GI Malignancies Flashcards
Risk factors for anal cancer
- HPV
- Immunosuppression, HIV/AIDS
- Smoking
Treatment difference between rectal and colon cancer
Surgery with adjuvant therapy in colon cancer
Surgery with neoadjuvant therapy in rectal cancer or TNT (total neoadjuvant treatment = chemotherapy + chemoradiation, followed by surgery)
Risk factors for hepatocellular carcinoma
Anything that causes cirrhosis
- Hep C, Hep B, NASH, alcohol
Risk factors for gallbladder cancer
- Cholelithiasis
- Chronic cholecystitis/porcelain gallbladder
- PSC/UC
How to assess peritoneal spread of gastroesophageal cancer
Diagnostic laparoscopy
(if positive = stage 4 and not worth doing surgery)
Genes associated with colon cancer
- APC gene (FAP - thousands of polyps)
- HNPCC gene
- dMMR (Lynch syndromes)
Most common symptoms of pancreatic cancer
Most common:
- unexplained weight loss
- jaundice, typically painless
May also see venous thromboembolism
Modifiable gastric cancer risk factors
- Poor dietary practices, smoked/cured foods, lack of refrigeration
- Heavy alcohol use
- Tobacco
- H. pylori infection
Rectal cancers proximal to dentate line are typically [blank] whereas anal cancers distal to the dentate line are more likely to be [blank]
Proximal/rectal: adenocarcinoma
Distal: squamous cell carcinoma
Most common symptom of hepatobiliary cancer
Painless jaundice
Treatment for patients with an CDH1 gene mutation identified in their youth
Prophylactic gastrectomy
Cholangiocarcinoma risk factors
- Ulcerative colitis
- Sclerosing cholangitis
Which patients should be screened for hepatocellular carcinoma and how is it done?
Screen patients with cirrhosis, Hep B/C
Use alpha-fetoprotein (tumor marker) and ultrasound to screen
Side effects of PD-L1 inhibitors generally
“-itises”
“Any -itis is possible with immunotherapy”
(pneumonitis, colitis, hepatitis, thyroiditis, etc.)
Anatomical landmark for anal and rectal cancer differentiation
Dentate line
non-modifiable risk factors for colon cancer
- Polyps (>1cm)
- Family/personal history
- Ulcerative colitis
Symptoms of hepatocellular carcinoma
Typically related to cirrhosis
- Weight loss, anorexia, jaundice, malaise, upper abdominal pain
Gastroesophageal cancer symptoms
- Dysphagia (most common)
- Weight loss, early satiety
- Bleeding, melena, iron deficiency
- Treatment refractory heartburn
Gold standard screening for colon cancer
Colonoscopy
Diagnosis method for gastroesophageal cancer
Upper endoscopy with biopsies
A patient with chronic cholecystitis has their gallbladder removed. Gallbladder cancer is found incidentally on pathology after removal. What should be done next?
Re-resection of the adjacent liver tissue
Genetic gastric cancer risk factors
CDH1 gene mutation
Most important factor in prognosis of colon cancer
Stage of the cancer
(determined by depth of tumor, lymph node involvement, metastasis)
Which cancers typically show up more in the proximal esophagus, and which show up more in the distal esophagus, GEJ, and stomach?
Proximal esophagus: Squamous cell carcinoma
Distal esophagus, GEJ, stomach: Adenocarcinoma
