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Gastrointestinal > Colon cancer > Flashcards

Colon cancer Flashcards

1
Q

Where does colon cancer most commonly affect?

A

2/3rd is colonic
1/3rd is rectal

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2
Q

Where is most commonly affected by colon cancer?

A
  • rectal — 40%
  • sigmoid — 30%
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3
Q

What are the possible risk factors for colon cancer?

A
  • age (>60 years)
  • alcohol, smoking
  • low-fibre diet, red meat
  • IBD
  • neoplastic polyps
  • genetic predisposition
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4
Q

What are the main genetic causes of colon cancer?

A
  • Sporadic ⇒ 95%
  • HNPCC ⇒ 5%
  • FAP ⇒ 1%
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5
Q

What is HNPCC the most common cause of?

A

Inherited colon cancer

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6
Q

What is another term for HNPCC?

A

Lynch syndrome

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7
Q

What type of inheritance does lynch syndrome have?

A

Autosomal dominant condition

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8
Q

Where does HNPCC most commoly affect?

A

Proximal colon

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9
Q

What are the main mismatch repair genes that cause HNPCC?

A

MSH2 (60% of cases)
MLH1 (30% of cases)

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10
Q

What other cancers are associated with HNPCC?

A

Endometrial cancer
Prostate cancer

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11
Q

What does FAP stand for?

A
  • Familial adenomatous polyposis
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12
Q

What type of inheritance does FAP have?

A

A rare autosomal dominant condition

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13
Q

What does FAP cause?

A

The formation of hundreds of polyps by the age of 30-40 years

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14
Q

What are the main symptoms of colon cancer?

A

Abdominal pain
Rectal bleeding
Change in bowel habit
Weight loss
Iron-deficiency anaemia

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15
Q

What can be used to stage colon cancer?

A

Duke’s classification

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16
Q

What is Dukes A?

A

Limited to the bowel wall (i.e. not beyond the muscularis).

17
Q

What is Dukes B?

A

Extends through the bowel wall (i.e. beyond the muscularis).

18
Q

What is Dukes C?

A

Regional lymph node involvement

19
Q

What is Dukes D?

A

Distant metastases

20
Q

What is the current NHS screening for colon cancer?

A

Faecal immunochemical test (FIT) every 2 years for men and women age 60-74

21
Q

If a FIT test is positive, what is the next investigation?

A

Sigmoidoscopy

22
Q

What is the first investigation for colon cancer?

A

Colonoscopy

23
Q

What is the function of a FIT test?

A

Used to detect, and can quantify, the amount of human blood in a single stool sample

24
Q

What is the fuction of a colonscopy?

A

Direct visualization of the colon
Biopsies to be taken
Removal of any polyps seen

25
Q

What can be done as an alternative to a colonscopy if it cannot be tolerated?

A

CT colonoscopy

26
Q

What can be used to stage colon cancer?

A

CT chest, abdomen and pelvis

27
Q

What is the function of CEA?

A

To monitor the theraputic response to intervention

28
Q

What staging can be used for colon cancer?

A

TNM staging

29
Q

What is the management of stage 1-3 disease?

A

Surgical resection ± post-operative chemotherapy.

30
Q

What is right hemicolectomy surgery for?

A

Tumours of the caecum and ascending colon

31
Q

What is left hemicolectomy surgery for?

A

Distal transverse colon and descending colon

32
Q

What is sigmoid colectomy surgery for?

A

Tumours of the sigmoid colon.

33
Q

What is the surgical management of tumours >8 cm from the anal canal or involving the proximal 2/3 of the rectum?

A

Anterior resection

34
Q

What is the surgical management of recal tumours <8 cm from the anal canal or involving the distal 1/3 of the rectum.

A

Abdomino-perineal (AP) resection

35
Q

What symptoms in someone over 40 would require an urgent 2 week wait referal?

A

Unexplained weight loss AND abdominal pain

36
Q

What symptoms in someone over 50 would require an urgent 2 week wait referal?

A

Unexplained rectal bleeding

37
Q

What symptoms in someone over 60 would require an urgent 2 week wait referal?

A

Iron–deficiency anaemia
Changes in their bowel habit

Gastrointestinal (65 decks)

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