Oesophageal Cancer Flashcards
What are the 2 main histological types of oesophageal cancer?
1) adenocarcinoma
2) squamous cell carcinoma
Which type of oesophageal cancer is more common in the developed world (UK/US)?
Adenocarcinoma
Which type of oesophageal cancer is more common in the developing world?
Squamous cell carcinoma
Location of oesophageal adenocarcinoma?
Lower third - near the gastroesophageal junction
Location of oesophageal squamous cell carcinoma?
Upper two-thirds of the oesophagus
Risk factors for adenocarcinoma of the oesophagus?
- GORD
- Barrett’s oesophagus
- smoking
- obesity
Risk factors for squamous cell carcinoma of the oesophagus?
- smoking
- alcohol
- achalasia
- Plummer-Vinson syndrome
- diets rich in nitrosamines
What is there typically a history of in oesophageal carcinoma?
GORD or Barrett’s
Clinical features of oesophageal cancer?
- dysphagia (initially with solids and progressing to liquids)
- weight loss
- odynophagia (painful swallowing)
- hoarseness (tumour invasion of the recurrent laryngeal nerve)
- retrosternal pain or discomfort
- regurgitation or vomiting (undigested food)
What is the most common presenting symptom of oesophageal cancer?
Difficulty swallowing (dysphagia), initially with solids and progressing to liquids.
Referral guidelines for oesophageal cancer?
Offer urgent direct access upper GI endoscopy (2ww) to assess for oesophageal cancer in people:
- with dysphagia or
- aged 55 and over with weight loss and any of the following: upper abdominal pain, reflux, dyspepsia.
What investigation is indicated in the 2ww for oesophageal cancer?
Urgent direct access upper GI endoscopy
1st line investigation in oesophageal cancer?
Upper GI endoscopy
