GI cancers Flashcards
What is a primary cancer?
Cancer cells arise directly from the cells in an organ.
What is a secondary cancer?
Cancer cells spread from another organ. Another name for metastases.
What are the first 3 hallmarks of cancers?
Sustaining proliferative signalling. Evading growth suppressors. Activating invasion and metastasis.
What is an Adenocarcinoma?
Cancer originating in glandular epithelium tissue.
What is a cancer of the squamous epithelium called?
Squamous cell carcinoma.
What are neuroendocrine tumours?
Tumour of enteroendocrine cell origin.
What are gastrointestinal stromal tumours?
Interstitial cells of cajal tumours.
What is a smooth muscle cancer called?
Leiomyosarcomas
What is an adipose tissue cancer called?
Liposarcomas.
Where are interstitial cells of cajal found?
Muscularis.
Criteria for whether screening should be conducted for a disease?
There should be an accepted treatment for the disease. There should be a suitable test or examination. The condition should be an important health problem.
2 screening tests for colorectal cancer?
Faecal immunochemical test (FIT) and a one-off sigmoidoscopy.
What does faecal immunochemical test detect?
Haemoglobin in faeces.
What is the purpose of doing a one-off sigmoidoscopy for cancer screening?
Remove polyps to reduce future risk of cancer.
Why is a sigmoidoscopy done and not a full colonoscopy?
Polyps are more commonly found in the sigmoid and rectum.
Who is eligible for an upper endoscopy done to screen for oesophageal cancer?
Individuals with barret’s oesophagus or dysplasia in oesophagus.
Who is eligible for a hepatocellular cancer screen?
Individuals with cirrhosis.
How is screening done for hepatocellular cancer?
Alpha-fetoprotein test, regular ultrasound.
Why is a biopsy of a cancer done?
Provides histologic typing - what type of cell does the cancer come from. Provides molecular typing - what mutations do the cells have. Provides tumour grade.
Pathologist role in cancer MDT
Confirms diagnosis of cancer using biopsy sample.
Why are radiological investigations for cancer done?
Provides radiological tumour stage. Provides re-staging after treatment. Interventional radiology.
What system is used to evaluate cancer stage?
T - Tumour size
N - Lymph node involvement
M - Metastases present
What interventional radiology is done for cancer?
Percutaneous biopsies.
How would you treat a blockage caused by a cancer?
Use of a stent.
What member of the MDT coordinates the overall cancer treatment plan?
Oncologist.
What is chemotherapy that happens before surgery called?
Neoadjuvant chemotherapy.
What is chemotherapy that happens after surgery called?
Adjuvant chemotherapy.
What part of the oesophagus can you develop squamous cell carcinoma?
Upper 2/3
What part of the oesophagus can you develop adenocarcinoma?
Lower 1/3
How to adenocarcinomas develop in the distal oesophagus?
Squamous epithelium becomes collumnar epithelium
What term is used to describe cancer that begins in cells that have changed into another cell type?
Metaplastic.
Who is at increased risk of an adenocarcinoma in the oesophagus?
Individuals with Barrett’s oesophagus.
Oesophageal cancer late stage symptom?
Dysphagia - difficult swallowing.
What investigations are done to stage oesophageal cancer and gastric cancer?
CT scan, PET CT scan, laparascopy and endoscopy ultrasound.
What increases your risk of gastric cancer?
Chronic gastritis, pernicious anaemia, partial gastrectomy.
What infections increase risk of gastric cancer?
H.pylori and epstein-barr virus.
How does H.pylori increase risk of gastric cancer?
Causes acid overproduction.
How does a partial gastrectomy increase risk of gastric cancer?
Bile reflux.
Gastric cancer symptoms?
Dyspepsia (upper abdominal discomfort after eating). Weight loss and abdominal mass on examination.
What conditions can gastric cancer cause?
Anaemia.
What surgery is done if tumour is present at oesophago-gastric junction?
oesophago gastrectomy - removal of oesophagus.
What surgery is done if tumour is present close to the oesophago-gastric junction?
Total gastrectomy.
What surgery is done if tumour is present in the body of the stomach?
Subtotal gastrectomy.
