Gastric Cancer

Question 1

What is gastric cancer?

Answer 1

cancer of the stomach.

Most commonly adenocarcinoma

Question 2

List 3 rarer histological types of gastric cancer

Answer 2

Lymphoma
Leiomyosarcoma
Stromal tumours

Question 3

Explain the aetiology of gastric cancer

Answer 3

UNKNOWN

Environmental insults in genetically predisposed individuals

Question 4

List 11 risk factors for gastric cancer

Answer 4

Smoked + processed foods  
Smoking  
Alcohol 
H. pylori infection  
Atrophic gastritis  
Gastric ulcers 
GORD  
Partial gastrectomy  
Gastric polyps  
FH
M > F

Question 5

Describe the epidemiology of gastric cancer

Answer 5

COMMON cause of cancer death worldwide
Highest incidence in JAPAN (+ Asia)
6th most common cancer in the UK
> 50 yrs

Question 6

List 6 symptoms of gastric cancer

Answer 6

Early satiety 
Epigastric discomfort  
Haematemesis, melaena, sx of anaemia
Systemic sx: weight loss, anorexia, N+V
Dysphagia (in tumours of gastric cardia)  
Sx of mets (e.g. ascites, jaundice)

Question 7

List 4 signs of gastric cancer

Answer 7

Epigastric mass
Abdominal tenderness
Ascites
Signs of anaemia

Question 8

What investigations should be performed for gastric cancer?

Answer 8

Bloods: FBC (check for anaemia), LFTs
Upper GI endoscopy + biopsy
CT/MRI: staging
Endoscopic USS: depth of invasion + lymph node spread

Question 9

How does gastric cancer onset correlate with symptoms?

Answer 9

Often asymptomatic early

Question 10

List 3 eponymous signs that may arise in gastric cancer

Answer 10

Virchow’s Node (aka Troisier’s sign- lymphadenopathy in left supraclavicular fossa)
Sister Mary Joseph’s Nodule (metastatic node on umbilicus)
Krukenberg’s Tumour (ovarian metastases)