GI cancers Flashcards
what are the causes of oral cancer
tobacco
alcohol
HPV
candida
high risk sites for oral cancer
Soft , non-keratinising sites:
ventral tongue
floor of mouth
lateral edges of tongue
red flags for oral cancer
red/white/ red & white lesion ulcer facial numbness pain change in voice = dysphonia dysphagia
strange manifestations of oral cancer
drooping eyelid/facial palsy fracture of mandible double vision blocked/bleeding nose facial swelling
what are the 2 types of oesophageal cancer
squamous cell carcinoma (SCC)
adenocarcinoma (AC)
cause of oesophageal cancer
smoking
male
old age
barrets oesophagus
describe the development of oesophageal cancer
- normal squamous oesophageal cells
- chronic inflammation
- barrett’s metaplasia
- low grade dysplasia
- high grade dysplasia
- adenocarcinoma
investigations of oesophageal cancer
endoscopy biopsies (minimum 6)
1st line investigation for new onset dysphagia >55y
endoscopy
what investigations are used for staging cancer
CT (chest, abdomen, pelvis)
PET-CT - metastases
treatment of SSC oesophageal cancer
radical chemo
treatment of AC oesophageal cancer
if T1a = endoscopic resection
no metastases or co-morbities = oesophagectomy +/- chemo
metastases = palliative
what is the main cause of gastric cancer
H.pylori
name the 3 benign gastric tumours
hyperplastic polyps
cystic fundic gland polyps
benign peptic ulcer
name the 3 malignant gastric tumours
carcinoma = adenocarcinoma
lymphoma = maltoma
gastrointestinal stromal tumour (GIST)
what are gastric lymphomas derived from
mucosal associated lymphoid tissue (MALT)
risk factor for gastric cancer
pernicious anaemia
partial gastrectomy
menetrier’s disease
H.pylori
symptoms of gastric cancer
dyspepsia weight loss anaemia mass recurrent vomiting
what is a polyp
protrusion above an epithelial surface
what is the most common benign poppy in the colorectal area
adenoma
describe a colorectal adenoma
non-invasive
dysplastic = precursor to adenocarcinoma
describe the microscopic appearance of a colorectal adenoma
tubular, villous, or tubullovillous
what is should be done with colorectal adenomas, why?
removal via endoscopically or by surgery as they are a precursor to adenocarcinoma
risk factors of colorectal cancer
red/processed meat
smoking
alcohol
obesity
what conditions predispose you to colorectal cancer
UC
crohn’s disease
adenomatous polyps
what are the genetic factors which cause colorectal cancer
FAP
HNPCC
what is Familial Adenomatous Polyposis (FAP)
> 100 polyps
what is Hereditary Non-Polyposis Coli (HNPCC)
<100 polyps
GENERAL symptoms of colorectal cancer
anaemia
cachexia
lymphadenopathy
weight loss
symptoms of colorectal cancer located on L side
blood PR
altered bowel habit
obstruction
investigations of colorectal cancer
sigmoidoscopy
colonoscopy
faecal occult blood test (FOBT) - screening programme
CT colography
describe Dukes staging
A = confined by muscularis propria B = through the muscular propria C = metastaised
describe TNM staging
T1 = submucosal only T2 = into muscle T3 = through muscle T4 = infiltrated adjacent structures
N0 = No lymph node involvement N1 = < 3 nodes involved N2 = >3 nodes involved
complications of colorectal cancer
obstruction leading to: 1. distension 2. constipation 3. pain 4. vomiting bleeding perforation
