Colorectal Flashcards
Stage I colon cancer
Stage I: tumour has grown into the submucosa (T1) or muscularis propria (T2).
Surgery: is main treatment for stage I
- usually involves a bowel resection, the type of bowel resection depends on location of tumour.
- Low anterior resection removes the tumour and the remaining colon is anastomosed so no colostomy is needed.
- Abdominal perineal resection (APR): done for tumours in the lower third of the rectum, a colostomy is needed.
Stage II colon cancer
Stage II: tumour has invaded through the muscularis propria (T3), may have invaded the serosa (T4) or directly invaded other structures (T4)
Surgery: is main treatment for stage II
- Usually involves a bowel resection, the type of bowel resection depends on location of tumour.
- Low anterior resection removes the tumour and the remaining colon is anastomosed so no colostomy is needed.
- Abdominal perineal resection (APR): done for tumours in the lower third of the rectum, a colostomy is needed.
Chemotherapy: offered after surgery if there is a high risk of cancer coming back due to high risk factors.
- Tumour is T4
- Fewer than 12 lymph nodes were removed
- The tumour has grown into nearby tissue and lymph space
- The tumour is high grade
- There is a blockage of the intestine
- Not enough healthy tissue was removed with the tumour.
Radiation therapy: may be offered after surgery to help prevent cancer from coming back in the same area or if entire tumour was not removed during surgery.
- May also be given with or without chemotherapy if patient is unable to undergo surgery.
Stage III colon cancer
Stage III: any size with tumour with nodal involvement
Surgery: is main treatment for stage III
- Usually involves a bowel resection, the type of bowel resection depends on location of tumour.
- Low anterior resection removes the tumour and the remaining colon is anastomosed so no colostomy is needed.
- Abdominal perineal resection (APR): done for tumours in the lower third of the rectum, a colostomy is needed.
Chemotherapy: usually given after surgery for stage III to reduce the risk of recurrence.
- Starts 4-8 weeks after surgery and is usually given for 6 months.
Radiation therapy: may be offered after surgery to help prevent cancer from coming back in the same area or if entire tumour was not removed during surgery.
- Not usually given for stage III because colon cancer doesn’t spread locally but usually has distant metastasis.
Stage I rectal cancer
Stage I: tumour has grown into the submucosa (T1) or muscularis propria (T2).
Surgery: usually involves bowel resection. Type of resection depends on location and size of tumour.
- A bowel resection will usually be done instead of a local excision due to chance of recurrence.
- Low anterior resection removes the tumour and the remaining colon is anastomosed so no colostomy is needed.
- Abdominal perineal resection (APR): done for tumours in the lower third of the rectum, a colostomy is needed.
Chemoradiation: two treatments are given together.
- Radiation may be given after surgery although not typically needed for stage I unless size of tumour was greater than expected.
Radiation: alone can be done in cases patient cannot undergo surgery.
Stage II rectal cancer
Stage II: tumour has invaded through the muscularis propria (T3), may have invaded the serosa (T4) or directly invaded other structures (T4)
Surgery: usually involves bowel resection. Type of resection depends on location and size of tumour.
- A bowel resection will usually be done instead of a local excision due to chance of recurrence.
- Low anterior resection removes the tumour and the remaining colon is anastomosed so no colostomy is needed.
- Abdominal perineal resection (APR): done for tumours in the lower third of the rectum, a colostomy is needed.
Chemoradiation: may be given before surgery
- Given over 25-30 treatments of radiation and chemotherapy of 5-6 weeks.
- Sometimes given after surgery.
Radiation: almost always offered after surgery.
- May be given alone before surgery, could be for 5 treatments of 25-30 depending on situation.
Chemotherapy:
- May be given alone after surgery.
- May be given with chemoradiation after surgery.
Stage III rectal cancer
Stage III: any size with tumour with nodal involvement
Surgery: usually involves bowel resection. Type of resection depends on location and size of tumour.
- A bowel resection will usually be done instead of a local excision due to chance of recurrence.
- Low anterior resection removes the tumour and the remaining colon is anastomosed so no colostomy is needed.
- Abdominal perineal resection (APR): done for tumours in the lower third of the rectum, a colostomy is needed.
Chemoradiation: may be given before surgery
- Given over 25-30 treatments of radiation and chemotherapy of 5-6 weeks.
- Sometimes given after surgery.
Radiation: almost always offered after surgery.
- May be given alone before surgery, could be for 5 treatments of 25-30 depending on situation.
Chemotherapy:
- May be given alone after surgery.
- May be given with chemoradiation after surgery.
