oesophageal cancer Flashcards
define
carcinoma of the oesophagus
2 types
adenocarcinoma:
- lower 1/3
- small outgrowths
- linked to BO
squamous cell carcinoma
- upper/mid oesophagus
- soften benigns as plaque or small outgrowth
epidemiology
male-female = 3:1
>60yrs
male prognosis worse than female
squamous cell carcinomas risk factor (6)
- smoking and alcohol
- human papillomarvirus
- diet low in fruits and veg
- drinking hot liquids
- atrophic gastritis
- poor oral hygeine
pathology
not fully understood
key presentation
PROGRESSIVE DYSPHASIA - shown by the gradually greater degree of difficulty when swallowing - first hard to swallow foods, then foods and liquids ect
- weight loss
- odynophagia - pain when swallowing
- regurgitation - cough up food
- aspiration - food reaches lungs
- fever
- dry cough
- night sweats
- hiccups
- hoarse voice
investigations
- 1st line/gold standard - endoscopy w biopsy
- 2nd line - barium swallowing - if doesn’t tolerate endoscopy (narrowing)
- CT / MRI / PET
management
if superficial (only in mucosa):
- endoscopic resection
if penetrates the submucosa:
- surgical resection (esophagectomy)
- lymphadenectomy (negative lymph nodes)
if invades muscularis propria with affected lymph nodes
- surgical resection
- neoadjuvant chemotherapy
metastatic
- pallitive
endoscopic resection
a minimally invasive procedure that uses an endoscope to remove abnormal tissue from the digestive tract
lymphadenectomy
a surgical procedure to remove lymph nodes, which are part of the body’s lymphatic system
prognosis
poor if late presentation
different types and where they appear on oesophagus
virus risk factor
human papillomarvirus
