GI Cancers Flashcards
What are the 5 most common cancers of the GI tract in the UK?
Bowel, pancreatic, oesophagus, stomach, liver.
How do Liver cancers spread within the body?
Bloodstream via portal system, Lymphatics, transcoelomic (through peritoneal cavity from ovary), commonly from breast or lung.
What is are the epithelial types found in the oesophagus?
What malignancy therefore arises?
Stratified squamous (squamous cell carcinoma) Lower portion simple columnar (adenocarcinoma)
What risk factors predispose to oesophageal cancer?
Smoking, Barrett’s oesophagus, acid reflux, chronic alcohol consumption.
How does oesophageal cancer clinically present?
What red flags are there to look out for?
Dysphagia,
Epigastric pain.
Anaemia, weight loss, recent onset of progressive symptoms, malaena, haematemesis.
How is oesophageal cancer staged?
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)
What is the epithelial cell type found in the stomach?
What cancer does this cause?
Columnar epithelium.
Adenocarcinoma.
What are the risk factors for stomach cancer?
High salt diet,
H-pylori infection,
Smoking,
Chronic inflammation (as with all cancer).
How does stomach cancer clinically present?
Epigastric pain, dysphagia, dyspepsia (indigestion).
Malaena, haematemesis,
What other cancers may be found in the stomach and which tissues are they derived from?
Gastric lymphoma - MALT,
Gastrointestinal stromal tumours eg sarcomas. Non epithelial tissue.
How is gastric cancer staged?
TNM staging system
Where are gastric cancers often located in the stomach?
Cardia (causing dysphagia), Antrum.
What cells primarily form malignancies in the pancreas?
Ductal cells (ductal adenocarcinoma, 80%)
What risk factors are there for pancreatic cancers?
Family history, smoking, chronic pancreatitis.
How does pancreatic cancer typically present?
Poor discernible features, therefore often presents very late.
Painless jaundice, weight loss, vomiting, diarrhoea and constipation.
How is pancreatic cancer staged?
TNM staging, T1 <2cm T2 2<4cm T3 >4cm T4 - tumour is growing outside the pancreas into larger blood vessels.
What is the adenocarcinoma sequence?
gene mutations in: APC, K-RAS, SMAD4/CDC4, P53.
What epithelial cell type is found in the large bowel?
What malignancy arises from this?
Simple columnar.
Adenocarcinoma.
What are the risk factors for large bowel cancer?
Diet (red meats, low fibre),
Inflammatory bowel disease,
Poly Powis syndromes.
What screening is carried out for bowel cancers?
Faecal occult blood samples,
Endoscopy.
How does right sided colon cancer clinically present?
Weight loss, Anaemia, Late changes to bowel habit, Mass in right iliac fossa +-. Fungating
How does left sided colon cancer present clinically?
Weight loss, Rectal bleeding, Tenesmus, Early change to bowel habit, Stenosing.
How is colorectal cancer staged?
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.
What are the five types of small bowel cancer?
Stromal, Lymphoma, Adenocarcinoma, Sarcoma, Carcinoid tumour.
