Oesophageal cancer Flashcards
What are the 2 major and more rare types of oesophageal cancer
Squamous cell carcinoma (SCC)
Adenocarcinoma (AC)
Melanoma
Sarcoma
Lymphoma
What are the risk factors for SCC and Adeno osophageal cancer
SCC:
- Male
- Smoking, alcohol
- Long standing achalasia
- Caustic injury
- HPV
- Tylosis
Adeno
- Male
- Gastroesophageal reflux and Barret’s oesophagus
- Obesity and reflux
- Smoking
What is the typical clinical presentation of oesophageal cancer
Progressive dysphagia
Involuntary weight loss and anorexia
Fatigue may occur due to anaemia in the presence of chronic, occult bleeding
Occasionally patients may vomit blood or pass melaena
What are the symptoms of advanced oesohgeal cancer
Coughing, choking, recurrent pneumonia due to tracheo-esophageal fstula (TOF)
Hoarseness of voice
Aspiration pneumonia
Virchows node (left supraclavicular cervical LN)
What are the typical and advanced findings on examination
Typical:
- Severely wasted
- Dehydrated
- Pale
- Lethargic
Advanced disease:
- Tinge of jaundice
- Heptomegaly
- Virchows node
- Aspiration pneumonia
- Pleural effusion
What are the common sites of metastasis
Lymph nodes
Lung
Liver
Bones
Adrenal glands
Brain
Peritoneal surfaces
What are the investigations to determine the general state of a patient with oesophageal cancer
Bloods
- Urea and electrolytes
- Full blood count
- Liver function tests
- Coagulation profile
Imaging: Chest xray, abdominal ultrasound
Assessment of cardiopulmonary reserve
- ECG, ECHO, Lung function
What are the diagnostic investigations for oesophageal cancer
Contrast swallow
Endoscopy
What modalities are used for staging of oesophageal cancer
CT scan chest, abdome and pelvis
Endoscopic ultrasound
PET CT scan
Staging laparoscopy
What is treatment for oesophageal cancer
Depends on stage
Endoscopic therapy - very early lesions
Surgery
Oncological treatment
- Chemotherapy
- Radiotherapy
