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MO2 > GI cancer JH > Flashcards

GI cancer JH Flashcards

1
Q

what are the possible upper GI cancers?

A

– Oesophageal
– Stomach
– Liver (notcovered)
– Pancreas
– Gallbladder(notcovered)
– Smallintestine(not covered)

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2
Q

what are the possible lower GI cancers?

A

– Colorectal
– Anus(notcovered)

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3
Q

where can gastric cancer start in?

A
  • Gastric mucosa (adenocarcinoma)
  • Connective tissueofthegastric wall(gastrointestinalstromal tumours(GIST))
  • Neuroendocrine tissue (carcinoid)
  • lymphoid tissues- lymphomas
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4
Q

how is h.pylori diagnosed/treated?

A

Can cause inflammation, potentially leading to
stomach ulcers or cancer
* Diagnosis through blood, breath or stool test
* Treat with 7-day triple therapy: two antibiotics
and a PPI BD

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5
Q

what are alarm symptoms?

A
  • Dysphagia
  • Weightloss(unintentional)
  • Epigastricmass
  • Recentonsetdyspepsiaif>55yrs
  • Persistentvomiting
  • Irondeficiencyanaemia
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6
Q

when would you use surgical management?

A
  • Surgery(only curative treatment)
  • Endoscopic mucosal resection
  • Early stage cancer
  • Total or subtotal gastrectomy
  • Major surgery
  • adjuvant chemo
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7
Q

what are the different combination chemo options?

A
  • epirubicin, oxaliplatin and capecitabine (EOX)
  • epirubicin, oxaliplatin and fluorouracil (EOF)
  • fluorouracil,oxaliplatin,docetaxel (FLOT)
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8
Q

when is radiotherapy used?

A
  • Rarely used in early stage cancer
  • Palliatesymptoms
  • Shrink tumour if causing obstruction
  • reduce gastric bleeding
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9
Q

what are the two types of oseophageal cancer?

A
  • Squamous cells (squamous cell carcinoma)
  • glandular cells
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10
Q

how do you surgically manage oesophageal cancer?

A
  • Surgery
    – MainstayofcurativeTx
  • Oesophagectomy
  • Full
  • Partial
  • Stenting
    – Symptom control of advanced
    disease
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11
Q

when to use chemo in oesophageal cancer?

A

– Inoperable local disease
– Unfit for surgery
– Can cure some early stage cancers
– Can also be used before surgery

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12
Q

what is pancreatic cancer?

A

Pancreas is a large gland
* Makes digestive enzymes and insulin
* Normally adenocarcinomas

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13
Q

what are the sympoms of pancreatic cancer?

A

pain in back or stomach, weight loss, jaundice

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14
Q

how is pancreatic cancer surgically managed?

A
  • Surgery-10% of patients
    – Pancreatectomy
  • Whipple’s procedure removes head of pancreas,
    duodenum, gall bladder
  • Distal removes body and tail
  • Total removes whole pancreas and associated structures
    –rarely used
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15
Q

what happens if its borderline resectable?

A
  • Tumour growth very close to blood vessels
  • Chemoradiotherapy can be used to shrink
    tumour enough for surgery
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16
Q

how does colon cancer present?

A

Dependingonthestageofpresentationpatientsmaypresent
– Anorexia
– Anaemia
– Changeofbowelhabit
* Passingofmucous
* Diarrhoea alternatingwithconstipation
* Bloodinstool
– Rectalbleeding
– Abdominalpain
– Intestinalobstruction
– Palpablemassinabdomen

17
Q

how do you treat colon cancers?

A

Treatmentisacombinationof
–Surgery
–Radiotherapy
–Chemotherapy
* This is dependant upon the site and stage of the
disease
* Surgery is nearly always the initial choice of
treatment

18
Q

what is a stoma?

A

Following colorectal surgery, many patients will
require permanent or temporary colostomy
* Specialist stoma nurse will provide support to
patients

19
Q

what is the adjuvant treatment for dukes b/c?

A

WEEKLY5-FLUOROURACILANDFOLINICACID

20
Q

what is the adjuvant treatment for dukes c- T1-3 n1 , t4 ir N2?

A
  • FOLFOX (Oxaliplatin+5FU)
  • CAPOX(XELOX)Capecitabine&Oxaliplatin)
  • capecitabine
21
Q

what is the chemo used for advanced diseases?

A
  • FOLFIRI(Irinotecan+5FU)
  • CAPIRI(XELIRI)Irinotecan& Capecitabine
22
Q

what is DPD?

A
  • Dihydropyrimidine dehydrogenase
    – Enzyme that helps process thymine and uracil. DPD also breaks down the drugs fluorouracil and capecitabine.
23
Q

what happens if a patient has a DPD deficiency?

A

means the patient is more likely to have severe side effects from these chemo drugs as they build up in the body

24
Q

what are some of the side effects that can occur from DPD deficiency?

A

– Neutropenia, anaemia, thrombocytopenia
– Diarrhoea( moreseverethanusuallyexpected)
– Mucositis
– N &V(moreseverethanusuallyexpected)

25
Q

does a lack of DPD cause symptoms?

A

no

26
Q

what is thesurgery treatment for metastatic disease?

A

surgery- pallative/ resection of liver or lung metastases/ resection considered for single metastases to other organs

27
Q

what is the chemo used for metastatic disease?

A
  • FOLFOX/FOLFIRI+
    Cetuximab(inoperable liver mets)-1st line
    treatment of metastatic colorectal cancer
  • Or Panitumumab +FOLFIRI/FOLFOX Continuous Infusion of 5
    fluorouracil
  • first line chemotherapyR egimes (XELOX/FOLFOX)

MO2 (55 decks)

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