Oesophageal Cancer Flashcards
What is Oesophageal Cancer?
Malignant tumour arising in the oesophagus.
What are the 2 major histological types of oesophageal cancer?
Squamous Cell Carcinoma: middle 1/3rd
Adenocarcinoma: lower 1/3rd
List 9 risk factors for squamous cell oesophageal cancer
Alcohol Smoking Plummer-Vinson syndrome Achalasia Scleroderma Coeliac disease Nutritional deficiencies Dietary toxins (e.g. nitrosamines; cured meats, pickles) FH
Describe the epidemiology of oesophageal cancer
8th most common cancer
M > F
Squamous cell carcinoma is more common in DEVELOPING COUNTRIES
Adenocarcinoma: more prevalent in WESTERN WORLD
List 9 symptoms of oesophageal cancer
Progressive dysphagia (initially worse for solids) Regurgitation Cough Choking after food Voice hoarseness Odynophagia (painful swallowing) Weight loss Hiccups if phrenic N is involved Fatigue (due to IDA)
List 4 signs of metastatic disease in oesophageal cancer
Supraclavicular lymphadenopathy
Hepatomegaly
Hoarseness
Signs of bronchopulmonary involvement
List 3 risk factors for oesophageal adenocarcinoma
GORD
Barrett’s oesophagus
Hiatus hernia
How may oesophageal cancer be missed?
Often ASYMPTOMATIC
There may be NO SIGNS
What are the first line investigations in patients with severe symptoms suggestive of oesophageal cancer?
Oesophagogastroduodenoscopy (OGD) with biopsy
Metabolic profile: may be very volume depleted + hypokalaemic
What other investigations are performed in patients with oesophageal cancer?
CT/MRI or thorax + abdo: to stage + identify mets
What is Plummer Vinson Syndrome?
Rare disease characterized by difficulty swallowing, IDA, glossitis, cheilosis + esophageal webs.
What may be indicated by cough in oesophageal cancer?
Oesophagotracheal or oesophagobronchial fitsula from local invasion by tumour
