Lecture 16- Upper GI cancer Flashcards
Upper GI malignancy symptoms
- Dysphagia
- Epigastric pain
- Jaundice
Dysphagia
Difficulty swallowing- usually progressive dysphagia
types of dysphagia
-
Caused by a blocked
- Extraluminal causes
- Intraluminal causes
- Luminal causes
progressive dysphagia example
when overtime swallowing solids becomes too hard - e.g. can only drink
- Red flag (ALARM) alongside dysphagia
- Anaemia
- Loss of weight
- Anorexia
- Recent onset of progressive symptoms
- Masses/ melaena
Causes of dysphagia- Benign
- Strictures
- Foreign bodies
- Nerves
Causes of dysphagia- malignant
- type of carcinoma links to its epithelium
- Stratified squamous= squamous cell carcinoma
- Columnar epithelium= adneocarcinomas
- Stratified squamous= squamous cell carcinoma
oesophageal cancer are prodominantly
squamous cell carcinomas
(lower 1/3 can develop into adenocarcinoma)
poor prognosisis
risk factors for oesophageal cancer
- Barrets
- Smoking
- Spread is common at presentation
diagnosis of barretts oesophagus
- Endoscopy
- Barium swallow
epigastric pain red flags
- Malena
- Haematemesis
- Gastric cancer
- Varices
- Ulcers
- Mallory Weiss (tear in oesophagus’
- Weight loss
- Risk factors for gastric cancers
benign causes of epigastric pain
- Gastritis
- Peptic ulcers
- Pancreatitis etc
malignant cause of epigastric pain
gastric cancer (poor prognosis)
what type of cancer is gastric cancer
adenocarcinoma
rarer- gastric lymphoma (better prognosis)
gastrointestinal stomal tumas–> sarcomas (usually asymptomatic and incidental finding)
risk factors for gastric cancer
- Smoking
- High salt diet
- Family history
- H. pylori
- Increased age
- male
gastric cancer diagnosis
endoscopy
symptoms of gastric cancer
- Weight loss
- Outflow obstruction
- Malena
- Haematemesis
treatment of gastric cancer
- Curative surgery
- Screening (less prevalent here due to less salty diet (in japan much more prevalent- have screening program)
red flags alongside jaundice
- Unintentional weight loss
- Hepatomegaly (irregular border)
- Ascites cause by damage by cancer to the liver
- Portal hypertension= increased hydrostatic pressure
- Liver function decrease = less albumin = less oncotic pressure
- Painlessv
malignant causes of jaundice
-
Primary Malignancy is very rare
- Hepatocellular carcinoma- links to underlying condition (chronic inflammation)
-
Metastasis- common site due to portal circulation
- Breast
- Colon
- Lung
- Skin
- Ovaries
- 3 ways of metastasises
- Haematogenous (through the blood)
- Lymphatic spread (carcinoma)
- Transcoelomic spread (through body cavity e.g. abdominal cavity and peritoneum)
- Pancreatic cancer 96% are
(extremely poor prognosis)
- exocrine ductal adenocarcinoma
symptoms if head of pancreas involved
jaundiced due to compression on common bile duct- obstruction
symptoms if tail body
more vague symptoms – malabsorption
- Neuroendocrine cell pancreatic cancer
(rare)- can produce insulin
risk factors for pancreatic cancer
- Risk factors
- Family history
- Smoking
- Male
- Increased age
- Chronic pancreatitis
- Rarer malignancy which causes jaundice
-
Cholangiocarcinoma (poor prognosis)- bile duct cancer
- Can have metastatic disease at presentation
