Oesophageal Cancer (2)

Question 1

Which type is most common?
→ What does this usually develop from?
→ What are its risk factors?

What is its other type?
→ What does this usually develop from?
→ What are its risk factors?

Answer 1

➊ Adenocarcinoma
→ Barrett’s
→ That of GORD and Barrett’s e.g. Obesity, Pregnancy, Hernia

➋ Squamous Cell Carcinoma
→ Normal oesophageal squamous epithelium
→ Smoking and Alcohol

Question 2

How does it present?

What are differentials for its main presenting symptom?

Answer 2

➊ • Progressive Dysphagia - Go from solid to liquid diet as the tumour progressively grows and obstructs the lumen
• Weight loss
• Hoarseness, Cough

N.B. Usually presents very late

➋ • Benign Oesophageal Stricture - due to GORD
• Oesophagitis
• Achalasia

Question 3

Which investigations should be done?

What’s its curative management option?

What are its palliative management options?

Answer 3

➊ • Endoscopy w/biopsy
• Staging CT

➋ Oesophagectomy
‣ Extensive and high risk as stomach is pulled up into the chest

➌ Stenting, Dilatation, Radiotherapy