Oesophageal Cancer Flashcards
How common is oesophageal cancer.
It is the 6th most common cancer worldwide.
Where does squamous cell oesophageal cancer. (2)
It occurs in the middle third of the oesophagus.
They also occur in the upper third.
What percentage of oesophageal cancers are due to squamous cell cancers. (2)
50% of tumours occur in the middle third.
20% occur in the upper third.
Where do adenocarcinomas tend to occur. (2)
In the lower third of the oesophagus.
At the cardia.
What percentage of oesophageal tumours are due to adenocarcinomas.
30%.
What are the types of oesophageal cancer. (3)
Squamous cell carcinoma.
Adenocarcinoma.
Primary cell cancer.
What are the risk factors for squamous cell carcinoma of the oesophagus. (9)
Smoking. Alcohol. Plummer-Vinson syndrome. Achalasia. Corrosive strictures. Coeliac disease. Breast cancer treated with radiotherapy. Tylosis. Diets low in vitamin A and C. Nitrosamine exposure.
What are the risk factors for adenocarcinoma of the oesophagus. (6)
Longstanding heartburn. Barrett's oesophagus. Smoking. Obesity. Breast cancer treated with radiotherapy. Older age.
What geographic areas have high rates of oesophageal squamous cell carcinoma. (5)
Ethiopia.
China.
South and east Africa.
Caspian regions of Iran.
What is the incidence of squamous cell carcinoma of the oesophagus in the UK.
5-10/100,000.
What percentage of malignant disease is due to squamous cell carcinoma of the oesophagus in the UK.
2.2%.
What is the male:female ratio of squamous cell carcinoma of the oesophagus.
2:1.
What age group is most affected by oesophageal cancer.
60-70 years old.
What are the clinical features of oesophageal cancer. (5)
Dysphagia (progressive, painless for solid foods then liquids).
Weight loss.
Retrosternal chest pain.
Signs from the upper third of the oesophagus:
Hoarseness.
Cough (may be paroxysmal if aspiration pneumonia).
What are the three commonest physical signs of oesophageal cancer.
Weight loss.
Anorexia.
Lymphadenopathy.
Why might strictures develop in oesophageal cancer.
The lesion itself may be ulcerative, proliferative or scirrhous, extending variably around the wall of the oesophagus to produce a stricture.
What complication arises with the development of an oesophageal stricture.
Causes difficulty in swallowing saliva and coughing and aspiration into the lungs is common.
Where does oesophageal cancer tend to metastasis to.
Usually to lymph nodes (commoner than distant metastases).
What are the two diagnostic tests in oesophageal cancer. (2)
Endoscopy with biopsy.
Barium swallow.
What is the overall male:female ratio of oesophageal cancer.
5:1.
How are oesophageal cancers staged.
TNM staging system.
What is the most common type of benign tumour of the oesophagus.
Leiomyoma.
What are the complications of oesophageal tumours. (2)
Strictures.
Fistulae between the oesophagus and the trachea or bronchial tree.
What are the clinical features of an oesophageal fistulae. (3)
Pleural effusions.
Pneumonia.
Coughing after swallowing.
