Oesophageal + gastric cancer Flashcards
4 oesophageal layers
mucosa
submucosa
muscularis externae
adventitia
2 histological types of oesophageal carcinoma
adenocarcinoma
SCC
Where is the commonest location of an adenocarcinoma of the oesophagus?
oesophagogastric junction
What is a normal oesophagus lined by?
pale pink stratified squamous epithelium
What is the lining of the stomach?
salmon-coloured columnar epithelium
What is Barrett’s oesophagus?
columnar epithelium grows into oesophagus (intestinal metaplasia)
What may a nodule in Barrett’s oesophagus be?
high grade dysplasia
or an early cancer
Presentation of oesophageal cancer (alarm symptoms)
progressive dysphagia (cancer until proven otherwise)
change to liquid diet
weight loss
regurgitation
persistent reflux not responding to PPI
What is the best imaging investigation for diagnosing oesophageal cancer?
upper GI endoscopy
Curative treatment of oesophageal cancer
chemo + surgery
Palliative treatment of oesophageal cancer
chemo +/- stent for any obstructions
What chemotherapy regimen is most commonly used for oesophageal cancer?
FLOT
Fluorouracil
Leucovorin
Oxaliplatin
Docetaxel
What surgery is used in oesophageal cancer?
oesophagectomy
Most common cause of gastric adenocarcinoma
Helicobacter Pylori
What can helicobacter pylori cause?
peptic ulcer disease
gastric adenocarcinoma
chronic gastritis
MALToma
Risk factors for gastric cancer
male
age
ethnicity (10x commoner in far east)
H pylori
obesity
cigarette smoking
pernicious anaemia
previous gastrectomy
gastric polyps
FAP, Lynch syndrome etc.
Gastric cancer presentation
iron deficiency anaemia
early satiety
weight loss
abdominal pain/mass
reflux
non-healing gastric ulcer
How can gastric cancer present in an emergency?
haematemesis
melaena
gastric outlet obstruction
perforated gastric ulcer
disseminated disease eg. ascites
How is gastric cancer diagnosed?
gastroscopy with biopsies
Curative treatment of gastric cancer
chemo + surgery - gastrectomy
Palliative treatment of gastric cancer
chemo +/- stent
What surgery is used for gastric cancer?
total gastrectomy
Complications of total gastrectomy
weight loss
dumping syndrome
nutritional deficiencies
