Bowel cancer Flashcards
risk factors for bowel cancer?
FH, FAP, (hereditary nonpolyposis colorectal cancer) Lynch Syndrome, IBD, increasing age, diet, obesity and sedentary lifestyle, smoking alcohol
what is FAP?
autosomal dominant- malfunctioning of tumour suppressor genes adenomatous polyposis coli.
HNPCC?
autosomal dominant- mutations in DNA mismatch repair genes
red flags?
change in bowel habit, unexplained weight loss, rectal bleeding, abdominal pain, iron deficiency anaemia , abdominal or rectal mass
2 week wait?
over 40- abdo pain and weight loss
over 50- rectal bleed
over 60- change in bowel habit or iron deficiency anaemia
gold standard investigation for colorectal cancer?
colonoscopy
tumour marker for bowel cancer?
carcinoembryonic antigen CEA- predicting relapse
when to perform hartmann’s procedure?
emergency: removal of rectosigmoid and form colostomy. indications are acute obstruction by tumour or significant diverticular disease
low anterior resection syndrome can cause symptoms?
urgency and frequency, faecal incontinence, difficulty controlling flatus
risk factors of disease recurrence after resection patients may be offered?
5FU and oxaliplatin
sporadic colon cancer may be due to gene mutations in?
APC gene. It is believed a further series of gene abnormalities e.g. activation of the K-ras oncogene, deletion of p53 and DCC tumour suppressor genes lead to invasive carcinoma.
what is the most common form of inherited colon cancer?
HNPCC lynch syndrome
most common genes affected in HNPCC are?
MSH2 and MLH1
amsterdam criteria?
at least 3 family members with colon cancer
the cases span at least two generations
at least one case diagnosed before the age of 50 years
what is gardners syndrome?
A variant of FAP called Gardner’s syndrome can also feature osteomas of the skull and mandible, retinal pigmentation, thyroid carcinoma and epidermoid cysts on the skin
