16 - Colorectal cancer Flashcards
1
Q
Colorectal carcinogenesis
A
- Most sporadic
- 1-3% are familial and associated with predisposing conditions
2
Q
Two major pathways of colorectal carcinogenesis
A
Chromosomal instability and Micro-satellite instability
3
Q
Risk factors
A
- Over 50
- Family history
- Lack of physical activity, alcohol, smoking
- High calorie, low fibre diet
- Genetics
4
Q
Clinical presentation
A
- Fatigue, anaemia, weakness
- Blood in faeces
- Altered bowel habits
- Cancer of another organ
- Haemorrhoids
5
Q
Diagnosis
A
Clinical, endoscopic and radiological features
6
Q
Invasion/spread
A
- Direct invasion to adjacent structures
- Blood vessels –> liver
- Lymph nodes
7
Q
Colorectal adenocarcinoma
A
Dysplastic glands + invasion to the sub mucosa and beyond
8
Q
Lynch syndrome
A
- Autosomal dominant disorder caused by pathogenic germline mutations
- In one of DNA mismatch repair genes or mutations involving adjacent genes which affect the function or expression of these genes
9
Q
Polyps
A
- Adenomas
- Hyperplastic polyps
- Haemartomatous polyps
- Non epithelial polyps
10
Q
Adenoma clinical presentation
A
- Asymptomatic
- Screening
- Incidental
- Faecal Occult Blood Test
11
Q
Adenoma
A
- Tubular
- Villous
- Tubullo-villous
- Serrated
- All adenomas are dysplastic with no invasion
12
Q
Adenoma carcinoma sequence
A
- Early invasive carcinoma show residual adenoma
- Risk of carcinoma related to number of adenomas
- Removal of adenomas result in reduction of the
incidence of carcinoma
13
Q
National bowel cancer screening program
A
- Testing for bowel cancer in people without symptoms
- Find adenomas (polyps) to prevent cancer
- Blood invisible to eye leak from growths into faeces before symptoms are noticed
14
Q
Facts of CRC
A
- Aus second biggest cancer killer (after lung)
- Most curable types if detected early
15
Q
Treatment
A
- Surgery
- Radiation
- Chemotherapy
- Target therapy
