoms (nausia, vomiting, constipation later)
Is colorectal cancer common?
yes- 3rd most common cancer in the UK
What type of cancer tends to affect the colon and where in the colon is most often affected?
Adenocarcinoma
50% are in rectum
30% are in sigmoid colon
What symptoms arise from left sided colon cancers?
- 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
What symptoms arise from right sided colon cancers?
- weight loss
- anaemia
- occult bleeding
- mass in RIF
- more advanced at presentation
Why are right sided colon cancers more advanced at presentation than left sided colon cancers?
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
What are the risk factors for colon cancer?
FHx, IBD, Familial adenomatous polyposis, high meat diet, sedentary lifestyle
What differentials are there for bowel obstruction?
Diverticular disease, colon cancer, volvulus, hernia
What are the differentials for per rectal bleeding?
haemorrhoids, anal fissures, gasteroenteritis, IBD, diverticular disease (bleeding), cancer
What are the differentials for changes in bowel habits?
thryoid disease, IBD, metformin/ other meds, irritable bowel syndrome, coeliac disease, lactose intolerance, cancer
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
