Colorectal Adenocarcinoma Flashcards
How common is colorectal adenocarcinoma?
2nd most common cause of cancer death in the UK
What is the aetiology of colorectal adenocarcinoma?
Genetics
- HNPCC
- FAP
Disease
- Crohn’s
- UC
Lifestyle
- Smoking
- Poor diet
What are the symptoms of bowel cancer dependent on?
What side it is on
What are the symptoms of bowel cancer in general?
Abdo mass
Pain
Obstruction
Perforation
What are the symptoms of bowel cancer on the left?
PR bleeding and mucus
Altered bowel habit
What are the symptoms of bowel cancer on the right?
Weight loss
Aneamia
Abdo pain
What is the staging algorithm of bowel cancer?
Duke’s Classification
What is Dukes stage 1 and survival rate?
Cancer hasn’t invaded past the muscularis mucosae
- 90% survival
What is Dukes stage 2 and survival rate?
Cancer has invaded past the muscularis mucosae
- 65%
What is Dukes stage 3 and survival rate?
Cancer has invaded regional lymph nodes
- 30%
What is Dukes stage 4 and survival rate?
Cancer has distant mets
- <10%
What screening program is there for bowel cancer?
Faecal occult blood test kits sent to homes and tested
What investigations can be done if occult blood is detected?
Proctoscopy
Endoscopy
CT/MRI
Liver ultrasound for mets
What is shown on bloods in some cases?
Microcytic anaemia
- Small red blood cells
What antigen can be used to help with staging and treatment efficacy?
CEA
- Cryoembryonic antigen
What does the surgical treatment of bowel cancer depend on?
The side it’s on
What can be done for right sided?
Right hemicolectomy
What can be done for left and rectal?
Left hemicolectomy
Abdominoperinal resection for rectal
What role can radiotherapy play?
Can be used neoadjuvantly
- May increase survival rate but also increase chance of complication
What role can chemotherapy play?
Increase survival
Palliation
What Dukes’ stages is chemotherapy used in?
B (sometimes)
C (good evidence)
What role do NSAIDs and aspirin play in colorectal cancer?
Evidence that they might be preventative
What other surgeries may need to be done in the management of colectomys?
Colostomies put in
What are the 3 types of polyp?
Inflammatory
Hamartomatous
Neoplastic
What causes inflammatory polyps?
IBD
What causes hamartomatous polyps?
Peutz jeghers syndrome
What causes neoplastic polyps?
Adenomas
What is peutz jeghers disease?
Autosomal dominant disorder causing hamartomatous growths in the bowel
Increases risk of bowel cancer by 20x
