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Flashcards in Oesophageal Cancer Deck (47)
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1

What is the incidence of oesophageal cancer?

12/100,000

2

Why is the incidence of oesophageal cancer increasing?

Due to increase in Barrett's oesophagus

3

What age does oesophageal cnacer occur?

50-70

4

What is the male to female ratio of oesophageal cancer?

M:F = 5:1

5

What countries have a higher incidence of oesophageal cancer?

Iran
Transkei
China

6

What are the risk factors for oesophageal cancer?

Alcohol
Smoking
Achalasia
GORD leading to Barrett's oesophagus
Plummer-Vinson synrome
Fatty diet
Reduced vitamin A and C
Nitrosamine exposure

7

What are the types of oesophageal cancer?

Adenocarcinoma
Squamous cell carcinoma

8

What % of oesophageal cancers are adenocarcinomas?

65%

9

What % of oesophageal cancers are squamous cell carcinomas?

35%

10

Where do adenocarcinomas of the oesophagus occur?

Lower 1/3

11

What causes adenocarcinoma of the oesophagus?

GORD → Barrett's → dysplasia → cancer

12

Where do oesophageal SCC occur?

Upper and middle 3rd

13

What are oesophageal SCC associated with?

Alcohol
Smoking

14

What is the most common type of oesophageal cancer worldwide?

SCC

15

How does oesophageal cancer present?

Progressive dysphagia
Weight loss
Retrosternal chest pain
Lymphadenopathy

16

What happens in progressive dysphagia?

Progresses from solids to liquids, often causing an alteration in dietary habits to soft food

17

What is the result of the change in diet as a result of the dysphagia in oesophageal cancer?

Exacerbation of weight loss

18

What symptoms of oesophageal cancer might occur if its in the upper 1/3?

Hoarseness
Cough, with or without aspiration pneumonia

19

Why might oesophageal cancer cause hoarseness?

Recurrent laryngeal nerve invasion

20

How does oesophageal cancer spread?

Direct extension, lymphatics, and blood

21

What % of patients with oesophageal cancer have mets at diagnosis?

75%

22

How is oesophageal cancer investigated?

Bloods
Upper GI endoscopy and biopsy
Barium swallow (not often used)
Staging investigations

23

What might be found on bloods in oesophageal cancer?

Anaemia
Deranged LFTs/albumin

24

What might cause deranged LFTs/albumin in oesophageal cancer?

Liver mets

25

What is found on barium swallow in oesophageal cancer?

Apple-core stricture

26

What staging investigations are done in oesophageal cancer?

CT
EUS
Laparoscopy/mediastinotomy to look for mets

27

What is Tis in oesophageal cancer?

Carcinoma in situ

28

What is T1 in oesophageal cancer?

Confined to submucosa

29

What is T2 in oesophageal cancer?

Invades muscularis propria (circular or longitudinal)

30

What is T3 in oesophageal cancer?

Invades adventitia