Bowel Cancer Flashcards
What are the main symptoms of colonic carcinoma?
- Often none
- Can get low level anaemia
- Rectal blood loss
Where do colonic carcinomas often originate?
Most carcinomas arise in polyps
- maybe pedunculated or flat
- most will bleed due to irritation and trauma
- most take 5 years to progress to malignancy
(If polyps are found on an endoscopy, the screening interval is reduced)
What are patient controlled factors of colonic carcinomas?
1.Diet:
- low fibre
- High fat
- high meat
- low veg
= Higher risk
- Smoking
- Alcohol
- Lack of exercise
What are medical factors contributing to colonic carcinoma?
- Genetics - p53 in 75%
- Ulcerative colitis
- Intestinal polyps
What is intestinal polyposis?
Patient genetically inherits a tendency to form lots of polyps - each of which have a risk of developing cancer
What is the risk of carcinoma on the small intestine?
Low risk
What conditions features growth of polyps in the small intestine?
Peutz-Jehgers Syndrome
What is the risk of carcinoma in the large intestine?
High
What conditions feature polyp growth in the large intestine?
- Gardeners syndrome
2. Cowden’s syndrome
How are colonic carcinomas classified?
By the level of their invasion into the bowel wall
5 year survival
A - submucosal - 80%
B - muscularis but no lymph node involvement - 65%
C - lymph nodes - 45%
D - liver or distant metastasis- 5%
What is the most effective treatment of colonic carcinomas?
Surgery
What treatment methods can be used to treat colonic carcinomas, but are palliative rather than curative?
- Hepatic metastases
- Radiotherapy
- Chemotherapy
What test is most commonly used for bowel cancer?
Faecal immunochemical test
- 2 year repeat If negative
- endoscopy if positive (England use as primary screening too)
What screening for bowel cancer is in place for Scotland ?
Over 50s invited to send stool sample
- FIT test
