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GI System > GI Cancers > Flashcards

GI Cancers Flashcards

1
Q

What are the 5 most common cancers of the GI tract in the UK?

A

Bowel, pancreatic, oesophagus, stomach, liver.

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2
Q

How do Liver cancers spread within the body?

A

Bloodstream via portal system, Lymphatics, transcoelomic (through peritoneal cavity from ovary), commonly from breast or lung.

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3
Q

What is are the epithelial types found in the oesophagus?

What malignancy therefore arises?

A

Stratified squamous (squamous cell carcinoma) Lower portion simple columnar (adenocarcinoma)

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4
Q

What risk factors predispose to oesophageal cancer?

A

Smoking, Barrett’s oesophagus, acid reflux, chronic alcohol consumption.

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5
Q

How does oesophageal cancer clinically present?

What red flags are there to look out for?

A

Dysphagia,
Epigastric pain.
Anaemia, weight loss, recent onset of progressive symptoms, malaena, haematemesis.

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6
Q

How is oesophageal cancer staged?

A

TNM staging
T - tumour size (mucosal, submucosal, muscularis, adventitia, other organs nearby eg heart lungs pleura and diaphragm)
N - lymph node involvement
M - metastases (absent or present)

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7
Q

What is the epithelial cell type found in the stomach?

What cancer does this cause?

A

Columnar epithelium.

Adenocarcinoma.

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8
Q

What are the risk factors for stomach cancer?

A

High salt diet,
H-pylori infection,
Smoking,
Chronic inflammation (as with all cancer).

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9
Q

How does stomach cancer clinically present?

A

Epigastric pain, dysphagia, dyspepsia (indigestion).

Malaena, haematemesis,

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10
Q

What other cancers may be found in the stomach and which tissues are they derived from?

A

Gastric lymphoma - MALT,

Gastrointestinal stromal tumours eg sarcomas. Non epithelial tissue.

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11
Q

How is gastric cancer staged?

A

TNM staging system

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12
Q

Where are gastric cancers often located in the stomach?

A

Cardia (causing dysphagia), Antrum.

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13
Q

What cells primarily form malignancies in the pancreas?

A

Ductal cells (ductal adenocarcinoma, 80%)

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14
Q

What risk factors are there for pancreatic cancers?

A

Family history, smoking, chronic pancreatitis.

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15
Q

How does pancreatic cancer typically present?

A

Poor discernible features, therefore often presents very late.
Painless jaundice, weight loss, vomiting, diarrhoea and constipation.

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16
Q

How is pancreatic cancer staged?

A 
TNM staging,
T1 <2cm
T2 2<4cm
T3 >4cm
T4 - tumour is growing outside the pancreas into larger blood vessels.
17
Q

What is the adenocarcinoma sequence?

A 
gene mutations in:
APC,
K-RAS,
SMAD4/CDC4,
P53.
18
Q

What epithelial cell type is found in the large bowel?

What malignancy arises from this?

A

Simple columnar.

Adenocarcinoma.

19
Q

What are the risk factors for large bowel cancer?

A

Diet (red meats, low fibre),
Inflammatory bowel disease,
Poly Powis syndromes.

20
Q

What screening is carried out for bowel cancers?

A

Faecal occult blood samples,

Endoscopy.

21
Q

How does right sided colon cancer clinically present?

A 
Weight loss,
Anaemia,
Late changes to bowel habit,
Mass in right iliac fossa +-.
Fungating
22
Q

How does left sided colon cancer present clinically?

A 
Weight loss,
Rectal bleeding,
Tenesmus,
Early change to bowel habit,
Stenosing.
23
Q

How is colorectal cancer staged?

A 
TNM or dukes staging
Dukes A - confined to mucosa,
B1 - muscularis propria
B2 - full thickness/into serosa
C1 - spread to up to 4 lymph nodes
C2 - more than 4 lymph nodes
D - distant metastasis.
24
Q

What are the five types of small bowel cancer?

A 
Stromal,
Lymphoma,
Adenocarcinoma,
Sarcoma,
Carcinoid tumour.
25
Q

What risk factors are there for small bowel cancer?

A

Crohn’s disease, coeliac disease, FAP, diet.

26
Q

What is the apple core deformity visualised on MRI?

A

Stenosing tumour that encroaches upon the lumen of the colon from all sides. Often found in descending colon.

27
Q

Which tumour marker is used for colorectal cancer?

Which tumour marker is used for pancreatic cancer?

A

CEA,

CA 19-9

28
Q

What is the most common type of primary malignancy affecting the liver?
Is the liver commonly affected by primary malignancy?

A

Hepatocellular carcinoma.

No, often a site of metastasis.

29
Q

Why is metastasis to the liver common?

A

Drains blood from the entire gut via the hepatic portal system. As such malignant spread through blood is likely to lodge in the liver.

GI System (11 decks)

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