Oesophageal Carcinoma Flashcards
What is dysphagia?
Difficulty swallowing
What is reflux?
Contents backing up the oesophagus
What is achalasia?
Muscles of the lower part of the oesophagus fail to relax, preventing food from passing to the stomach.
What should you suspect in a patient with dysphagia who answers yes or no to this question?
“Difficulty swallowing solids and liquids from the start?2
- Yes - motility disorder - achalasia, CNS, pharyngeal causes
- No - solids then liquids - suspect stricture (benign or malignant)
What should you suspect in a patient with dysphagia with these isolated features?
- Intermittent
- Constant and worsening
- Intermittent - suspect oesophageal spasm
2. Constant and worsening - suspect malignant stricture
If a patient with dysphagia finds it difficult to initiate swallowing, what should you suspect?
Bulbar palsy
If a patient with dysphagia finds swallowing painful, what should you suspect?
Ulceration, malignancy, oesophagitis, infection, spasm.
If a patient with dysphagia has a neck bulge or a gurgle on drinking, what should you suspect?
Pharyngeal pouch
What is the most common type oesophageal carcinoma?
Adenocarcinoma (80%)
What are the risk factors for developing oesophageal carcinoma?
Low socioeconomic status, obesity, Barrett’s oesophagus, smoking, alcohol.
What type of cancer is found in the top 2/3 of the oesophagus, and what type is found in the bottom 1/3?
- Top 2/3 - squamous cell carcinoma
2. Bottom 1/3 - adenocarcinoma
What is this a presentation of?
Progressive dysphagia from solids to liquids, weight loss, retrosternal chest pain.
Oesophageal carcinoma
How is suspected oesophageal carcinoma investigated?
- Oesophageal endoscopy with biopsy - type and grade
2. CT/MRI for staging using TNM
What is the treatment for oesophageal carcinoma?
- Poor survival rates
- Radical surgery if localised
- Chemoradiotherapy
- Palliation in advanced disease
- 5-10% survival at 5-years due to high stage on presentation
