Oesophageal Cancer

Question 1

what is the benign tumours

Answer 1

squamous papilloma

Question 2

what is malignant

Answer 2

squamous cell carcinoma and adenocarcinoma

Question 3

characteristics of squamous cell

Answer 3

commoner in eastern males, 40% occurs in middle oesophagus, 15% in upper third

Question 4

characteristics of adenocarcinoma

Answer 4

commoner in caucasians, mostly in lower third of oesophagus (reflux abuse greatest here)

Question 5

what are symptoms

Answer 5

progressive dysphagia 
chest pain 
weight loss (loss of appetite)
hoarse voice 
metastaes - direct invasion / lymphatic / vascular

Question 6

how to diagnose

Answer 6

endoscopy (all new dysphagia >55)
mucosal abnormality mandates at least 6 biopsies
thorax/abdomen CT for staging (PET for distal node disease)
barium swallow
ultrasound (regional nodal disease)

Question 7

treatment for squamous cell

Answer 7

localised SCC treated with radical chemoradiotherapy

no surgery

Question 8

treatment for adenocarcinoma

Answer 8

if Tis or T1a - endoscopic resection

is no evidence of metastases and no comorbidities - oesophagectomy +/- chemotherapy