Oesophageal cancer

Question 1

What is the aetiology of Oesophageal cancer?

Answer 1

50-70 y/o
Male
Oriental asian

Question 2

What are some of the risk factors for Oesophageal cancer?

Answer 2

Alcohol
Smoking
Chronic Achalasia
Barrett's oesophagus
Fatty diet

Question 3

What are the two main types of Oesophageal cancer?

Answer 3

Adenocarcinoma (Majority), lower 3rd of oesophagus. Associated with GORD/Barretts
Squamous cell carcinoma (Rarer), upper and middle 3rds of oesophagus. Associated with Smoking and Alcohol

Question 4

What is the presentation of Oesophageal cancer?

Answer 4

Progressive dysphagia from liquids to solids
Weight loss
lymphadenopathy
Retrosternal chest pain
If in upper third, may have hoarseness of voice due to recurrent laryngeal nerve invasion

Question 5

How can Oesophageal cancer spread?

Answer 5

Direct invasion
Lymphatics
Blood
Most metastasised by diagnosis

Question 6

What investigations should be done in a patient with suspected Oesophageal cancer?

Answer 6

Bloods - FBC, LFTs (Mets)
OGD - Samples
Barium swallow - Apple core stricture
CT
Oesophageal ultrasound

Question 7

What is the surgical management of Oesophageal cancer?

Answer 7

Most can’t be operated on, tend to do Ivor lewis approach

May have chemotherapy before to shrink tumour slightly

Question 8

What are some of the palliative care measures you can do for a patient with Oesophageal cancer?

Answer 8

Laser coagulation
Stenting
Secretion reduction
Analgesia
Radiotherapy

Question 9

What are some of the benign Oesophageal tumours?

Answer 9

Leiomyoma (Smooth muscle)
Lipoma (Fat tissue)
Haemangioma (Endothelial cells)
Benign polyps