Gastric cancer

Question 1

Define gastric cancer

Answer 1

Cancer of the stomach (most commonly adenocarcinoma)

Question 2

Cause of gastric cancer

1 main + 3 rarer

Answer 2

Adenocarcinoma

Lymphoma
Leiomyosarcoma
Stromal tumours

Question 3

Aetiology of gastric cancer

Answer 3

UNKNOWN

Environmental & genetics

Question 4

Risk factors for gastric cancer

8

Answer 4

Smoked & processed foods
Smoking
Alcohol
H. pylori infection
Atrophic gastritis
Pernicious anaemia 
Partial gastrectomy
Gastric polyps

Question 5

Epidemiology of gastric cancer

prevalence, location, age

Answer 5

COMMON cause of cancer death worldwide
Highest incidence in Japan (& Asia generally)
6th most common cancer in UK
Usual age of presentation >50 yrs

Question 6

Presenting symptoms of gastric cancer

8

Answer 6

Often asymptomatic early
Early satiety
Epigastric discomfort
Dysphagia (in tumours of gastric cardia)
Systemic symptoms
weight loss
anorexia
N/V
Symptoms of metastases

Question 7

Signs of gastric cancer on physical examination

7

Answer 7

Epigastric mass
Abdominal tenderness
Ascites
Signs of anaemia
Virchow’s node
Sister Mary Joseph’s nodule
Krukenberg’s tumour

Question 8

Investigations for gastric cancer

4

Answer 8

Upper GI endoscopy
Bloods
CT/MRI
Endoscopic USS

Question 9

Investigations for gastric cancer - bloods

2

Answer 9

FBC - anaemia

LFTs

Question 10

Investigations for gastric cancer - CT/MRI

1

Answer 10

For staging

Question 11

Investigations for gastric cancer - endoscopic US

1

Answer 11

Assess depth of gastric invasion & lymph node involvement