Colorectal Flashcards
What are the risk factors for colorectal cancer
Family history
Family adenomatous polyposis (autosomal dominant, malfunction of APC tumour suppressor gene)
Hereditary non-polyposis colorectal cancer (Lynch syndrome, autosomal dominant, malfunction of DNA mismatch repair genes)
Inflammatory bowel disease
Increasing age
Poor diet (high red meat, low fibre)
Obesity
Sedentary lifestyle
Alcohol
Smoking
How might a patient with colorectal cancer present
Changes in bowel habit
Unexplained weight loss
Rectal bleeding
Unexplained abdominal pain
Iron deficiency anaemia
Mass on palpation
What are the NICE guidelines for 2ww for colorectal cancer
Over 40 - abdominal pain and unexplained weight loss
Over 50 - Unexplained rectal bleeding
Over 60 - Changes in bowel habit, iron deficiency anaemia
Explain the bowel cancer screening programme
Faecal immunochemical test
Assesses amount of Hb in stool
60 - 74
Every 2 years
If positive, colonoscopy
What investigations are needed for bowel cancer
Colonoscopy
Sigmoidoscopy
CT colonography (if unfit for colonoscopy)
Staging CT
CEA tumour marker
How is colorectal cancer staged
Duke’s staging
TNM
Explain Duke’s staging for colorectal cancer
A - mucosa and part of bowel wall muscle
B - extends through bowel wall muscle
C - lymph node involvement
D - distant metastasis
How is colorectal cancer managed
Surgery
Chemotherapy
Radiotherapy
Palliative care
What are the different types of surgical resection for colorectal cancer
Right hemicolectomy (caecum, ascending colon, proximal transverse colon)
Left hemicolectomy (distal transverse colon, descending colon)
High anterior resection (sigmoid colon)
Low anterior resection (sigmoid colon, upper rectum)
What are the symptoms of low anterior resection syndrome
Urgency and frequency of bowel movements
Faecal incontinence
Difficulty controlling flatulence
