Tumours Of Oesophagus And Stomach

Question 1

What are the most common cancers of the oesophagus?

Answer 1

Squamous cell carcinoma

Adenocarcinoma

Question 2

Which is most oesophageal cancer is most prominent in eastern countries?

Answer 2

Squamous cell carcinoma

Question 3

Which is most oesophageal cancer is most prominent in western countries?

Answer 3

Adenocarcinoma

Question 4

Which cancer has one of the worst prognosis oesophageal or gastric?

Answer 4

Gastric cancer ~ 6-9 months

Question 5

Which test helps to differentiate between upper and lower GI bleeding?

Answer 5

Blood urea nitrogen (it increases drastically after ingesting proteon or blood as in UGI bleeding)

Decreased Haemoglobin (<10g/dl)

Question 6

What are the obvious signs of bleeding in the GIT?

Answer 6

1)Haematemesis -
bright red(rapid and profuse) or coffee grounds (after beong there ablnd being oxidised for some time, less severe)
Usually UGIT

2) malena -
black, tarry stool with altered blood, smelly - upper GIT

3) haematochezia - bright, red stool (different from rectorrhagia)

Question 7

Where is the most common site for adenocarcinoma of the oesophagus?

Answer 7

At the squamo-columna junction / Z- line

Question 8

How can we treat squamous cell carcinoma?

Answer 8

Radiotherapy (highly sensitive to it)

Question 9

What are the irritants that lead to squamous cell carcinoma?

Answer 9

Alcohol
Smoking
Food (hot tea - east asian countries)

Question 10

What are the common causes/ risk factors that lead to oseophageal adenocarcinoma?

Answer 10

Obesity

Acid reflux

Question 11

Where does oesophageal adenocarcinoma commonly present?

Answer 11

Lower oesophagus - z line

Question 12

What are the probable causes of dysphagia?

Answer 12

Stricture (benign - peptic, fibrous/ malignant - carcinoma of oesophagus, stomach or extrinsic)

Oesophagitis (eosinophilic/ candidiasis)

Dysmotility (achalasia/ non- specific motility disorder)

Question 13

What are the 1st line investigations for dysphagia?

Answer 13

1) Endoscopy and biopsy
2) no abnormality found = videofluorpscopic swallowing assessment
3) if tumour - check if benign or malignant, stage it
4) PET scan to see extend of the metastasis

Question 14

What is the most common presenting complain in these tumours?

Answer 14

Dysphagia and haematemesis/ malena

Question 15

What are the management options for non-resectable carcinomas of oesophagus and stomach?

Answer 15

1) palliative care => stent to improve dysphagia

2) chemo-radiotherapy