gastric cancer Flashcards
intestinal gastric cancer
assoc with H.pylori
commonly on lesser curvature of stomach
diffuse gastric cancer
not asoc with h.pylori
assoc with signet cells
Menetrier’s disease
pre-cancerous
hyperpplasia of gastric mucosa
assoc with parietal cell atrophy
reduced stomach acid - achlorydria
Krukenberg tumour
‘signet ring tumour’
secrete mucin, readily metastasise to ovaries
abdo bloating, ascites, dyspareunia
Sister Mary Joseph nodule
S/c peri-umbilical metastasis assoc with intestinal type gastric cancer
Linitis Plastica
muscles of stomach become thicker –> stomach holds less food
assoc with diffuse stomach cancer
risk factors
smoking pernicious anaemia H.pylori alcohol dierty nitrosamines atrophic gastritis adenomatous polyps achloryhdria
features
iron def anaemia loss weight anorexia malaena haematemesis dysphagia
indiciations for 2wk wait OGD
dysphagia (any age)
age ≥55 + weight loss +
- upper abdo pain/reflux/dyspepsia
- upper abdo mass
indications for 6wk wait OGD
haematemesis (any age)
≥55yrs +
- Rx resistent dyspepsia
- upper abdo pain and low Hb
- raised platelets + other things
Rx - invasive gastirc cancer
partial or total gastrectomy + neoadjuvant chemotherapy
Rx - not surgical
fluourouracil (chemo) + radiotherapy