GI Cancers Intro PDF

GI Cancers Intro Lecture Number 9.1 Status Done Type Lecture 9.1 GI Cancers Intro Overview Gastrointestinal (GI) cancers are a significant health burden due to their high prevalence and poor prognosis. This lecture outlines essential concepts, including the ep...

GI Cancers Intro Lecture Number 9.1 Status Done Type Lecture 9.1 GI Cancers Intro Overview Gastrointestinal (GI) cancers are a significant health burden due to their high prevalence and poor prognosis. This lecture outlines essential concepts, including the epidemiology, risk factors, symptoms, patterns of spread, and treatment options for the five major types of GI cancer: oesophageal, stomach, pancreatic, liver, and colorectal cancer. Understanding the clinical red flags, diagnostic tools, and management strategies is critical for early detection and improving patient outcomes. Learning Objectives Objective 1: Understand the epidemiology of common GI cancers. Objective 2: Identify the risk factors associated with oesophageal, stomach, pancreatic, liver, and colorectal cancers. Objective 3: Recognise clinical presentations, symptoms, and red flags for early detection. Objective 4: Describe the diagnostic approach and potential spread of each GI cancer. Objective 5: Outline the treatment options for GI cancers, including surgical and palliative care. Key Concepts and Definitions Epidemiology: The study of the incidence, prevalence, and mortality of diseases within populations. Adenocarcinoma: A type of cancer that forms in mucus-secreting glands; common in GI cancers. Dysphagia: Difficulty swallowing, often a red-flag symptom for oesophageal cancer. Painless Jaundice: Yellowing of the skin and eyes without associated pain, a hallmark symptom of pancreatic cancer. Metastasis: The spread of cancer from its original site to other parts of the body via blood, lymph, or direct invasion. Clinical Applications Case Study: A 65-year-old male with a history of reflux presents with progressive dysphagia and unintentional weight loss. Oesophageal cancer is suspected. Diagnostic Approach: Endoscopy and CT scan are used to visualise the oesophagus and detect potential metastases. Treatment Options: If detected early, endoscopic resection may be possible. Advanced cases often require surgery and palliative care. Complications/Management: Complications include dysphagia, weight loss, and the need for supportive care in late- stage cancers. Pathophysiology Oesophageal Cancer: Progression from Barrett’s oesophagus to adenocarcinoma due to chronic reflux and mucosal damage. Stomach Cancer: Chronic infection with H. pylori triggers chronic inflammation, leading to cellular dysplasia and cancer. Pancreatic Cancer: Mutation accumulation and chronic inflammation from pancreatitis contribute to neoplastic transformation. Liver Cancer: Cirrhosis due to hepatitis B/C or alcoholic hepatitis promotes hepatocellular carcinoma (HCC). Colorectal Cancer: Polyps develop dysplastic changes leading to adenocarcinoma, with inflammatory bowel disease (IBD) increasing cancer risk. Pharmacology Chemotherapeutic Agents: Used for palliative care and in combination with surgery for certain GI cancers. Medications: Drugs like 5-fluorouracil (5-FU) are used in colorectal cancer. Supportive Care Drugs: Medications to manage symptoms like nausea, vomiting, and pain. Differential Diagnosis Oesophageal Cancer: Differential includes oesophagitis, oesophageal strictures, and achalasia. Stomach Cancer: Differential includes peptic ulcer disease and gastric lymphoma. Pancreatic Cancer: Differential includes chronic pancreatitis and gallstones. Liver Cancer: Differential includes metastatic cancer to the liver, hepatic adenoma, and cirrhosis. Colorectal Cancer: Differential includes irritable bowel syndrome (IBS) and diverticulitis. Investigations Endoscopy: Used for oesophageal and stomach cancer detection. Colonoscopy: Key for detecting colorectal cancer. Imaging: CT scan for staging and detecting metastases. Tumour Markers: CA 19-9 for pancreatic cancer, alpha-fetoprotein (AFP) for liver cancer. Key Diagrams and Visuals Summary and Key Takeaways Takeaway 1: GI cancers are among the most common forms of cancer with high mortality rates. Takeaway 2: Early detection relies on identifying key symptoms and risk factors. Takeaway 3: Treatment often involves surgery, chemotherapy, and palliative care. Takeaway 4: Red flags include dysphagia, unexplained weight loss, painless jaundice, and changes in bowel habits. Further Reading/References Cancer Research UK: Epidemiology and treatment of GI cancers. Link National Cancer Institute: Information on treatment options and cancer terms. Link Peer-Reviewed Articles: Key research articles from The Lancet, BMJ, and NEJM. Questions/Clarifications Question 1: What are the differences in prognosis for right-sided vs. left-sided colorectal cancer? Question 2: Why is pancreatic cancer often diagnosed so late? Question 3: How does chronic H. pylori infection contribute to both gastric and oesophageal cancer risk? Question 4: What distinguishes spontaneous colorectal cancer from IBD-associated colorectal cancer?