Colo-rectal Cancer Flashcards
What is a benign colorectal neoplasia called and what is a maligant colorectal neoplasia called?
Adenoma - benign
Adenocarcinoma - malignant
What can be inflammatory, hamartomatous, metaplastic and neoplastic?
Colorectal polyps
What genes, when normal promote cell growth and division however, when mutated cause excess cell growth and division?
Oncogenes
What genes when normal suppress cell growth and division and when mutated allow cell growth and division?
Tumour suppressor genes
What 4 genes are involved in colo-rectal cancer?
- APC
- Kras
- p53
- 18qloss
What three macroscopic appearances does colorectal cancer have?
Polypoidal, ulcerative and annular
What colorectal neoplasm is tubular and villous?
Adenomas
What kind of colorectal neoplasm can be well or poorly differentiated?
Adenocarcinoma
What two staging methods are there for colorectal cancer?
Dukes and TNM
What does the D mean in Dukes staging?
Distant metastases
What do T1, T2, T3 and T4 mean in TNM staging?
T1 - submucosa only
T2 - into muscle
T3 - through muscle
T4 - adjacent structures (including peritoneum)
What do NO, N1 and N2 mean in TNM staging?
N0 - no lymph node involvement
N1 - 3 nodes involved
What two nodes can colorectal cancer spread to?
- Periocolic nodes
2. Perivascular nodes
What kind of gene is LKB1?
Tumour suppressor
What is the inheritance like in colorectal cancer?
Autosomal dominant
What is FAP?
A mutation in APC gene
What is HNPCC?
Mutation in DNA mismatch repair gene
What two mutations give autosomal dominant inheritance in colorectal cancer?
FAP and HNPCC
Name two predisposing conditions for colorectal cancer?
Adenomatous polyps
IBD
Give 5 symptoms of colorectal cancer?
Anaemia, tenesmus, rectal bleeding, change of bowel habit and pain
What are three general clinical findings of colorectal cancer?
Anaemia
Chachexia
Lymphadenopathy
What are three abdomen clinical findings with colorectal cancer?
Mass
Hepatomegaly
Distension
What are two rectum clinical findings with colorectal cancer?
Mass and Blood
What are 4 methods of diagnosing colorectal primary disease?
- Barium enema
- CT colography
- Sigmoidoscopy
- Colonoscopy
What technique used in screening can detect 70% of cancers?
FOBT
Name two staging investigations for colorectal cancer regarding the lungs?
CXR or CT
Name 2 staging investigations for colorectal cancer regarding the liver?
US or CT
What two investigations can be done to stage primary rectal cancer?
CT or MRI
What are obstruction, bleeding, perforation, vomiting, pain, constipation and distension all signs of?
Emergency presentation of colorectal cacner
What three ways are there to treat obstruction in colorectal cancer?
Colostomy alone
Resection and colostomy
Stenting
What are right hemicolectomy, extended right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy and subtotal colectomy all used for?
Colonic cancer
Name three surgical methods for rectal cancer?
- Abdomino-perineal excision
- Anterior resection
- Local excision
What agent is used for chemotherapy for colorectal cancer?
5-fluorouracil (5-FU)
What is an adjuvant for stage C colorectal cancer?
Chemotherapy
What are two new drugs for advanced colorectal cancer?
Oxaliplatin
Irinotecan
What are 2 biological agents used for advanced colorectal cancer?
Cetuximab
Bemab
What is Dukes class A?
Tumour confined to bowel wall (97% 5 year survival)
What is Dukes class B?
Tumour extends across bowel wall (80% 5 year survival)
What is Dukes class C?
Involvement of regional lymph nodes (48% 5 year survival)
How often are people screened?
Every 2 years for 60-75 using Faecal Occult Blood
