Common malignancies of the GI tract Flashcards

1
Q

Types of oesophageal cancer

A

Squamous (proximal 2/3)

Adenocarcinoma (distal 1/3)

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2
Q

Presentation of oesophageal cancer

A

Progressive Dysphagia
Odynophagia
Weight Loss
Long history of reflux

Oesophageal cancer often presents late

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3
Q

Risk factors for oesophageal adenocarcinoma

A

Barrats oesophagus

Chronic gastro-oesphageal reflux

Smoking

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4
Q

Types of gastric cancer

A

Adenocarcinoma

Can be at the gastro-oesophageal junction or the stomach

Cancers can present as polyps, ulcers of diffuse spread of neoplasia (linitis plastica)

Lymphoma also common in the stomach (B-cell, non-Hodgkins). Responds well to chemotherapy

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5
Q

Risk factors for gastric cancer

A

Diet (major cause)
H. pylori infection (chronic ulcers)
Chronic gastritis

Smoking

Alcohol

Blood group A

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6
Q

Common symptoms of gastric cancer

A

Dyspepsia

Bleeding

Gastric outlet obsrucion (projectile vomiting)

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7
Q

Most common cause of cancer in the liver

A

Metastasis (secondary spread from elsewhere)

Primary liver cancer is rarer, caused by alcohol and liver infections (hepatitis)

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8
Q

Presentation of pancreatic cancer

A

Painless obstructive jaundice

Abdominal pain

Weight loss

Recently diagnoses diabetes (<2 years)

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9
Q

Dukes’ classification of cancer

A

A – confined to bowel wall

B – spread through bowel wall

C – involves lymph nodes;
C1 – apical node clear
C2 – apical node involved

D – distant spread

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10
Q

TNM staging of cancer

A

Tumour size
T1 – superficial to muscle
T2 – into muscle but not through bowel wall
T3 – Through bowel wall
T4 – Perforated, or involving serosa or locally spreading

Lymph Nodes
N1 – 1-3 local nodes
N2 – 4+ local nodes

Metastasis
M1 – Distant spread

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11
Q

Types of small bowel cancer

A

Primary cancers rare, secondaries more common

Carcinoma - very rare but can occur

Lymphoma - various types can occur. In particular, EATCL (enteropathy associated T cell lymphoma) occurs as complication of long-standing coeliac disease

Endocrine - carcinoid tumours

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12
Q

Risk factors for colorectal cancer

A

Diet - red meat, low fibre, low fruit and vegetable and dairy

Obesity

Low physical activity

Alcohol

Genetic: FAP, HNPCC

IBD

Type 2 diabetes

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13
Q

Presentation of colorectal cancer

A

Altered bowel habits

PR bleeding (fresh - left sided, altered - right sided)

Iron deficiency anaemia

Anorexia

Weight loss

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14
Q

Distribution of colorectal cancers

A

Rectum (27%)

Sigmoid colon (20%)

Caecum (14%)

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