Cancer of the GI SystemCancer of the GI System

Esophageal cancerEsophageal cancer

Pathogenesis:RareSecondary to infiltration/structure

alterationMost common at

gastroesophageal junctionUlcerationExposure to irritant – long-term

Esophageal cancerEsophageal cancerManifestation:Early stage asymptomaticChest pain or dysphagiaPyrosisRadiating pain

Esophageal cancerEsophageal cancer

Treatment:Reflux preventionPrimary lesion

removalRadiationChemotherapyIf malignancy

wide spread – palliative care

Gastric cancerGastric cancerX-RAY OF A

STOMACH CANCER

2% of all new cancers diagnosed in USA

10620 annual deaths

Causes:◦ Infection with

H.Pylori◦ Dietary salt◦ Pickled food◦ Food additives

Gastric cancerGastric cancer

Pathogenesis:Begins in glands of mucosa50% are in prepyloric antrumPrecursors: gastritis, intestinal

metaplasia, or duodenal reflux

Gastric cancerGastric cancerManifestation

◦Early stages asymptomatic◦Loss of appetite◦Malaise◦Upper abdominal pain/vomiting

Treatment◦Surgery◦Chemotherapy ◦Radiation

Colon and rectal cancerColon and rectal cancerThird most common cancer in the

USA78% colon28% rectumSmall intestine cancers are rareAnal carcinoma less then 1%

Colon and rectal cancerColon and rectal cancer

Pathogenesis:Genetic factorsEnvironmental factorsPolypsDiet low in grains, fruits, vegetablesLow physical activity Frequent constipation/prolonged

contact of fecal mass with colon mucosa

Colon and rectal cancerColon and rectal cancer

Clinical manifestation:Descending colon: obstruction Ascending colon: polypoid, pain,

red stools, anemia, palpableRectal carcinoma: spread to

nearby structures (i.e. prostate or bladder).

Cancer and rectal cancerCancer and rectal cancerEvaluation

◦Screenings (i.e. colonoscopy)Treatment/prevention

◦Proper diet◦Diagnostic and surgery◦Radiation before surgery◦Chemotherapy

Liver cancerLiver cancerFifth most common

cancer in the U.S.Third leading cause

of death worldwideMostly metastasis

from primary cancerRisk factors:

HBV/HCV infections, cirrhosis, mycotoxin exposure, heavy smoking and ETOH consumption

Liver cancerLiver cancer

Pathogenesis:Hepatocellular carcinoma:

primary cancer, associated with cirrhosis

Cholangiocellular carcinoma: most prevalent in Asian populations. Caused by parasitic infection or mechanical damage.

Liver cancerLiver cancerManifestation

◦Vague abdominal symptoms◦Nausea/ vomiting/ fullness feeling◦Pain or jaundice

Treatment◦Surgical lobe removal when possible◦Thermal ablation◦Liver transplant

Gallbladder cancerGallbladder cancerRare but lethalCommon in the

ages 50-60 yearsObesity risk factorGreater risk by

natives AmericansMostly caused by

metastasis Primary cancer

due to cholecistits

Gallbladder cancerGallbladder cancerManifestations

◦Steady right upper quadrant pain◦Loss of appetite/ diarrhea/ weakness/◦Obstructive jaundice

Treatment◦Surgical resection◦Chemotherapy mostly palliative

Pancreas cancerPancreas cancerFourth most common cause of

death in U.S. men(cancer capture on X-ray below):

Pancreas cancerPancreas cancerPothogenesis

◦ 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

Treatment◦ Pancreatectomy and chemotherapy