Clinical Aspects of Colorectal Cancer

Question 1

List 7 risk factors for colorectal cancer.

Answer 1

Neoplastic polyps
IBD
Genetic predisposition
Low fibre diet
Alcohol
Smoking
Previous cancer

Question 2

Describe the clinical features of colorectal cancer. Consider:

a) Symptoms caused by any tumour (4)
b) Symptoms caused by a tumour on the left side of the colon (4)
c) Symptoms caused by a tumour on the right side of the colon (2)

Answer 2

GENERAL:
Palpable mass
Bowel perforation
Haemorrhage
Fistula

LEFT SIDED:
Rectal bleeding/mucous
Altered bowel habits
Bowel obstruction
Tenesmus

RIGHT SIDED:
Weight loss
Abdominal pain

Question 3

What 2 signs might you find O/E of colorectal cancer?

Answer 3

Palpable mass

Anaemia

Question 4

How does colorectal cancer commonly metastasise? (4)

Answer 4

Local
Lymphatics
Bloods
Transcoelomic

Question 5

Which investigations would you do for colorectal cancer? (6)

Answer 5

1. Bloods (FBC, LFTs)
2. Stool tests (faecal occult blood)
3. Colonoscopy
4. Biopsy
5. CT scan (for mets)
6. Other imaging:
   a. Sigmoidoscopy
   b. Barium enema
   c. US of liver

Question 6

How would you manage colorectal cancer? (2)

Answer 6

Adjuvant chemotherapy

Surgery

Question 7

Give 4 examples of surgeries used to treat colorectal cancer.

Answer 7

Right/left hemi-colectomy
Sigmoid colectomy
Anterior resection
Abdomino-perineal (AP) resection

Question 8

What is the role of adjuvant therapy in colorectal cancer?

Answer 8

Aim to shrink tumour before surgery