Gastric cancer Flashcards
What kind of cancer is gastric cancer usually?
Adenocarcinoma
What are the risk factors for gastric cancer?
male, H pylori, increasing age, smoking, alcohol, salt in diet, family history and pernicious anaemia
What enzyme does H pylori produce?
urease enzyme which acts to break down urea into CO2 and ammonia, the ammonia then neutralises stomach acid so bacterium can make an alkaline microenvironment causing damage to epithelial cells, inflammation, ulceration and then gastric neoplasia
How much more likely are you to get gastric cancer if you are infected with H pylori?
6x
What are the clinical features of gastric cancer?
vague and non-specific but might get dyspepsia, dysphagia, early satiety, vomiting, melena, anorexia, weight loss, anaemia, may have a mass
What are the differential diagnosis of gastric cancer?
non-specific symptoms, so peptic ulcer disease, GORD, gallstones, pancreatic malignancy
What laboratory tests would you do for gastric cancer?
routine bloods, with full blood count and LFTs
What imaging needs to be done for gastric cancer?
urgent upper GI endoscopy, to visualise and take biopsy, Histology, CLO test and HER2/NEU protein expression for monoclonal therapies , CT chest abdopelvis and staging laparoscopy
What is the management for gastric cancer?
nutrition, surgery, perioperative chemotherapy,, total or subtotal gastrectomy, endoscopic mucosal resection, palliative- supportive stenting
What are some complications of a gastrectomy?
death, anastomotic leak, re-operation, dumping syndrome, vitamin b12 deficiency
What are the main complications of gastric cancer?
gastric outlet obstruction, iron-deficiency anaemia, perforation and malnutrition
What is the mortality rates for gastric cancer
15% at 10 years
