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Alimentary Clinical medicine > Colon Cancer > Flashcards

Colon Cancer Flashcards

1
Q

what are the risk factors for colon cancer?

A 
age 
male sex
previous adenoma (CRC)
diet (low fibre, fruit and veg, Ca & high red meat and alcohol)
obesity
lack of exercise
diabetes mellitus 
HNCC
FAP
CRC syndromes
IBD
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2
Q

what is the presentation of colorectal cancer?

A 
rectal bleeding (mixed in with stool)
loose stool >4wks
iron deficiency in men
non-mestration in women
palpable rectal mass or right lower abdominal mass
acute colonic obstruction
weight loss
anorexia
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3
Q

what are the investigations used to diagnose colon cancer?

A

colonoscopy
barium enema
CT colonography
CT abdomen/pelvis

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4
Q

what are the main treatments for colon cancer?

A

surgery
chemotherapy
radiotherapy

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5
Q

when is radiotherapy given?

A

only in rectal cancer

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6
Q

how is colon cancer staged?

A

TNM

dukes

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7
Q

describe how dukes staging criteria works.

A

A - only invasion of submucosa
B - invasion through muscularis but not lymph node involvement
C - lymph node involvement
D - metastasis

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8
Q

what treatment would someone with dukes A stage colon cancer or someone with cancer polyps have?

A

endoscopic or local resection

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9
Q

in what type of cancer is radiotherapy only used for?

A

rectal cancer

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10
Q

what therapy is used neoadjuvant?

A

radiotherapy

may also be with chemo

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11
Q

what therapy is adjuvant?

A

chemotherapy

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12
Q

what treatment is given if there is positive lymph node involvement?

A

chemotherapy

+/- surgery

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13
Q

name a chemotherapy drug.

A

5-FU (fluorouracil)

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14
Q

what palliative care is given to someone with colon cancer?

A

chemotherapy and/or colonic stenting

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15
Q

what is the prognosis of someone with Dukes stage A,B,C and D at 5 yrs?

A 
A = 83%
B = 64%
C = 38%
D = 3%
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16
Q

What is the most effective screening method for colorectal cancers?

A

faecal immunological test (FIT)

17
Q

what ways can we screen for colonic cancers?

A 
faecal occult blood test 
faecal immunochemical test
flexible sigmoidoscopy 
colonoscopy 
CT colonoscopy
18
Q

at what age does someone qualify for the Scottish bowel screening programme?

A

age 50-74yrs

19
Q

why is the FIT test more reliable than the FOB test?

A

FIT is more accurate as it is specific for human haemoglobin
it is both automated and quantitative
reduced interval cancer rate

20
Q

what ‘high risk groups’ are screened for colorectal cancers?

A 
FAP
HNCC
inflammatory bowel disease
previous adenomas/CRC
family history of CRC
21
Q

what type of mutation causes FAP?

A

mutation of the APC gene on chromosome 5

22
Q

is FAP dominant or recessive?

A

autosomal dominant

23
Q

when are people with FAP screened for colon cancer?

A

screened from 10-12 yrs annually

24
Q

what treatment can be given to people with FAP?

A

prophylactic protocolectomy

NSAIDS chemoprevention

25
Q

what role does NSAIDS have on the treatment of FAP?

A

reduces the no. if polyps and prevents recurrence of higher grade adenomas in the retained rectal segment

26
Q

what are the complications of FAP?

A

Extra colonic manifestations i.e. Gastric, cystic, funds, hyperplastic polyps & Periampullary cancer- 90% chance of developing duodenal adenomas
Desmoid tumours
CHRPE - congenital retinal hypertrophy of the pigment epithelium

27
Q

is HNPCC dominant or recessive?

A

autosomal dominant

28
Q

what is the mutation in HNPCC?

A

DNA mismatch repair (MRR) genes

i.e. MLH1 & MSH2

29
Q

what is the characteristic is HNPCC tumours?

A

micro satellite instability (MSI)

frequent mutations in short repeated DNA sequences

30
Q

when does screening in people with HNPCC begin ?

A

25 yrs old - every 2 yrs

31
Q

what side is HNPCC found in the colon?

A

right side

32
Q

what are associated cancers of HNPCC?

A

endometrial
genitourinary
stomach
pancreas

33
Q

how is HNPCC diagnosed?

A 
genetic testing
clinical criteria (amsterdam / bethesda)

Alimentary Clinical medicine (23 decks)

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