Gastric Cancer Flashcards
Most common histopathology of gastric cancer
Adenocarcinoma
Epidemiology of gastric cancer
Older (50% are >75y)
M > F
3 RFs for gastric cancer
Diets rich in Nitrates/ Salts
H. pylori
Smoking
How can H pylori lead to gastric cancer?
Triggers inflammation of mucosa → atrophy + intestinal metaplasia
3 Sx at early stages of gastric cancer
Often asymptomatic
Loss of appetite
Nausea
3 general signs of late gastric cancer
Weight loss
Signs of IDA
Palpable epigastric tumour
4 Sx of gastric outlet obstruction
Dysphagia (esp. if arises in proximal stomach)
Abdo pain
Early satiety
Vomiting
2 signs of upper GI bleeding
Haematemesis
Melena
2 signs of metastatic disease in gastric cancer
Hepatomegaly
Ascites
4 masses that indicate metastatic disease in gastric cancer
Left supraclavicular adenopathy (Virchow’s node)
Umbilical nodule (Sister Mary Joseph)
Mass on DRE (Blumer shelf)
Ovarian mass (Krukenberg tumour)
2 paraneoplastic syndromes possible in gastric cancer
Leser-Trelat sign (sudden onset multiple Seb K’s)
Acanthosis nigricans
Ix for gastric cancer
Oesophago-gastro-duodenoscopy with biopsy
Bloods for IDA
CT CAP (staging)
What may be seen on histology of gastric cancer biopsy?
Signet ring cells
Contain a large vacuole of mucin which displaces the nucleus to one side.
Higher numbers of signet ring cells a/w worse prognosis
Surgical tx for gastric cancer
Total gastrectomy: proximal/ mid 1/3
Subtotal gastrectomy: distal
Oesophagectomy: adenocarcinoma of oesophagogastric junction
Typical chemotherapy agents used in gastric cancer
Fluorouracil
Oxaliplatin/ Cisplatin
Docetaxel
