Oesophageal Cancer Flashcards
What are the 2 major histological types of oesophageal cancer?
Squamous Cell Carcinoma: middle 1/3rd
Adenocarcinoma: lower 1/3rd
5 risk factors for squamous cell oesophageal cancer
Alcohol Smoking Plummer-Vinson syndrome Diet low in fruit + veg, high in nitrosamines FH
Describe the distribution of oesophageal cancer by type
M>F
SCC more common in DEVELOPING COUNTRIES
Adenocarcinoma: more prevalent in WESTERN WORLD
3 most common Sx of oesophageal cancer
Progressive dysphagia (initially worse for solids)
Odynophagia (painful swallowing)
Weight loss
List 3 signs of metastatic disease in oesophageal cancer
Supraclavicular lymphadenopathy
Hepatomegaly
Hoarseness
List 3 risk factors for oesophageal adenocarcinoma
GORD
Barrett’s oesophagus
Hiatus hernia
How may oesophageal cancer be missed?
Often ASYMPTOMATIC
There may be NO SIGNS
What are the first line investigations in patients with severe symptoms suggestive of oesophageal cancer?
Oesophagogastroduodenoscopy (OGD) with biopsy
Metabolic profile: may be very volume depleted + hypokalaemic
What other investigations are performed in patients with oesophageal cancer?
CT thorax + abdo: to stage + identify mets
What is Plummer Vinson Syndrome?
Rare disease characterized by difficulty swallowing, IDA, glossitis, cheilosis + esophageal webs.
What may be indicated by cough in oesophageal cancer?
Oesophagotracheal or oesophagobronchial fitsula from local invasion by tumour
6 less common Sx of oesophageal cancer
Regurgitation Cough Choking after food Voice hoarseness (Recurrent laryngeal N) Hiccups (phrenic N) Fatigue (due to IDA)
Tx for oesophageal cancer suitable for surgery
Endoscopic therapy (resection for removal) Oesophagectomy
Tx for oesophageal cancer not suitable for surgery/ additional medical management
Chemoradiotherapy: Carboplatic + Paclitaxel
Post-op: Nivolumab
