Oesophago-gastric Cancer

Question 1

What are the main causes of Adenocarcinoma and Squamous cell carcinoma in Oesophageal cancer?

Answer 1

Adenocarcenoma - Reflux disease (Barrett’s)

Squamous cell carcinoma - Smoking and Alcohol

Question 2

Main cause of Adenocarcinoma in Gastric Cancer?

Answer 2

H.Pylori (+ other factors)

Question 3

What would be the classic signs and symptoms of Oesophageal cancer?

Answer 3

Dysphagia
Odynophagia
Haematemesis, Regurgitation, dysphonia
Weight loss
Adenopathy, effusion, hepatomegaly
Paraneoplastic syndrome (Hypercalcaemia, inapropriate hormone production)

Question 4

What would be the classic signs and symptoms of Gastric cancer?

Answer 4

Dyspepsia - (Abdo pain, emesis, anorexia, dysphagia, early satiety)
Upper GI bleed
Weight loss
Abdo mass
Jaundice
Paraneoplastic syndromes - (Hypercalcaemia, inapproriae hormone production)

Question 5

For diagnosis of Oesophageal cancer what tests would you do after GI exam?

Answer 5

Upper endoscopy and biopsy
Barium meal
CT (MRI) scan of chest + abdo
Bronchoscopy

Question 6

For diagnosis of Gastric cancer what tests would you do after a GI exam?

Answer 6

Upper endoscopy
Barium meal
CT (MRI) scan

Question 7

What would be the treatment of Oesophageal cancer?

Answer 7

Palliation of oesophageal obstruction
Radiotherapy - (Palliative)
Intubation/Stents
Terminal care
Surgery is only chance of "cure" but only 50% of patients suitable and ALOT of contraindications

Question 8

Explain the treatments of Gastric Cancer?

Answer 8

Surgery - (Palliation, improves survival, LOTS OF CONTRAINDICATIONS)
Radiotherapy
Chemotherapy
Intubation of proximal lesions