GASTRIC CANCER Flashcards
two types of oesophageal cancer
adenocarcinoma
squamous
where is adenocarcinoma more present
in the developed world
aetiology of adenocarcinoma oesophageal cancer
GORD
Barretts oesophagus
Smoking
Achalasia
Obesity
location of adenocarcinoma
lower 1/3 near the GO junction
Presentation of oesopphgeal cancer
vomiting
PROGRESSIVE DYSPLASIA
anorexia and weight loss
odynophagia, hoarseness, melaena, cough
risk factors for oesophageal caner
SMOKING
Alcohol
achalasia
obesity
low veg, fruit
hot drinks
location of squamous cell carcinoma
upper 2/3
what is ALARMS
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Melaena
Swallowing issues
investigations for oesophageal cancer
1st line- upper GI endoscopy + biopsy
CT scan or endoscopic US
Management of oesophageal cancer
-operable disease- surgical resection
- chemotherapy
-palliation
two types of gastric cancer
1- intestinal / differentiated
2- diffuse/ undifferentiated
rf for type 1 gastric cancer
Male
H. pylori
chronic gastritis
old age
histology and appearance of T1GC
glandular
large irregular
location of T1GC
antrum and lesser curvature
rf for T2GC
blood type a
younger age
histology and appearance of t2gc
- poorly differentiated
- signet ring cells
- gastric linitis - submucosa invasion
location OF T2GC
anywhere- esp cardia of the stomach
why is T2GC more common in the cardia of stomach
defective adhesion bc CDH-1 mutation — defective e cadherin —- increase in ability to invade and spread
red flags for GI cancer that would make you do an urgent 2 week referral
- dysphagia of any age
- over 55 and weight loss with:
upper abdo pain
reflux
dyspepsia
consider non urgent endoscopy if …?
haematememsis
treatment resistant dyspepsia
upper abdo pain
anaemia
clinical presentation of Gastric cancer
anorexia
nausea
anaemia
fatige
epigastric pain
investigation for GC
Gastroscopy - 8-10 biopsies
endoscopic US
CT/MRI
management of GC
Nutritional support
surgical resection
chemo
protective mechanisms against gastric cancer
fruit, veg, folate, fibre
What is a Mallory Weiss tear
Tear in Oesophagus due to sudden increases in intra abdominal pressure
What can cause a MW tear
Forceful vomiting
Chronic coughing
Weight lifting
Hiatus hernia
Signs and symptoms of a Mallory Weiss tear
Haematamesis
Melena
Postural hypertension
Dizziness
What are oesophageal varices
Enlarged veins that protrude into the Oesophagus
Cause of oesophageal varies
Hypertension in portal venous system due to underlying liver issues
Key phrase for oesophageal varies
Coughing out a lot of blood
Signs and symptoms of oesophageal varies
Haematamesis
Ab pain
Systemic shock
Acute bleed emergency response would involve …
ABCDE
VASOPRESSIN
Bleeding abnormality- then Vit k then infusion
