1. Cancer of the GI System

2. Esophageal cancer Pathogenesis: Rare Secondary to infiltration/structure alteration Most common at gastroesophageal junction Ulceration Exposure to irritant – long-term

3. Esophageal cancer Manifestation: Early stage asymptomatic Chest pain or dysphagia Pyrosis Radiating pain

4. Esophageal cancer Treatment: Reflux prevention Primary lesion removal Radiation Chemotherapy If malignancy wide spread – palliative care

5. Gastric cancer X-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

6. Gastric cancer Pathogenesis: Begins in glands of mucosa 50% are in prepyloric antrum Precursors: gastritis, intestinal metaplasia, or duodenal reflux

7. Gastric cancer Manifestation ◦ Early stages asymptomatic ◦ Loss of appetite ◦ Malaise ◦ Upper abdominal pain/vomiting Treatment ◦ Surgery ◦ Chemotherapy ◦ Radiation

8. 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%

9. 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

10. 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).

11. Cancer and rectal cancer Evaluation ◦ Screenings (i.e. colonoscopy) Treatment/prevention ◦ Proper diet ◦ Diagnostic and surgery ◦ Radiation before surgery ◦ Chemotherapy

12. Liver cancer 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

13. Liver cancer Pathogenesis: Hepatocellular carcinoma: primary cancer, associated with cirrhosis Cholangiocellular carcinoma: most prevalent in Asian populations. Caused by parasitic infection or mechanical damage.

14. Liver cancer Manifestation ◦ Vague abdominal symptoms ◦ Nausea/ vomiting/ fullness feeling ◦ Pain or jaundice Treatment ◦ Surgical lobe removal when possible ◦ Thermal ablation ◦ Liver transplant

15. Gallbladder cancer 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

16. Gallbladder cancer Manifestations ◦ Steady right upper quadrant pain ◦ Loss of appetite/ diarrhea/ weakness/ ◦ Obstructive jaundice Treatment ◦ Surgical resection ◦ Chemotherapy mostly palliative

17. Pancreas cancer Fourth most common cause of death in U.S. men(cancer capture on X-ray below):

18. Pancreas cancer Pothogenesis ◦ 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