GI Cancers Flashcards
What are the most common cancers for men and women?
Women = Breast
Men = Prostate
What is cancer?
What is a primary cancer?
What is a secondary cancer / metastasis?
A disease caused by an uncontrolled division of abnormal cells in a part of the body
Arising directly from the cells in an organ
Spread from another organ, directly or by other means (blood or lymph)
What are the 3 types of cells in the GI tract?
Using that information, what are the different types of cancers of the GI tract?
- Eptihelial cells
- Neuroendocrine Cells
- Connective Tissue
- Squamous cell carcinoma (SCC), adenocarcinoma
- Neuroendocrine Tumours (NETs), Gastrointestinal Stromal Tumours (GISTs)
- Leiomyoma/leiomyosarcomas
Liposarcomas
Oesophageal anatomy:
What are the 3 parts to the oesophagus?
Cervical
Middle
Lower
What are the 2 most common types of oesophageal cancer?
1.
Squamous Cell Carcinoma
- From normal oesophageal squamous epithelium
- Upper 2/3
- Acetaldehyde pathway
- Less developed world
Related often to alcohol consumption as some molecules get oxidised
Less common in the UK
2.
Adenocarcinoma
- From metaplastic columnar epithelium
- Lower 1/3 of oesophagus
- Related to acid reflux
- More developed world
More common in westernised / more developed world
How does acid reflux progress to cancer?
What are the guidelines to look for Barrett’s?
If there is no dysplasia, go for regular check ups every 2-3 years
If there is low grad dysplasia, regular check ups every 6 months
If there is high grade dysplasia, intervention programmes / treatments are put in place
What is oesophageal cancer?
In which sex group is it found more commonly in?
Missed a slight
What are the survival rates of oesophageal cancer and why?
Symptoms = quite generalised, difficulty swallowing and unintended weight loss
What is the management pathway for GI cancers?
3 main steps:
- Diagnosis:
- Staging:
Laparoscopy - keyhole surgery, small incision, abdomen inflated with CO2, use a camera to look around
PET scan - cancers use up more glucose, so cancerous areas will take up a higher proportion of the radioactive glucose inserted into the patient
- Treatment plan:
Neo-adjuvant chemo, followed by radical surgery (curative intent)
Palliative care
Stent
How does an oesophagectomy work?
2-stage Ivor Lewis approach
When oesophagus is taken out, stomach is lifted and stretched up to replace the part removed
What is colorectal cancer?
How common is it?
What is the lifetime risk?
What are the 3 forms of colorectal cancer?
- Sporadic - mutation slips through the checking process, therefore develop cancer without a fmily history of it, generally the older population and is an isolated lesion
- Familial -
- Hereditary syndrome - Polyps become cancerous
How do polyps develop in the colon and rectum, and how do those polyps develop into cancer?
What are some risk fators for colorectal cancer?
How does colorectal cancer present in clinic? (like 3 slides long)
Depends on the location of the cancer:
Tenesmus = feel the need to go to the loo
Local invasion of the pelvis = bladder issues,
What are some examinations that an be performed to look for colorectal cancer?
What are some investigations to pick up colorectal cancer? (another like 4 slides)
Why is CEA useful?
CEA = not a good diagnostic tool, but if someone is diagnosed to have cancer, cancer reduction / growth can be monitored by blood tests looking for CEA before and after treatment
What are some imaging tests for colorectal cancer?
What is the treatment plan generally for patients with colorectal cancer?
Surgery
Which parts of the gut are taken out depending on the location of the cancer:
[next like 4 slides]
What is pancreatic cancer?
What are the most common forms?
How does it present clinically?
What are the survival rates for pancreatic cancer?
Common, relatively lethal because it metastasises very quickly (e.g. metastasises to colorectal cancer)
Like oesophageal cancer - no specific symptoms indicating pancreatic cancer. Although, many physical signs?
What age group tend to get pancreatic cancer?
What are the incidence and mortality rates?
What are the risk factors for developing pancreatic cancer?
What are some inherited syndromes that increase lifetime risk for pancreatic cancer?
How does pancreatic cancer develop over time? (pathogenesis)
How does pancreatic cancer present clinically? [another 4 slides]
Depends on the location:
How can pancreatic cancers be indicated clinically?
- Marker
2.
3.
What are some investigations that can be performed to look for pancreatic cancer? [few slides]
Which parts of the pancreas are taken out depending on where the pancreatic cancer is?
What is primary liver cancer?
What are the survival rates for this type of cancer?
What is the best treatment plan?
What is gallbladder cancer?
What are the survival rates?
What is the best treatment plan?
How is gallbladder cancer detected?
Generally doesn’t cause symptoms until it is too late
Stop at secondary liver metastases
