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GI > ESOPHAGEAL CANCER > Flashcards

ESOPHAGEAL CANCER Flashcards

1
Q

do men or women get esophageal cancer more?

A

MEN

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2
Q

what age population do you see this in?

A

6th to 7th decade of life
increase risk with age

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3
Q

what are the 3 types of esophageal cancer

A

SCC
adenocarcinoma
metastatic caner

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4
Q

what kind of esophageal cancer is most common worldwide?

A

SCC

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5
Q

what race is SCC more common in?

A

blacks and asians

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6
Q

what kind of esophageal cancer is most common in the US?

A

adenocarcinoma
(Accounts for 2/3 esophageal carcinoma cases)

increasing incidence

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7
Q

what race is adenocarcinoma more common in?

A

whites

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8
Q

what percent of esophageal cancer does metastatic account for?

A

3%

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9
Q

what are the 2 cancers most likely to metastasize?

A

melanoma and breast cancer

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10
Q

what are the sx of esophageal cancer in early stages?

A

asx

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11
Q

when does DYSPHAGIA occur in esophageal cancer?

A

when constriction of esophageal lumen is <13 mm

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12
Q

what is a huge tell tale sign of esophageal cancer related to dysphagia?

A

PROGRESSIVE DYSPHAGIA: starts with solids-> semi solids-> liquids and/or saliva

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13
Q

what sx is present in almost all cases despite good appetite?

A

weight loss

its cancer…duh

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14
Q

what is another huge sx of esophageal cancer?

A

ODYNOPHAGIA

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15
Q

what are the OTHER sx of esophageal cancer besides the big 3?

A
  1. chest pain- pressure of burning pain that radiates to the back
  2. GI bleed
  3. vocal cord paralysis and hoarseness d/t compression of recurrent laryngeal nerve
  4. dyspnea- malignant pleural effusion or pulmonary metastasis
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16
Q

what is the most common malignant tumor in the proximal 2/3 of the esophagus?

A

SCC

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17
Q

what is an early lesion of SCC?

A

friable tissue, erythema, and erosions

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18
Q

what is an advanced lesion of SCC?

A

infiltrating or ulcerated mass, may be circumfrential

19
Q

what are the BIG 3 (ONLY 3) RF for SCC?

A
  1. ALCOHOL
  2. tobacco use (in any form)
  3. HPV infection
20
Q

what is the most common malignant tumor in the distal 1/3 of the esophagus?

A

adenocarcinoma of the esophagus

21
Q

what does adenocarcinoma of the esophagus most often arise from?

A

barrett’s esophagus

22
Q

in short, what is barrett’s esophagus?

A

a condition brought on by chronic GERD and reflux esophagitis

23
Q

what is an early lesion of adenocarcinoma of the esophagus?

A

mucosal irregularities, ulcer, or nodule

24
Q

what is an advanced lesion of adenocarcinoma of the esophagus?

A

ulcerated or exophytic mass with obstruction

25
Q

what are the BIG 3 (ONLY 3) RF for adenocarcinoma of the esophagus?

A
  1. GERD!!
  2. tobacco use (in any form)
  3. obesity (central fat distribution)
26
Q

what is the dx study of choice to identify the cancer?

A

endoscopy with brush cytology and biopsy

27
Q

what is the dx study of choice to determine tumor extent?

A

CT chest and abdomen

28
Q

what is the dx study of choice to determine the depth of the tumor in the esophageal wall and regional lymph node involvement?

A

endoscopic ultrasound of the esophagus

29
Q

what basic blood tests should be run?

A
  1. CBC w/ diff
  2. electrolytes
  3. liver function
30
Q

what does esophageal cancer tx depend on?

A

tumor staging, size, and location

31
Q

what is TNM staging classification?

A

0-IV

32
Q

what is the best tx for esophageal cancer?

A

surgical resection, often combined with chemotherapy for advanced cancers

33
Q

what is the best tx for a tumor of ADVANCED age?

A

immunotherapy plus chemotherapy

34
Q

what is T1 tumor staging?

A

mucosa and submucosa

35
Q

what is T4 tumor staging?

A

lymph nodes involved

36
Q

what does prognosis depend on?

A

tumor stage

37
Q

what is the overall prognosis of esophageal cancer?

A

overall survival is poor d/t patients presenting w/ advanced disease

38
Q

what has a 80% survival rate?

A

cancer restricted to mucosa

39
Q

what has a <50% survival rate?

A

cancer with submucosal involvement

40
Q

what has a -20% survival rate?

A

cancer w/ extension to muscularis

41
Q

what is the 5 year survival of esophageal cancer?

A

<5%

42
Q

what are the best prevention options?

A
  1. drink alc in moderation or not at all
  2. dont smoke
  3. maintain healthy weight
  4. manage acid reflux and other throat irritants
  5. eat healthy diet rich in fruits and veggies
  6. avoid drinking very hot liquids
43
Q

compare and contrast the epidemiology, location, and RF for esophageal adenocarcinoma and SCC.

A

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GI (22 decks)

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