Oesophageal Cancer Flashcards

1
Q

what is oesophageal cancer

A

The two main histological types are squamous cell carcinoma and adenocarcinoma

they are usually mucosal lesions

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2
Q

what is the more common type of oesophageal cancer

A

squamous cell carcinoma

-usually seen in the top 2/3rd of the oesophagus

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3
Q

where can adenocarcinomas be seen

A

lower third of the oesophagus

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4
Q

what are adenocarcinomas associated with

A

GORD and obesity

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5
Q

what does recurrent reflux cause

A

metaplastic formations of mucin-producing glandular tissue - BARRETS OESOPHAGUS

this can develop into neoplasia

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6
Q

what are the risk factors for oesophageal carcinoma

A

SMOKING

high alcohol intake

achalasia

Zenker diverticulum

oesophageal web

high intake of hot beverages

increased dietary intake of nitrosamines

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7
Q

how does oesophageal carcinoma present

A

progressive dysphagia from solids to liquids

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8
Q

how does oesophageal carcinoma differ from motility disorders

A

they usually present with dysphagia of solids and liquids from the start

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9
Q

other presenting symptoms of oesophageal carcinoma

A

Weight loss is the second most common symptom, due to a combination of anorexia and dysphagia.

Regurgitation

Cough

Choking after food

Voice hoarseness - local pharyngeal nerve

Odynophagia (painful swallowing)

Weight loss

Fatigue (due to iron deficiency anaemia)

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10
Q

why does dysphagia occur in oesophageal cancer

A

Dysphagia only really occurs when there is obstruction of more than two-thirds of the lumen. Hence, patients often present late. Patients may also have pain on swallowing (odynophagia)

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11
Q

what are some signs of metastatic disease

A

Supraclavicular lymphadenopathy

Hepatomegaly

Hoarseness

Signs of bronchopulmonary involvement

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12
Q

what investigations will be done for suspected oesophageal carcinoma

A

endoscopy- biopsy

oesophagogastroduodenoscopy

imaging- barium swallow and CXR

staging - CT chest and abdomen

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13
Q

how to treat oesophageal carcinoma

A

oesophagectomy

chemotherapy

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14
Q

prognosis

A

Oesophageal cancer remains one of the most lethal of all malignancies. Without aggressive treatment, the cancer tends to obstruct the oesophagus and cause severe dysphagia. In addition to local progression causing pain, the disease tends to metastasise widely to the lungs, liver, and bone.

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