Gastric cancer

• Who is gastric cancer more common in?


  Men
• What is the primary risk factor for gastric cancer?

  H. pylori
• What are some risk factors for gastric cancer?

  H. pylori

  Diet

  Smoking

  Alcohol

  Pernicious anaemia

  FHx
• How do patients with gastric cancer present?


  Dyspepsia

  Epigastric pain

  Weight loss

  Anaemia

  Nausea and vomiting

  GI bleeding
• Which nodes should you look at for gastric cancer?

  Virchow's node

  Sister mary joseph node
• When should you offer urgent direct access upper GI endoscopy?


  Dysphagia

  Age 55 + weight loss + upper abdo pain or reflux or dyspepsia
• How is gastric cancer investigated?


  Endoscopy + biopsy
• How is gastric cancer staged using imaging?


  CT chest, abdo and pelvis

  Laparoscopy (identify occult peritoneal disease)
• How is gastric cancer managed?


  Surgery

  Chemo

  Radiation

  Targeted therapy

  Supportive and palliative care
• What is neoadjuvant chemotherapy?


  Given before surgery to shrink the tumour
• What is adjuvant chemotherapy?


  Given after surgery to eradicate residual disease
• What is palliative chemotherapy?


  Used for metastatic or unresecatble disease to control symptoms
• What are some complications of gastric cancer?


  Obstruction

  Bleeding

  Perforation
• What are some common areas for gastric cancer to metastasise to?


  Liver

  Lymph node

  Ovarian

  Malignant ascites