GI Cancer

Question 1

What is the most common GI cancer?
What is its risk risk factors?

Answer 1

Colorectal cancer
RF: adenoma, family history, smoking, obesity >50 years, PMH of cancer or radiotherapy

Question 2

How does colorectal cancer present?
What are the stats of cases in each part of colon?

Answer 2

Iron deficiency anaemia
High blood pressure
Diarrhoea
Palpable mass
PR bleeding
Sacral pain
Metastasis symptoms eg jaundice, coughs, bladder symptoms
2/3 of cases are in descending colon and rectum
1/2 in sigmoid colon and rectum

Question 3

How do you investigate and manage colorectal cancer?

Answer 3

Faecal occult blood- avoid red meat 3 days prior
Blood tests: FBC
Colonoscopy-look for polyps
CT colonoscopy- less invasive better tolerated
Abdominal mass
DRE
Hepatomegaly (metastasis)
Bone pain (metastasis)
Management: resection and primary anastomosis, radio, chemo,

Question 4

How does pancreatic cancer present?

Answer 4

Jaundice
Weight loss
Diabetes- due to loss of islet cells
Pain in epigastrium
Acute pancreatitis
GI bleeding
Worst type of Gi cancer to get - top 4 causes of death

Question 5

What are the investigations and treatment for pancreatic cancer?

Answer 5

Ultrasound
Dual-phase CT
Tumour markers
Treatment:HOP and TOP resection

Question 6

What is the main type of liver cancer?
What causes it?
What is the most common treatment?

Answer 6

Hepatocellular carcinoma (HCC)-
normally due to cirrhosis
Liver transplant

Question 7

How does end stage gall bladder cancer present?
Is chemo effective?
What is the most effective treatment?

Answer 7

Porcelain Gall bladder
No
Surgical excision

Question 8

Why is secondary liver metastasis important?

Answer 8

It’s the most common type of cancer
Happens due to other cancer metastasising