GI Malginancy Flashcards
what pre-malignant change predisposes to oesophageal cancer
Barrets oesophagus
what is Barrets oesophagus
constant reflux causes change of squamous epithelium to columnar epithelium
- premalignant
Types of oesophageal cancer
squamous cell (upper 2/3rds) adenocarcinoma (lower 1/3rd)
Barrets oesophagus predisposes to which type of cancer
adenocarcinoma
risk factors for oesophageal cancer
smoking GORD Barrets oesophagus alcohol achalasia
most common presenting symptom of oesophageal cancer
dysphagia
investigation of oesophageal cancer
upper GI endoscopy
management of oesophageal cancer
Ivor-Lewis oesophagectomy if appropriate
chemotherapy
signet ring cells are associated with what cancer
gastric cancer
virchows node indicates what type of cancer
gastric cancer
presentation of gastric cancer
dyspepsia
nausea, vomiting
anorexia, weight loss
dysphagia
investigation of gastric cancer
endoscopy + biopsy
treatment of gastric cancer
sub total gastrectomy if 5-10cm from OG junction
total gastrectomy if <5cm from OG junction
symptoms of colorectal cancer
change in bowel habit -- more frequent + loose weight loss PR bleeding tenesmus iron deficiency anaemia
genetic conditions that increase risk of colorectal cancer
familial adenomatous polyposis syndrome (FAP)
hereditary non-polyposis colon cancer (HNPCC)
How are FAP and HNPCC inherited
autosomal dominant
gene affected in FAP
APC gene chromosome 5
gene affected HNPCC
MSH2
Screening offered for colorectal cancer
faecal immunochemical testing (FIT)
- sent through post and sample tested for blood
given every 2 years to adults 50-74 years old
investigation for colorectal cancer
colonoscopy
tumour marker in colorectal cancer
CEA
staging system for colorectal cancer
Dukes Classification A - confined to bowel wall B - extending through muscle of bowel wall C - lymph node involvement D- metastatic disease
right hemicolectomy
removal of tumours in caecum, ascending colon and proximal transverse colon
left hemicolectomy
removal of tumours of distal transverse colon and descending colon
sigmoid colectomy
removal of tumours of sigmoid colon
anterior resection
removal of tumours of high rectum
abdominoperitoneal resection
removal of rectum + anus
- permanent colostomy
types of liver cancer
hepatocellular carcinoma (80%) cholangiocarcinoma (20%)
main risk factor for hepatocellular carcinoma
liver cirrhosis
causes of liver cirrhosis that predispose to hepatocellular carcinoma
hep B + C
alcohol
non-alcoholic fatty liver disease
what condition is linked to cholangiocarcinoma
primary sclerosing cholangitis
- RUQ pain, jaundice, fatigue
tumour marker for hepatocellular carcinoma
alpha feto protein (AFP)
presentation of hepatocellular carcinoma
RUQ pain jaundice ascites pruritis hepatomegaly weight loss
presentation of cholangiocarcinoma
painless jaundice (same as pancreatic cancer)
investigation of hepatocellular carcinoma
USS + AFP blood test
treatment of hepatocellular carcinoma
resection of area of liver in early disease
transplant if confined to liver
kinase inhibitors to extend life e.g. sorafenib
what virus are oropharyngeal cancers linked to
HPV
