Oesophagus and Stomach Cancers Quiz

Oesophagus - Squamous Cell Carcinoma

• Primarily affects elderly males
• Risk factors include tobacco use, alcohol consumption, and gastroesophageal reflux disease (GERD)
• Often diagnosed at a late stage, leading to a poor prognosis
• Early detection leads to favorable outcomes
• Diagnosed through biopsy

Oesophagus - Adenocarcinoma

• Accounts for 50% of oesophageal cancers
• Often develops in Barrett's oesophagus, often associated with GERD and hiatus hernia
• Precursor conditions include inflammation, ulceration, metaplasia, and dysplasia (5-10%)
• Biopsy can diagnose these issues

Stomach - Adenocarcinoma

• Over 90% of stomach cancers occur in the antrum (half).
• A relatively small percentage (3%) are fatal.
• Primarily affects the elderly and carries a poor prognosis unless caught early
• Risk factors include Helicobacter pylori infection, autoimmune gastritis, and smoking.

Stomach - Other Tumours

• Lymphomas (MALT) associated with Helicobacter infections
• Carcinoids and GISTs are also stomach tumours

Stomach - Gastritis (Acute)

• Characterized by superficial ulcerations
• Often caused by medications (especially NSAIDs and aspirin)
• Other causes include alcohol use, smoking, chemotherapy, infections, and severe burns.

Stomach - Gastritis (Chronic - Helicobacter)

• The most common form of chronic gastritis
• Associated with peptic ulceration, intestinal metaplasia, dysplasia, and cancer
• Antibiotic treatment is a standard course of action

Stomach - Gastritis (Chronic - Autoimmune)

• Pernicious anemia is a common presentation
• Antibody production toward intrinsic factor and parietal cells is typical
• Vitamin B12 deficiency is a frequent consequence
• Primarily occurs in elderly individuals.

Stomach - Peptic Ulcer

• Develops due to a conflict between defensive and aggressive forces within the stomach
• Common locations include the antrum and duodenum
• Helicobacter pylori is a critical contributor to ulcer development
• Management involves proton pump inhibitors (PPIs), antacids, and surgical intervention for complications such as bleeding, perforations or obstructions

Small Intestine

• Adenocarcinoma is an uncommon cancer of the small intestine
• Carcinoids, GISTs, and lymphomas are other relevant small intestine tumour types
• Coeliac disease and gluten-sensitive enteropathy are significant causes of malabsorption in the small intestine
• Signs of these conditions include flat villi and increased intraepithelial lymphocytes (IELs) on biopsy.
• Ischemia (lack of blood flow) is also a possible cause of issues.

Large Intestine - Polyps

• Hyperplastic polyps are common and benign
• Adenomatous polyps are significant as they are often precancerous
• Progression from adenoma to carcinoma is a known pathway
• Other polyps include hamartomatous and inflammatory

Large Intestine - Cancer

• Adenocarcinoma is the most frequent type of large intestine cancer
• Accounts for 10-15% of cancer deaths
• The average age of diagnoses involves older adults
• 20% under 50
• Family history (HNPCC, FAP) and high-energy diets with low fiber are associated risk factors
• Staged utilizing Duke's system

Large Intestine - Inflammatory Bowel Disease

• Ulcerative colitis and Crohn's disease.
• Recurrent inflammatory disorders of the GIT (Gastrointestinal Tract)
• Ulcerative colitis affects the rectum and extends proximally.
• Crohn's disease usually begins in the terminal ileum, but affects any part of the GIT.
• Requires histology and evaluation of complications for treatment.

Ischemic Bowel Disease

• Reduced blood flow to the bowel is a cause of this condition.
• Obstructions like thrombosis, embolisms, volvulus, hernias, or adhesions are potential causes.
• The affected area and degree of wall involvement (transmural or mucosal) depend on the site and severity of the obstruction.

Diverticular Disease

• A common condition effecting the elderly.
• Can also affect younger adults (20s-30s)
• Diverticula are sacs that can form in the wall of the large intestine.
• Dietary factors like low fiber intake can contribute to disease development.
• Diverticular disease can lead to blockage (obstruction), inflammation, perforation, or even the formation of a tumour.

Liver

• Acute Hepatitis: Caused by viruses (A, B, C, D, E) and medications
• Chronic Hepatitis: Viral (B, C, and sometimes D); autoimmune (AIH with anti-smooth muscle and antimitochondrial antibodies), resulting in primary biliary cirrhosis (PBC). Drug-induced is possible.
• Jaundice: Occurs when liver cells (hepatocytes) fail to process and eliminate bilirubin, leading to its accumulation and yellowing of the skin and eyes

Liver - Cirrhosis

• Fibrosis, scarring, and distorted liver structure are hallmarks of cirrhosis
• It can have various causes, including alcoholism, chronic hepatitis, and autoimmune diseases
• Liver failure
• Hepatocellular carcinoma (HCC) risk

Liver Tumours

• Metastasis: Most common type by far.
• Hepatocellular Carcinoma (HCC): Often linked to hepatitis B
• Bile Duct Cancer (Cholangiocarcinoma): May form due to gallstones

Pancreas - Acute Pancreatitis

• Associated factors include gallstones and alcohol abuse
• Autodigestion by enzymes is implicated.
• Diagnosable via elevated serum amylase
• Symptoms include shock; some cases resolve with rest.
• Complications such as pseudocysts and abscesses may arise

Pancreas - Chronic Pancreatitis

• Repeated attacks, characterized as often subclinical.
• Less often biliary tree-related
• Results in fibrosis
• Diabetes mellitus (DM) may develop during progression
• Risk of pancreatic cancer

Pancreas - Carcinoma

• Adenocarcinoma – the main type
• Fifth most common cause of cancer deaths
• Late diagnosis is typical, which results in a poor prognosis.
• Head of the pancreas is the most common affected area
• Serum marker CA 19-9 has diagnostic value
• Islet cell tumors are potential
• Risk factors include smoking

Gall Bladder - Gallstones

• 20% adults experience gallstones, though 80% show no clinical signs.
• Cholesterol stones (80%) and pigment stones (20%) are distinct types.
• Females, individuals in their 40s, those with a high Body Mass Index (BMI), and those of a fertile age have an increased risk
• Associated with gall bladder inflammation

Gall Bladder - Cholecystitis

• Inflammation of the gall bladder is usually associated with gallstones.
• Acute inflammation is frequently triggered by obstruction of the gall bladder neck or cystic duct.
• Acute cholecystitis can sometimes resolve on its own, but Chronic cholecystitis may follow recurring episodes.
• 90% of cases are linked to gallstones

Test your knowledge on the types, risk factors, and prognosis of oesophageal and stomach cancers. This quiz covers squamous cell carcinoma, adenocarcinoma, and other tumours related to these organs. Understand the importance of early detection and the role of biopsy in diagnosis.