Gastric cancer

Question 1

Define gastric carcinoma

Answer 1

Cancer of the stomach

Question 2

What type of cancer is it most likely?

Answer 2

Adenocarcinoma (glandular cells)

Question 3

What causes it?

Answer 3

Environment and genetics

Question 4

Presentation? (7)

Answer 4

Heartburn/ upper abdo pain
nausea & vomiting
FLAWS
Jaundice,
Dysphagia due to the tumour compressing cardiac sphincter of the stomach> more difficult for food to go down and enter stomach
Melena» if the tumour has caused a bleed in the stomach
Symptoms of anaemia (lethargy, fatigue etc) due to the bleed in the stomach

Question 5

Signs on PE?

Answer 5

Epigastric mass
Epigastric tenderness
Sister Mary joseph’s nodule (growth on umbilicus due to mets)
Krukenberg’s tumour (ovarian tumour due to mets)
Virchow’s node if metastatic

Question 6

what is the main cause of gastric carcinoma?

Answer 6

h pylori

Question 7

how is prognosis for gastric cancer?

Answer 7

poor

Question 8

App Ix? (5)

Answer 8

Bloods- FBC (check for anaemia)
Upper GI endoscopy
CT/MRI for staging and mets
Endoscopic USS» checking the depth of tumour infiltration
Laparoscopy» check to see if tumour can be resected

Question 9

2 Types of gastric cancer in terms of progression?

Answer 9

Early stage= only in mucosa and submucosa

end stage= tumour has infiltrated the propria muscularis

Question 10

Mx?

Answer 10

Only palliative care as the prognosis is really bad

Surgical (pyloric stenting etc) and medical palliation