GI: Cancer Flashcards
How are GI infections treated?
- Fluid resuscitation
- Antibiotics if immunocompromised
- Treatment of underlying conditions
Describe how G.I. cancers may spread within the body
- Blood stream
- Lymph
What are risk factors of oesophageal carcinomas?
- Smoking
- Obesity
- Barrett’s
What are histological features of malignancies in the oesophagus?
- Squamous cell carcinoma
- Lower third can develop adenocarcinoma from Barretts
What is the incidence of GI cancer from most common to least common?
- Bowel
- Pancreas
- Oesophagus
- Stomach
- Liver
What is the clinical presentation of Gastric Cancer?
- Similar pain to peptic ulcer
- 50% have palpable mass
What are risk factors of Gastric Cancer?
- Smoking
- High salt diet
- Family history
- Chronic inflammation (chronic gastritis by H.Pylori)
What is the most important environment factor for stomach cancer?
-H.Pylori
Which part of the GI tract is the most common site for a primary gastrointestinal lymphoma?
Stomach
- MALT tissue
- Most associated with H.Pylori
- Similar presentation to gastric carcinoma but prognosis better
What are the histological features of stomach cancers?
- Adenocarcinomas
- Arise from chronic gastritis common or metaplasia.
Stomach ulcers potentially malignant
Why does gastric cancer have a poor prognosis?
-Present late and are therefore advanced
How does pancreatic cancer present?
Head
- Painless jaundice (Interferes with biliary flow into duodenum. )
- Persistent pain
- Weight loss anorexia
- Fatigue
Body/Tail
-Symptoms more vague
What are the risk factors for pancreatic cancer?
- Family history
- Smoking
- Chronic pancreatitis
- Men more than women
- Incidence increases with age. Typical over 60 years
What is the histological features of pancreatic cancer?
- Commonly (80%) are ductal adenocarcinomas
- Commonly affects head of pancreas
What is the clinical presentation of small bowel cancer?
- Per rectum bleeding
- Change in bowel habit (frequency, consistency, discomfort)
- Weight loss
- Abdominal pain
What are risk factors of small bowel cancer?
- Inflammatory bowel disease
- Coeliac disease
- Familial adenomatous polypoids
- Diet
What are risk factors of large bowel cancer?
- Family history
- Inflammatory bowel disease
- Polyposis syndromes (FAP)
- Diet and lifestyle
What the histological features of small bowel cancer?
Rare!
- Stromal
- Lymphoma
- Adenocarcinoma
- Sarcoma
- Carcinoid tumours
What are the histological features of large bowel cancer?
-Adenocarcinoma (mostly in rectum and sigmoid colon)
Most can be viewed with sigmoidoscope
What is the basis for most colorectal cancer?
- Adenomas are the basis of most colorectal cancers.
- Demonstrated by familial adenomatous polyposis, an inherited condition where invariably the numerous adenomas present will undergo malignant change.
What genetic events are coleorectal cancers related to?
- Activation of oncogene
- Ineffective DNA repair
- Loss of tumour suppressor genes
What are the features of rectal cancers?
Usually ulcerating and therefore give PR bleeding. They can also produce the symptom of tenesmus due to distension of the rectum.
What is the clinical presentation of left sided colon cancer?
- Weight loss
- Bowel obstruction (Contents are more solid on left side)
- Tenesmus
- Early change in bowel habit
- Less advanced disease at presentation
- Rectal bleeding
- Abdominal pain
- Mass in left illiac fossa
What is the clinical presentation right sided colon cancer?
- Weight loss
- Anaemia
- Occult bleeding
- Mass in right iliac fossa
- Disease more likely to be advanced at presentation
- Caecum and colon are more distensible so obstruction doesn’t occur early
Describe the adenoma-carcinoma sequence
Benign growth derived from genetic changes
- Become hyperplastic
- Abnormal differential leads to dysplasia of the cells
- Dysplastic cells have potential to become cancerous
