Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cancer > Bowel cancer > Flashcards

Bowel cancer Flashcards

1
Q

Risk factors for colon cancer

A

Family history in first degree relative
Personal history - colorectal adenomas, colocrectal cancer, ovarian cancer
Hereditary conditions - lynch syndrome, FAP
Personal - Chronic UC or crohns colitis
Excessive alcohol use
Cigarette smoking
Race and ethnicity - african american
Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does prognosis of colorectal cancer depend on

A

Penetration of tumour through bowel wall
Presence or absence of nodal involvement
Presence or absence of distant metastases
Bowel obstruction/perforation = poor prognsosi
Elevated CEA = negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Do HNPCC colon cancer patients have a good outlook

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is CEA useful in colon cancer

A

Only in cadidates for resection of liver or lung metastases postoperatively
Stage II/III rectal cacner every 2-3 months for at least 2 years after diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clinical features of colorectal cancer

A

Rectal bleednig
Change in bowel habits
Abdominal pain
Intestinal obstruction
Change in appetite
Weight loss
Weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does bright red blood in the toilet suggest about anatomy of where bowel cancer is

A

Left hand side = bright red blood
Right hand side = dark dried blood - FIT test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnostic evaluation for rectal cancer

A

Physical exam and history
PR
Colonsocopy
Biopsy
CEA assay
Immunohistochemistry
MSI testing/DNA mismathc repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What might see on physical exam in colorectal cancer

A

Palpable mass and bright blood in rectum
Adenopathy, hepatomegaly, pulmonary signs if metastatic
Iron deficiency anaemia
Electrolyte, LFT abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

High risk pathological features colorectal cnacer

A

Positive surgical margins
Lymphovascular invasion
Perineural invasion
Poorly differentiated histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the circumferetnial resection margin

A

Measured in millimeters, CRM is defined as the retroperitoneal or peritoneal adventitial soft-tissue margin closest to the deepest penetration of the tumor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Significance of MSI testing in colorectal cancer

A

5-10% of rectal adenocarcinomas have mismatch repair deficiency
Dont respond well to chemoterhapy
BUT improved survival under 50
Ass w lynch syndrome
Prognosis of II/III rectal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who gets colorectal cancer

A

More common in males 3:1
>70 years peak incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where are colorectal cancers located?

A

Rectal - 40%
Sigmoid 30%
Descending colon 5%
Transverse colon 10%
Ascending colon and caecum 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

R sided colon cancer presentation

A

Palpable mass in RIF
Diarrhoea
Weight loss
Anaemia
Occult GI bleeding - non visible but + FIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

L sided colon cancer presentation

A

Palpable mass in LIF
CHange in bowel habit - constipation
Tenesmus
Rectal bleeidng
Signs and symtpoms of bowel obstruction
Tend to present earlier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is troissiers sign

A

Enlarged virchows lymph node in L SCF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

FAP specific extracolonic features

A

Congenital hypertrophy of retinal pigment epithelium - CHPRE
Osteomas of the jaw
Pre-pubertal epidermoid cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Histological types of colon cancer

A

Adenocarcinomas - majority. Mucinous or signet ring
Scirrhous tumours
Neuroendocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T staging of bowel cancer tumours

A

T0/is - No evidence of primary tumour
T1 - Tumour invades submucosa - through muscularis mucosa but not propia
T2 - Tumour invades muscularis propia
T3 - Tumour invades through muscularis propia into pericolorectal tissues
T4a - invades visceral peritoneum perforating it
T4B - Tumour directly invades or adheres to adjacent organs or structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

N stages of colon cancer

A

N0 - no regional lymph node metastases
N1 - 1-3 peri-colic lymph nodes + or any number tumour deposits present and all identifiable lymph nodes negative
N1 - 1-3 nodes
N2 - 4>
N3 - vascular trunk or apical node mets in any lymph nodes

More complex
N1a - one regional lymph node +
N1b - 2-3 regional +
N1c = no regional lymph nodes + but tumour deposits in subserosa, mesentery or nonperitonealised pericolic/perirectal tissues
N2a = 4-6 regional lymph nodes affected
N2b = 7 or more regional lymph nodes +

21
Q

What defined if a lymph node is affected in cancer

A

> 0.2mm

22
Q

M stages colorectal cancer

A

M0 = no evidence of metastases by imaging
M1a = metastasis to one site or organ identified without peritoneal
M1b = metastasis to 2 or more sites or organs identified without peritoneal metastasis
M1c - metastasis to peritoneal surface with or without other metastases

23
Q

What is most important section of staging for prognosis colon cancer

A

Nodal involvement

24
Q

Treatment for colorectal cancer

A

Surgery
Surgery only in stages O+I
Adjuvant chemo from stage II
Metastases - harsher and longer chemo regimes
StageIV and recurrent - systemic therapy, immunotherapy

25
Q

Surgical treatment for colon cancer

A

Open surgical resectionn of primary and regional lymph nodes if localised
Curative in 25-40% of patients with resectable metastases in liver an dlung

26
Q

What adjuvant chemotherapy is used in stage II/III colon cancer

A

5-FU +/- oxaplatin
Capecitabine - equivalent alterantive
Irinotecan

27
Q

What test need to do before start patinet on 5FU

A

DYPD gene testing
DPYD2A -> severe life threatening toxicities to fluoropyrimidines eg 5FU

28
Q

Recurrence of colon cancer stage II risk factors

A

Inadequate lymph node sampling.
T4 disease.
Involvement of the visceral peritoneum.
A poorly differentiated histology.

29
Q

what does stage III colon cancer denote

A

lymph node involvement

30
Q

Causes of sporadic colon cancer

A

Series of genetic mutations
Allelic loss of APC gene
Activation of K-ras oncogene
p53 deletion
DCC tumour supressor gene deletion

31
Q

What kind of cancer is often seen caused by HNPCC/lynch syndrome

A

Proximal colon, poorly differentiated and highly aggressive

32
Q

What is Garners syndrome

A

Variation of FAP -> osteomas of skull and mandible, retinal pigemntation, thyroid carcinoma and epidermoid cysts on skin

33
Q

Treatment for stage III colon cancer

A

Wide surgical resection and anstomosis
Adjuvant chemotherapy
Clinical trials

34
Q

What first line immunotherapy for colon cancer

A

Pembrolizumab monotherapy

35
Q

What is often first site of metastases in bowel cancer

A

liver - from portal vein

36
Q

what can present similarly to colon cancer perforation

A

perforated diverticulitis

37
Q

lifestyle risk factors bowel cancer

A

red meat
alcohol
high calorie intake
smoking
sedentary lifestyle
obesity

38
Q

Where do marjority of colorectal cancers originate from

A

70% adenocarcinomas from benign adenomatous polyps

39
Q

Risk factors bowel cancer

A

Family history of colorectal cancer in a first-degree relative
Personal history of colorectal adenomas, colorectal cancer, or ovarian cancer
Hereditary conditions, including familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary nonpolyposis colorectal cancer [HNPCC])
Personal history of long-standing chronic ulcerative colitis or Crohn colitis
Excessive alcohol use
Cigarette smoking
Race/ethnicity: African American
Obesity

40
Q

What site of cacner most likely caused by carcinogens from smoke

A

Bladder

41
Q

INitial investigations for sus colorectal cancer

A

Rectal exam
FBC
Renal and liver function assessmnet
Colonoscopy or flexi sigmoidoscopy if cant
Double contrast barium enema as alternative
CT chest abdo pelvis
CEA blood - prognosis

42
Q

How is long standing pancolitis monitored

A

Colonoscopy with multiple biopsies

43
Q

How distinguish liver cysts from bowel cancer mets

A

MRI

44
Q

What is best chemo for colon cancer currently accepted as

A

FOLFOX

45
Q

Chances of relapse with colon cancer

A

1 in 3
even if treated with chemo

46
Q

Options for metastatic treatment of colon cancer

A

EGFR mAb - cetuximab
VEGF - bevacizumab

47
Q

Genetic mutations ass with colon cancer

A

BRAFV600 mutant
KRAS or NRAS mutant
P13K novel treatment
PTEN
MEK and AKT inhibitors can target KRAS or NRAS mutant tumours

48
Q

What is the only effective predictive marker to EGFR mAb therapies

A

KRAS

Cancer (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions