Esophageal and Gastric Cancer (#1)

Question 1

How common is esophageal cancer in Canada?

Answer 1

Carcinoma of the esophagus represents almost 1% of all new cases in Canada

Question 2

Who is more susceptible of developing esophageal carcinoma?

Answer 2

• More common in persons over the age of 60 yrs

- Occurs more frequently in men

Question 3

How many new cases will be diagnosed and approximately how many Canadians will die of this disease?

Answer 3

2200 new cases will be diagnosed and approximately 2100 Canadians will die of this disease

Question 4

What are the 2 forms of esophageal cancer?

Answer 4

Squamous cell carcinoma and adenocarcinoma

Question 5

Etiology of squamous cell carcinoma?

Answer 5

Mostly attributible to alcohol and tobacco use

Question 6

Etiology of adenocarcinoma?

Answer 6

Associated with barrett esophagus (GERD)

Question 7

Out of the two forms of esophageal CA, which is the most common?

Answer 7

Squamous cell carcinoma is the most common esophageal cancer globally, but in Canada it is decreasing.

Question 8

Describe the relationship between esophageal adenocarcinoma and Barrett esophagus.

Answer 8

The pathogenesis of adenocarcinoma form Barrett esophagus is a multistep process, with the development of dysplasia being a critical step in the process. Thus, endoscopic surveillance of persons with Barrett esophagus provides the means for detecting adenocarcinoma @ an earlier stage, when it is most amenable to curative surgical resection.

Question 9

What are the therapeutic interventions for esophageal canceR?

Answer 9

Treatment of esophageal cancer depends on tumour staging.

• surgical resection provides a means of cure when done in early disease and palliation when done in late disease
• radiation may be used as an alternative to surgery
• chemotherapy may be used before surgery

Question 10

How common is gastric cancer? And where is it most common globally?

Answer 10

Second common tumour in the world. It occurs particularly in countries such as Japan, Korea, and China

Question 11

Who is most susceptible in developing gastric cancer?

Answer 11

It is more common in lower socioeconomic groups and exhibits a male-to-female ratio about 2:1.

Question 12

Etiology of gastric cancer.

Answer 12

• genetic factors
• carcinogen factors in the diet
• autoimmune gastritis
• gastric adenomas or polyps
• chronic infection with H. pylori

Question 13

Major manifestations of gastric cancer.

Answer 13

• often asymptomatic until late in their course
• indigestion
• anorexia
• weight loss
• vague epigastric pain
• vomiting
• abdominal mass

Question 14

Diagnostics for gastric cancer?

Answer 14

• barium x-ray studies
• endoscope with biopsy
• cytologic studies (eg. Pap smear) of gastric secretions
• CT and endoscopic ultrasonography often are used to delineate the spread of a diagnosed stomach cancer.

Question 15

What are 3 approaches to interventions for gastric cancer?

Answer 15

1. Surgery -> depending on the location and extent of the lesion (treatment of choice)
2. Irradiation
3. Chemotherapy
   (2&3 usually used for palliative purposes or to control metastatic spread of the disease)