S11.1 GI Cancers Flashcards
What are some red flag symptoms of dysphagia?
ALARM
Anaemia, loss of weight, anorexia, recent onset of progressive symptoms, masses/malaena.
What are some differentials for dysphagia?
Oesophageal carcinoma
What type of cancer is oesophageal carcinoma?
Usually squamous cell carcinoma (associated with vitamin A deficiency, HPV), or adenocarcinoma (associated with Barret’s oesophagus)
Describe the presentation and risk factors for oesophageal carcinoma
Presentation: progressively-worsening dysphagia with weight loss
Risk factors: smoking, obesity, Barrett’s
Give some red flag symptoms of epigastric pain
Melaena, haematomesis
Describe gastric cancers and their causes
Usually an adenocarcinoma in cardia or antrum
Associated with gastritis and blood group A
What are the features and risk factors of gastric cancers?
Features: epigastric pain, vomiting, weight loss
Risk factors: smoking, high salt, family history
Describe how gastric cancers can spread
Direct spread to liver, lymph nodes, ovaries.
Shall cause enlarged Virchows nodes
Describe gastric lymphomas
Affects MALT tissue, prognosis better than adenocarcinoma
Strong association with H. pylori so eradicating this may lead to tumour regression
Describe GI stromal tumours
Sarcomas (cancer of soft tissue not epithelia), involves pleomorphism, mitoses and necrosis.
Give some red flag symptoms of jaundice
Hepatomegaly, ascites, painless, weight loss
Why is the liver common site for metastasis?
Drains entire GI tract so common site for metastases such as those from breast, prostate, stomach and oesophagus
What type of tumour causes pancreatic cancer?
Usually ductal adenocarcinoma
Can also have acinar tumours
Give some symptoms and differentials of obstruction
Symptoms: abdo distension and pain, weight loss, constipation, vomiting
Differentials: hernia, volvulus, large/small bowel cancer
Give some red flag symptoms and differentials of pre-rectal bleeding
Red flags: anaemia, weight loss, change in bowel habit
Differential: haemorrhoids, anal fissure, bowel cancer
Give some red flag symptoms and differentials of a change in bowel habit
Red flags: anaemia, weight loss, pre-rectal blood loss
Differentials: thyroid disorder (overactive), inflammatory bowel disease, bowel cancer
What type of tumour is large bowel cancer?
Colorectal adenoma which is then a precursor to colorectal adenocarcinoma (dukes staging)
What are the risk factors and symptoms of large bowel cancer?
Risk factors: family history, IBD, polyposis syndrome, diet (low fibre)
Symptoms: left sided (weight loss, abdo pain, rectal bleeding), right sided (weight loss, anaemia)
What types of tumours cause small bowel cancer?
Lymphoma, Stromal tumours, Sarcoma, Adenocarcinoma, Carcinoid tumour
What are the risk factors and symptoms for small bowel cancer?
Risk factors: IBD, coeliac disease.
Symptoms: weight loss, abdo pain, blood in stools.
