Gastric Cancer

Question 1

Causes

Type

Answer 1

Helicobacter pylori

Autoimmune - pernicious anaemia

Diet: cured meats

Family history

Smoking

Type: adenocarcinoma

Question 2

Clinical features

Answer 2

Epigastric pain

Weight loss

Nausea

Red flags: anaemia / Malena, dysphagia

Virchow’s node

Question 3

2 week wait indications

Answer 3

Dysphagia

Over 55 years old with weight loss &:

• dyspepsia
• reflux
• upper abdominal pain

Question 4

Complications

Answer 4

Local - invasion of local structures
Obstruction
Haemorrhage

Systemic: DVT, metastasis

Mortality

Question 5

Investigations

Answer 5

Bloods - anaemia, electrolytes with phosphate and magnesium because malnutrition
LFTs for mass

Imaging: OGD and biopsy as gold standard

Ct

Question 6

Management

Curative

Answer 6

MDT

Medical: adjuvant and neoadjuvant

Interventional: gastro Tommy: total or subtotal
Radiotherapy

Question 7

Management

Answer 7

MDT

Medical: palliative chemotherapy and analgesia

Surgical: stent, palliative radiotherapy or gastrectomy