Oesophageal Cancer + Achalasia Flashcards
What are the two main types of oesophageal cancer?
Squamous cell carcinoma
Adenocarcinoma
Which type of oesophageal cancer is most common?
Squamous cell carcinoma
What are the risk factors associated with squamous cell carcinoma?
Alcohol smoking Hot drinks Caustic strictures (swallowing bleach) Plummer vinson syndrome
Where do squamous cell carcinomas usually occur?
upper 2/3rds of the oesophagus
Where do adenocarcinomas usually occur?
Lower 1/3rd of the oesophagus
What are the pain risk factors for adenocarcinoma?
GORD
Obesity
Male
What do the columnar cells in Barretts oesophagus produce?
Mucous
What is the gastrooesophageal junction?
the junction between the columnar epithelium in the stomach and the squamous epithelium in the oesophagus
What are risk factors for any type of oesophageal cancer?
smoking
>60
achalasia
How does achalasia in oesophageal cancer present?
PROGRESSIVE - you start off with trouble swallowing solids then end up finding it hard to swallow liquids
(Other causes of achalasia have bad achalasia from the start, it isn’t usually progressive).
What are the symptoms of oesophageal cancer?
Asymptomatic for long time progressive dysphagia odynophagia heartburn vomiting weight loss pain in chest or. back
what are complications of oesophageal cancer?
tracheal fistula - leading to aspiration pneumonia
lung cancer
head and neck cancer (smoking is a common cause in them all)
What is the investigations for oesophageal cancer?
endoscopy + Biopsy
What is treatment for initial stages of cancer?
oesophagectomy (using stomach as oesophagus)
endoscopic tumour resection
mucosal ablation using radiofrequency
What is the treatment for more severe oesophageal cancer?
chemotherapy + surgery
palliative treatment with oesophageal stent to reduce dysphagia