GI cancer :

Question 1

what are the three main types of gut cancer?

Answer 1

• oesophageal cancer
• colon cancer
• pancreatic cancer

Question 2

what cancers affect epithelial cells?

Answer 2

squamous - Squamous cell carcinoma
( found the top of the oesophagus)

glandular epithelium -
adenocarcinoma

Question 3

what cancers affect neuroendocrine cells?

Answer 3

• enterochrommafin cells - carcinoid tumours
• interstitial cells of cajal -
  GI stromal tumours

Question 4

what cancers affect connective tissue?

Answer 4

smooth muscle - leiomyoma

adipose tissue - lipoma

Question 5

what are primary and secondary cancers?

Answer 5

• primary cancer is arising directly from the cells in the organ
• secondary cancer is after metastasis

Question 6

what are the types of oesophageal cancer?

Answer 6

• squamous cell
  Upper 2/3 of oesophagus.
  Acetaldehyde pathway.
  more common in poor countries
• adenocarcinoma
  lower 1/3 of the oesophagus
  Related to acid reflux
  more common in rich countries

Question 7

how to identify oesophageal cancer?

Answer 7

• we are trying to diagnose carcinoma from barretts oesophagus
• we can use an endoscopy, OGD or gastroscopy

Question 8

what is barretts oesophagus?

Answer 8

• metaplasia of cells
  around 5% can turn into dysplasia
  of which 0.5% turn into a carcinoma

Question 9

what are risk factors for colorectal factors?

Answer 9

• age
• strong family history
• Uncontrolled ulcerative colitis
• previous polyps

Question 10

what is the progression of colorectal cancer?

Answer 10

• it is a sequence of genetic errors

Question 11

what are symptoms of colorectal cancer?

Answer 11

• normally totally asymptomatic
• change in bowel habit
• blood in stool
  Bright blood probably from the colorectal area
  black or dark red blood is bad

Question 12

what symptoms are not associated with colorectal cancer?

Answer 12

• rectal bleeding with itch
• soreness
• change in bowel habits
  to harder or less frequent
• abdominal pain in absence of obstruction

Question 13

how is colon cancer normally identified?

Answer 13

• using a colonoscopy

Question 14

ads and disads of abdominal x ray ?

Answer 14

ad: cheap, easy, quick
disad: not very sensitive

Question 15

ads and disads of CT scan:

Answer 15

Advantages: quick
easy
see
large lesions.

Disadvantages:
could miss small lesions
cannot take samples
cannot carry out treatment.

Question 16

ads and disads of Barium enema:

Answer 16

Advantages: quite sensitive and specific
Disadvantages: time insensitive | technically demanding | unacceptable for patients.

Question 17

ads and disads of Colonoscopy:

Answer 17

Advantages: safe | quick | high sensitivity | able to obtain tissue

Disadvantages: 2 prep days of iatrogenic diarrhoea | small risk of perforation | small risk of dehydration

Question 18

ads and disads of Virtual colonoscopy:

Answer 18

disads : Quick | easy | reduced bowel prep so more tolerable | good for lesions greater than 6mm

ads: unable to obtain tissue | unable to remove lesions.

Question 19

what are symptoms of pancreatic cancer?

Answer 19

• usually asymptomatic
• Pain in 70%.
• Anorexia in 10%.
• Weight loss in 10%.

also might be ; jaundice, new diabetes, lost weight

Question 20

why might pancreatic cancer cause jaundice?

Answer 20

enlargement on the head of the pancreas

impinges on the common bile duct → diabetes and jaundice.

Question 21

what identifies early pancreatic cancer?

what identifies late pancreatic cancer?

Answer 21

• EARLY – abdominal pain, depression, glucose intolerance

LATE – weight loss, jaundice, ascites

Question 22

what is the prognosis like for pancreatic cancer?

Answer 22

1-year survival rate 18%, 5-year survival rate 2%.

Question 23

what are risk factors for pancreatic cancer?

Answer 23

• smoking
• drinking
• obesity
• family history