GI cancers Flashcards
What is cancer
How do you justify screening for cancer
Wilson and Jungner criteria
Imporant health problem
Accepted treatment
Facilities for diagnosis
Recognizable latent or early symptomatic stage
Suitable test
Acceptable for population
Natural history of the condition, including developpment from latent to declared disease
How do you secreen for colorectal cancer
How do you screen for oesophageal cancer
How do you screen for pancreatic and gastric cancer
How do you screen for hepatocellular cancer
Regular ultrasound and AFP (alpha fetoprotein) for high risk individuals with cirrhosis
- Viral or alcoholic hepatitis
What is the 2 week wait cancer pathways
Whos in cancer MDT
Role of pathologist
Confirms diagnosis
Histological typing
Role of the radiologist
What does the surgeon do
What does the gastroenterologist do
What does an oncologist do
Oesophageal cancer - pathogenesis
Squamous Cell Carcinoma - upper 2/3
Develops from normal oesphageal squamous
Commenest in developing world
Adenocarcinoma - lower 1/3
Squamous that becomes columnar, related to acid reflex
Commonest in developed world
Presentation of oesophageal cancer
Oesophageal cancer diagnosis and staging
Upper GI endoscopy
Lesion found - biopsy taken to confirm diagnosis
CT of chest and abdomen
PET-CT scan to exclude metastases
Staging laparoscopy - liver nad peritoneal metastases
Endoscopic ultrasnad to clarify depth of invasion
Treatment options for oesophageal cancer
Curative - neoadjuvant chemotherapy - oesophagectomy
Palliative - palliative chemotherapy - steroids to reduce oedema around tumour - stent
Gastric cancer pathogenesis
cHRONI
How does chronic gastritis turn into malignancy
Presentation of gastric cancer
Dyspepsia
Anaemia
Loss of weight or appetite
Abdominal mass
Recent onset of progressive symtpoms
Melena or haematemesis
Swalloing difficulty
55 years or above
Diagnosis and Staging of gastric cancer
Endscopy + biopsy
Straging
CT chest abdomen and pelvis - distant lesions
PET-CT
Diagnostic laproscopy - peritoneal and liver metastases
Endoscopic ultrasound - local invasion and node involvement
Treatment options of gastric cancer
Oesophagogastrectomy
Total gastrectomy
Subtotal gastrectomy
