GI cancer: Oesophageal cancer Flashcards
Types of oesophageal cancer
Squamous cell carcinoma
- from squamous epithelium
Adenocarcinoma
- from columnar glandular epithelium
Squamous cell carcinoma Epidemiology
Asia + Middle east
Male: Female = 2:1
60-70
Squamous cell carcinoma Aetiology
Eating certain food, cereals, foods containing nitrous amides
Not eating enough of other foods: Vitamin A, and C, Iron
Achalasia
Chewing tobacco
HPV
Risk factors squamous cell carcinoma
Smoking
Alcohol
Achalasia
Nitrosamines (dietary)
Hot beverages
Where are squamous cell carcinomas most commonly seen
Upper 2/3 of the oesophagus
Which type of epithelium can adenocarcinoma only occur in
Columnar epithelium = thus strongly associated with Barrett’s Oesophagus
Epidemiology Adenocarcinoma
White
Middle ages ~ 50
Male
Aetiology Adenocarcinoma
Barrett’s oesophagus
Obesity
Smoking
Alcohol
Rare: coeliac disease + scleroderma
Risk factors Adenocarcinoma
Genetic susceptibility
Age > 45
Male
GORD
Obesity
Smoking
Oesophageal cancer is more common in…
Men
Which type of oesophageal cancer is most common
Adenocarcinoma is most common in western world
SCC is more common in Japan
Signs
Lymphadenopathy
Anaemia
Vocal cord paralysis
Melaena on digital rectal examination/Haematemesis
Symptoms ALARMS
Anaemia
Loss of weight
Anorexic
Recent sudden six worsening
Melena/ haematemesis
Swallowing PROGRESSIVE dysphagia
- Often asymptomatic until very advanced *
Diagnosis
GOLD STANDARD = Oesophago-gastro duodenoscopy + Biopsy (with barium swallow)
CT/PET for staging
Treatment
Medically fit = chemo and surgery
Unfit = palliative
