Gastro: Oesophageal Cancer: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Oesophageal Cancer🎧 A high-yield breakdown of this aggressive upper GI malignancy. Perfect for exam prep and clinical scenarios.🧠 Key Learning Points📌 Definition• Malignant tumour of the oesophageal lining.• SCC – upper/mid-oesophagus; AC – lower oesophagus (Barrett’s-related).📌 Causes & Risk Factors• SCC: Smoking, alcohol• AC: GORD → Barrett’s• Others: Obesity, low fruit/veg diet, nitrosamines, genetics, hiatal hernia• Rare: Plummer–Vinson, ptilosis, poor dental hygiene, H. pyloriMnemonic:– S for Squamous → Smoking, Spirits– A for Adeno → Acid, AC, Barrett’s📌 Pathophysiology• Chronic inflammation → mutations → dysplasia → malignancy• SCC: squamous cells; AC: glandular metaplasia (Barrett’s)• Invasion + metastatic potential📌 Symptoms• Progressive dysphagia, weight loss• Regurgitation, chest pain, hoarseness, persistent cough• Advanced: odynophagia, melena, anorexiaRed Flags: Dysphagia, anaemia, chest pain, voice change, GI bleeding📌 Differential Diagnosis• Oesophageal stricture, achalasia, GORD• Gastric/bronchial cancer, lymphadenopathy, benign lesions📌 Diagnosis• Gold standard: Upper GI endoscopy + biopsy• Staging:– EUS (tumour depth)– CT TAP– PET-CT (occult spread)– Laparoscopy (junctional tumours)• Bloods: FBC, U&E, LFTs, CRP, glucose• HER2 testing (targeted therapy planning)📌 Management1. Early (T1N0):• EMR or surgical resection (Ivor Lewis)2. Localised (T2/T3 N+):• Neoadjuvant chemo/chemoradiotherapy → surgery → adjuvant chemo3. Advanced SCC / Unresectable:• Radical chemoradiotherapy, palliative care4. Metastatic / Palliative:• Symptom control (e.g. radiotherapy, stents)• Nutrition: PEG/NJ tube• HER2+? → TrastuzumabImportant procedures:• Bronchoscopy (if hoarseness/high tumour)• FNA of palpable neck nodes• Feeding support📌 Complications• Obstruction, bleeding, perforation• Fistulae (e.g. tracheo-oesophageal)• Metastases (liver, lungs, bone)• Treatment risks: chemo side effects, leaks, infections• Social + psychological impact📌 Prognosis• 5-year survival ~20–25% overall• Better if early-stage and fit for surgery• Late-stage = poor prognosis• HER2+, nodal spread → worse outcome📌 Prevention & Screening• Stop smoking/alcohol, manage GORD/obesity• Barrett’s surveillance if high risk• No general screening currently recommended 📎More MSRA Resourcesfor Oesophageal Cancer📝 Revision Notes:https://www.passthemsra.com/topic/oesophageal-cancer-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/oesophageal-cancer-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/oesophageal-cancer-accordion-qa-notes-2/🚀 Rapid Quiz:https://www.passthemsra.com/topic/oesophageal-cancer-rapid-quiz-2/🎓 Full Course:https://www.passthemsra.com/courses/gastroenterology-for-the-msra/ #MSRA #MSRARevision#MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes#MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision#MSRARevisionWebsite #OesophagealCancer