11. GI malignancy Flashcards Preview

ESA 3- GI system > 11. GI malignancy > Flashcards

Flashcards in 11. GI malignancy Deck (17)
Loading flashcards...
1
Q

what type of cancer can occur in the GI tract

A
  • mostly adenocarcinomas (as most GI tract consists of columnar epithelium)
  • some squamous cell carcinomas (as stratified squamous epithelium in oesophagus and anus)
2
Q

which GI cancer is most common

A

bowel - 4th most common cancer in UK

followed by pancreas, oesophagus, stomach, liver

3
Q

what is the common presentation of oesophageal cancer

A

DYSPHAGIA

Associated red flags (ALARM):

  • Anaemia
  • Loss of weight
  • Anorexia
  • Recent onset of progressive symptoms
  • Mass/Malaena
4
Q

which types of cancer can occur in oesophagus

A
  • mostly squamous cell carcinoma

- can have adenocarcinomas in lower 1/3 due to Barrett’s oesophagus

5
Q

what is Barrett’s oesophagus

A

METAPLASIA of stratified squamous epithelium to gastric glandular columnar epithelium

Due to persistent acid reflux (GORD)

Increased risk of metaplasia and oesophageal adenocarcinoma

6
Q

what is the likely presentation for gastric carcinoma

A

EPIGASTRIC PAIN

Associated red flags:

  • malaena
  • haematemesis
  • palpable mass
7
Q

name an important risk factor for gastric carcinoma

A

H. pylori infection: causes chronic inflammation (often involved in gastric lymphoma (MALT tissue))

8
Q

what is the typical presentation for liver cancer

A

JAUNDICE

Associated red flags:

  • hepatomegaly (with irregular border)
  • ascites
  • painless (if painful, more likely inflammation/infection)
9
Q

suggest 2 reasons why liver cancer might cause ascites

A
  1. pressure build-up in portal system due to tumour compression
  2. reduced liver function causing low albumin
10
Q

what are the common causes of liver cancer

A
  • primary malignancy is rare but hepatocellular carcinoma can be associated with HepB/C-induced inflammation
  • common site for metastases that spread via blood as drains entirety of GI tract. so common site for metastases from colon and other GI, but also breast and prostate
11
Q

describe the presentation of a P with pancreatic cancer of head or body/tail

A

Head of pancreas:

  • painless jaundice
  • +/- enlarged palpable non-tender gallbladder

Tail/body of pancreas:
- vague symptoms, e.g. abdo pain, malabsorption, endocrine disorders

12
Q

how does small intestine adenocarcinoma present

A
  1. obstruction: abdominal distension, abdominal pain, nausea and vomiting
  2. rectal bleed
  3. change in bowel habit (frequency/consistency/discomfort)
13
Q

how does colorectal adenocarcinoma present

A
  1. obstruction: abdominal distension, abdominal pain, constipation
  2. rectal bleed (rectal cancers usually ulcerating)
  3. change in bowel habit (frequency/consistency/discomfort)
  4. tenesmus (if rectum)
14
Q

why do right-sided colon cancers often present later than left-sided

A

Right-sided: caecum and ascending colon are more distensible

Left-sided: are usually stenosing and as content is more solid, obstructive symptoms more common

15
Q

what is the colorectal adenoma-carcinoma sequence

A

benign adenomas (polyps) are the basis for most colorectal cancers, with accumulation of mutations causing dysplasia and then malignancy

16
Q

how can most bowel carcinomas be viewed

A

via a sigmoidoscope

17
Q

name 2 inherited conditions which increases occurrence of bowel carcinomas

A

1) FAMILIAL ADENOMATOUS POLYPOSIS (FAP)
- autosomal dominant mutation in ACP gene (tumour suppressor gene)
- numerous adenomas develop at early age, mainly in colon, and subsequently become malignant, with progression to adenocarcinoma by age 35

2) HEREDITARY NON-POLYPOSIS COLORECTAL CANCER (Lynch syndrome)
- autosomal dominant mutation in DNA mis-match repair genes
- also increases risk of other cancers, esp. endometrial