Gastric cancer Flashcards
What is gastric cancer?
Gastric cancer = malignant tumour/neoplasm that can develop in any portion of the stomach
Most commonly adenocarcinomas
What are the risk factors for gastric cancer?
Pernicious anaemia
Helicobacter pylori infection - Bacteria cause inflammation, which results in atrophy, metaplasia and carcinoma
N-nitroso compounds (vegetables and food additive)
Diet low in fruits and vegetables - High vitamin C content reduces formation of N-nitroso compounds
High-salt diet - Damages gastric mucosa and enhances carcinogenic effects of N-nitroso compounds
Smoking
What is the epidemiology of gastric cancer?
3rd most common cause - cancer death, Present with advanced disease
Increasing incidence in the West - Decrease in distal gastric cancers but Marked increased in proximal gastric cancers
Highest incidence in East Asia, Eastern Europe and South America
2x more common in men
More common in older people
What are the symptoms of gastric cancer?
Abdominal pain – epigastric, similar to peptic ulcer disease Hematemesis Indigestion Weight loss Vomiting Dyspepsia Dysphagia +/- odynophagia
ALARMS Anaemia + abdominal pain Loss of weight Anorexia (loss of appetite) Reflux (dyspepsia) Meleana + haematemesis Swallowing (dysphagia, odynophagia)
What are the signs of gastric cancer?
Lymphadenopathy
Cahexia
Anaemia
Jaundice
Hepatomegaly
Troisier’s sign (Virchow’s node) = metastatic cancer
Sister Mary Joseph node: umbilical node = metastatic cancer
What investigations are appropriate for diagnosis of gastric cancer?
OGD (Oesophago-Gastroduodenoscopy) with biopsy
Ulcer, mass or mucosal changes
Bloods - Pernicious anaemia
Further investigations
Endoscopic ultrasound - Determines clinical T and N stage
CT abdomen/pelvis/chest - Metastatic disease
CXR - Metastatic disease
Laparoscopy - Metastatic disease
