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Cancer Of The Upper Gi Tract Notes

Medicine Notes > Gastrointestinal (GI) System Notes

This is an extract of our Cancer Of The Upper Gi Tract document, which we sell as part of our Gastrointestinal (GI) System Notes collection written by the top tier of Bristol University students.

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Lecture 10 Cancer of the upper GI tract




Anatomy of oesophagus o 25cm in posterior mediastinum o Cricopharyngeus to stomach o Muscular wall, no serosa o Aortic branches o Vagus innervation o Squamous lining, columnar at OGJ Cancer of the oesophagus (two types) o Squamous cell cancer
? In western world, incidence decreasing (still high in east)
? Aetiology

* Cigarettes & alcohol (highest risk factors, combined= x20 risk)

* Diet (low in fruit & veg, nitrosamines, vit. A & C, riboflavin &

* Plummer- Vinson syndrome (iron d. anaemia & dysplasia) RARE

* Tylosis (thickening of skin on palms and soles) RARE

* Achalasia

* Eating/drinking scolding hot things increases risk o Adenocarcinoma
? Increasing incidence in western world
? Majority of oesophageal cancer seen (80-90%)
? Aetiology

* Barrett's oesophagus (caused by GORD0


* BMI (overweight=increased risk)

* Smoking and alcohol

* Occupation

* Radiotherapy

* H. pylori= protective against adenocarcinoma Barrett's oesophagus o UK definition
? " Oesophagus in which portion of normal squamous lining replaced by metaplastic columnar epithelium visible macroscopically" o Malignant risk
? Specialised intestinal metaplasia (0.4-0.6% per year- low risk)
? Low grade dysplasia (0.8-1.6% per year)
? High grade dysplasia (6-12% per year- High risk and treat using endoscopy)
? Invasive adenocarcinoma o Treatment
? Control symptoms & reduce complications (meds or surgery- don't know if stops cancer progression)
? Proton pump inhibitors or anti-reflux surgery
? Endoscopic dilatation if stricture
? Endoscopic surveillance

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