Oesophageal cancer

Question 1

Define Oesophageal cancer

Answer 1

Usually mucosal lesion in the epithelium lining the oesophagus
Either squamous or adenomas -mainly adenocarcinomas

Question 2

Aetiology and risk factors of Oesophageal cancer

Answer 2

Usually adenocarcinomas-
Barrets oesophagus is common cause (metaplasia in distal oesophagus due to constant reflux-more common
Smoking is a big factor for squamous carcinoma

Risk factors:
age, 
smoking-squamous
drinking-squamous
Non white-squamous
high temp beverages-squamous 
GORD
High BMI
Male 7x Fem
HPV
Hiatus hernia

Question 3

Epidiemology of Oesophageal cancer

Answer 3

On the rise in the western world
140 per 100000 in china
3 In 100000 in west
adenocarcinoma rising faster than other cancers
used to be squamous>Adeno now, other way around

Question 4

Signs and Sx of Oesophageal cancer

Answer 4

Most common 1st sign-Dysphagia
-> but usually happens late in disease -> bad prognosis
(Hx usually of not swallowing liquid, then not swallowing solids)
Odynophagia-PAIN when swallowing
FLAWS -weight loss

Hoarsness
Hiccups
Cough

Question 5

Investigations for Oesophageal cancer

Answer 5

OGD-best and first test in people with suspected

severe/complete obstruction-dehydrated-hypokalemia (can swallow K rich saliva)
, high urea and cr