Transcript Cancer of the GI System - GI-Group-2010

Cancer of the GI System
Esophageal cancer
Pathogenesis:
 Rare
 Secondary to infiltration/structure
alteration
 Most common at gastroesophageal
junction
 Ulceration
 Exposure to irritant – long-term
Esophageal cancer
Manifestation:
 Early stage asymptomatic
 Chest pain or dysphagia
 Pyrosis
 Radiating pain
Esophageal cancer
Treatment:
 Reflux prevention
 Primary lesion removal
 Radiation
 Chemotherapy
 If malignancy wide
spread – palliative care
Gastric cancer
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X-RAY OF A
STOMACH CANCER
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2% of all new cancers
diagnosed in USA
10620 annual deaths
Causes:
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Infection with H.Pylori
Dietary salt
Pickled food
Food additives
Gastric cancer
Pathogenesis:
 Begins in glands of mucosa
 50% are in prepyloric antrum
 Precursors: gastritis, intestinal metaplasia,
or duodenal reflux
Gastric cancer
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Manifestation
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Early stages asymptomatic
Loss of appetite
Malaise
Upper abdominal pain/vomiting
Treatment
◦ Surgery
◦ Chemotherapy
◦ Radiation
Colon and rectal cancer
Third most common cancer in the USA
 78% colon
 28% rectum
 Small intestine cancers are rare
 Anal carcinoma less then 1%
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Colon and rectal cancer
Pathogenesis:
 Genetic factors
 Environmental factors
 Polyps
 Diet low in grains, fruits, vegetables
 Low physical activity
 Frequent constipation/prolonged contact
of fecal mass with colon mucosa
Colon and rectal cancer
Clinical manifestation:
 Descending colon: obstruction
 Ascending colon: polypoid, pain, red
stools, anemia, palpable
 Rectal carcinoma: spread to nearby
structures (i.e. prostate or bladder).
Cancer and rectal cancer
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Evaluation
◦ Screenings (i.e. colonoscopy)
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Treatment/prevention
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Proper diet
Diagnostic and surgery
Radiation before surgery
Chemotherapy
Liver cancer
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Fifth most common
cancer in the U.S.
Third leading cause of
death worldwide
Mostly metastasis from
primary cancer
Risk factors: HBV/HCV
infections, cirrhosis,
mycotoxin exposure,
heavy smoking and
ETOH consumption
Liver cancer
Pathogenesis:
 Hepatocellular carcinoma: primary cancer,
associated with cirrhosis
 Cholangiocellular carcinoma: most
prevalent in Asian populations. Caused by
parasitic infection or mechanical damage.
Liver cancer
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Manifestation
◦ Vague abdominal symptoms
◦ Nausea/ vomiting/ fullness feeling
◦ Pain or jaundice
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Treatment
◦ Surgical lobe removal when possible
◦ Thermal ablation
◦ Liver transplant
Gallbladder cancer
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Rare but lethal
Common in the ages
50-60 years
Obesity risk factor
Greater risk by natives
Americans
Mostly caused by
metastasis
Primary cancer due to
cholecistits
Gallbladder cancer
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Manifestations
◦ Steady right upper quadrant pain
◦ Loss of appetite/ diarrhea/ weakness/
◦ Obstructive jaundice
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Treatment
◦ Surgical resection
◦ Chemotherapy mostly palliative
Pancreas cancer
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Fourth most common cause of death in
U.S. men(cancer capture on X-ray below):
Pancreas cancer
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Pothogenesis
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Arise often from exocrine cells
Genetic – growths factors overexpressed in ductal cancer
Can occur in head, body, or tail
Often causes metastasis to the liver
Clinical Manifestations
◦ Generally asymptomatic till obstruction occurs
◦ Jaundice
◦ Weight loss
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Treatment
◦ Pancreatectomy and chemotherapy