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PHAM02 > Wk 16: GI cancers in practice > Flashcards

Wk 16: GI cancers in practice Flashcards

1
Q

What are the different types of GI cancers?

A

Upper GI:

  • Oesophageal
  • Stomach
  • Pancreas

Lower GI:
- Colorectal

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2
Q

Where can gastric cancer start?

A
  • Gastric mucosa (adenocarcinoma)
  • Connective tissue of gastric wall (GIST)
  • Neuroendocrine tissue (carcinoid)
  • Lymphoid tissue
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3
Q

What percentage of gastric cancer is preventable + what are the factors that are preventable?

A

54%

  • H pylori
  • Smoking
  • Alcohol
  • Obesity
  • Diet
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4
Q

What is H pylori?

A
  • Bacteria in mucus lining of stomach
  • Causes: inflammation, stomach ulcers + cancer
  • Diagnose: blood, breath + stool
  • Treatment: 7 day triple: 2 Abx + PPI BD
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5
Q

What are the alarm symptoms of gastric cancer?

A
  • Dysphagia
  • Unintentional weight loss
  • Epigastric mass
  • Recent dyspepsia >55yrs
  • Persistent vom
  • Iron deficiency anaemia
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6
Q

What are the types of surgery available for gastric cancer?

A
  • Endoscopic mucosal resection - early stage
  • Total/subtotal gastrectomy
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7
Q

What are the chemo/radiotherapy available for gastric cancer?

A

Chemo:
- Neoadjuvant/adjuvant

  • Palliative: red symptoms
  • EOX, EOF, FLOT

Radio:
- Not for early stage

  • Palliative: shrink if obs - red gastric bleed
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8
Q

Where can oesophageal cancer start?

A
  • Squamous cells
  • Grandular cells (adenocarcinoma)
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9
Q

What percentage of oesophageal cancer is preventable + what are the factors that are preventable?

A

59%

  • Smoking
  • Alcohol
  • Obesity
  • Gord
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10
Q

What are the symptoms of oesophageal cancer?

A
  • Dysphagia
  • Heartburn
  • Indigestion
  • Nausea
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11
Q

What are the surgical management available to esophageal cancer?

A

Surgery:
- Oesophagectomy (partial/full)

Stenting: symptom control

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12
Q

When do you use chemoradiotherapy in esophageal cancer?

A
  • Inoperable local disease
  • Unift for surgery
  • Early stage
  • Before surgery
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13
Q

When do you use palliative chemotherapy or radiotherapy in oesophageal cancer?

A
  • Chemo: metastatic/locally advanced
  • Radio (external beam/brachytherapy): red dysphagia + chest pain
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14
Q

What is the targeted treatment for oesophageal cancer?

A

Herceptin in HER2 +ve cancer

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15
Q

What percent of pancreatic cancer is preventable + what are the factors that are preventable?

A

31%
- Smoking

  • Obesity
  • Alcohol
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16
Q

What are the symptoms of pancreatic cancer?

A
  • Pain in back/stomach
  • Weightloss
  • Jaundice
17
Q

What are the surgical management available to pancreatic cancer?

A

Pancreatectomy:
- Whipple: removes head of pancreas, duodenum + gallbladder

  • Distal: removes bod + tail
  • Total: removes pancreas
18
Q

When do you offer chemoradiotherapy in pancreatic cancer?

A
  • Borderline resectable: shrink tumour before surgery
  • Locally advanced cancer
19
Q

What are the symptoms of colorectal cancer?

A
  • Anorexia
  • Anaemia
  • Passing mucus
  • Di then constipation
  • Blood in stool
  • Rectal bled
  • Palpable mass
20
Q

What age do you not normally see GI cancer?

A

<55yrs old

21
Q

What is the treatment for colorectal cancer?

A

Combination of surgery, radio + chemo (surgery = initial)

22
Q

Can you reverse a stoma?

A

Yes depending on position + quantity of bowel removed

23
Q

What is DPD?

A

Dihydropyrimidine dehydrogenase:
- Enzyme that process thymine + uracil

  • Breakdown fluorouracil + capecitabine
24
Q

What happens if a patient is DPD deficient?

A

Severe side effects as chemo drugs build up:
- Neutropenia, anaemia, thrombocytopenia

  • Di
  • N+V
  • Mucositis
25
Q

What is the surgery used for metastatic disease?

A
  • Palliative
  • Resection liver/lung metastases
  • Resection for single metastases
26
Q

What is the chemo for metastatic disease?

A
  • 1st line: Xelox/Folox
  • 1st line metastatic colorectal: Folox/Folfiri + cetuximab
  • Combined w/ raltitrexed

PHAM02 (35 decks)

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