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Y3 - Gastrointestinal including liver > Oesophageal cancer > Flashcards

Oesophageal cancer Flashcards

1
Q

How many regions does the Oesophagus have?

A

3

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2
Q

Give the 3 regions of the the oesophagus

A

cervical, thoracic , abdominal

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3
Q

Give the name of the area where the oesophagus connects to the stomach?

A

gastro oesophageal junction

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4
Q

What are the layers of the oesophagus?

A
  1. Mucosa
  2. Submucosa
  3. Muscularis,
  4. adventitia
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5
Q

What is the mucosa of the oesophagus?

A

non-keratinised stratified squamous epithelium

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6
Q

What is the role of the mucosa?

A
  1. Secretes
  2. Absorbs
  3. Protects
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7
Q

What is the sub mucosa of the oesophagus?

A

contains all the nerves that help contractions and move the food from mouth to stomach

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8
Q

What is the muscularis propria?

A

circular layer of muscle:

  1. creates peristalsis
  2. takes nutrients from the mucosa to the blood stream
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9
Q

What is the lamina propria?

A

areolar connective tissue underlying a mucous membrane

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10
Q

Where does the cervical region start?

A

Pharynx

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11
Q

Where does the cervical region drain?

A

drains into deep cervical nodes
deep lymphatic duct
thoracic duct
tracheobronchial

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12
Q

Where does the thoracic region start?

A

starts at tracheal bifurcation

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13
Q

Where does the thoracic region drain?

A

superior and posterior mediastinal nodes

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14
Q

Where does the abdominal region drain?

A

left gastric and coeliac nodes

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15
Q

What is Barrett’s Oesophagus?

A

Squamous epithelium of the oesophagus becomes damaged and undergoes metaplasia to gastric mucosa (columnar glandular epithelium)

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16
Q

What is the epidemiology of oesophageal cancer?

A

15th most common cancer in women
the most common site is the lower 1/3
High in deprived areas
59% of cases are preventable

17
Q

What are 8 risk factors for oesophagus cancer?

A
  1. Age
  2. obesity
  3. Adenocarcinoma
  4. Smoking
  5. Alcohol
  6. Barrett’s Oesophagus
  7. Previous RT
  8. Drinking very hot drinks
18
Q

Presentations of oesophageal cancer (10)

A
  1. Dysphagia
  2. Weight loss
  3. Acid reflux
  4. Heartburn
  5. Burping
  6. Hoarse voice
  7. Pain
  8. Polyps
  9. Loss of appetite
  10. Nausea and vomiting
19
Q

What are some investigations for oesophageal cancer?

A
  1. Endoscopy
  2. Biopsy
  3. Scan for spread
  4. Barium swallow
  5. Gastroscopy
20
Q

What are 4 treatment options?

A
  1. Surgery
  2. Chemotherapy
  3. Radiotherapy
  4. Oesophagectomy
21
Q

What are the two main types of oesophageal cancer?

A
  1. Squamous cell carcinoma
  2. Adenocarcinoma
22
Q

Where does SCC commonly occur in the oesophagus?

A

in the middle and upper third of oesophagus

23
Q

What is SCC of oesophagus commonly associated with?

A

Smoking and excessive alcohol

24
Q

Where does adenocarcinoma cancers typically occur?

A

Adenocarcinoma – more common in high income countries, typically occur in the lower third of the oesophagus, and arises as a consequence of metaplastic epithelium (termed Barrett’s oesophagus) which progresses to dysplasia, to eventually become malignant
Risk factors for this subtype are long-standing GORD, obesity, and high fat intake

25
Q

Squamous dysplasia- pre cancerous management?

A

patient encouraged to change lifestyle
* endoscopic mucosal resection
* laser ablation
* balloon cryoablation

26
Q

What happens in an Endoscopic Mucosal Resection (EMR)?

A

-Removes superficial lesions or submucosal neoplasms
-Radiofrequency ablation used to kill cancer cells
-Option for some small, very early stage cancers

27
Q

What is balloon cyroablation?

A

Balloon catheter inserted and inflated, cells frozen

28
Q

What surgery would be used?

A

oesophagectomy
- removal of part of the oesophagus with cancer in it
oesophagus reconnected and stomach pulled further up
transthoracic

29
Q

Name 7 complications of surgery?

A

need to go to ICU after due to extensive recovery
swallowing issues
may need permanent PEG
psychosocial support
heart problems
chest infections
blood clots/stroke

30
Q

What are 3 options to treat dysphagia?

A

endoscopic dilation
stent
pertucaneous endoscopic gastronomy

Y3 - Gastrointestinal including liver (34 decks)

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