Colorectal Ca Flashcards
3rd most common site of cancer in US
colorectal cancer
second leading cause of cancer death among all adults
colorectal cancer
disorder with high risk of colorectal ca in which pt. develop colonic polylps that can become malignant
FAP or familial adenomatous polyposis
most significant risk factor of colorectal ca
old age
CLINICAL MANIFESTATIONS
*abdominal pain and cramping
*constipation
*distention
*as well as bright-red blood in
Left-sided
CLINICAL MANIFESTATIONS
- dull abdominal pain and melena (usually cause anemia)
Right-sided
CLINICAL MANIFESTATIONS
- tenesmus (painful straining at stool)
- not specific for colon cancer
- rectal pain, feeling of incomplete evacuation after a bowel movement
- alternating constipation
Rectal lesions
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only screening test that can also simultaneously remove precancerous polyps, thus preventing colorectal cancer
-
other experts recommend this every 5 to 10 years beginning at the age of 50
colonoscopy
important tumor marker that suggests colorectal ca, as well as its progression of recurrence
CEA - carcinoembryonic antigen
*check stool samples for hidden (occult) blood
*occult blood in the stool may indicate colon cancer or polyps in the colon or rectum
*occult blood is passed in such small amount that it can be detected only though the chemicals
* can only detect the presence or absence of blood – it can’t determine what’s causing the bleeding
-possible for false positive result if you take high dose of vitamin c bc it oxidizes feces
FECAL OCCULT BLOOD TEST (FOBT)
*Carcinoembryonic Antigen Studies (CEA) may not be highly reliable indicator because not all lesions secrete CEA
*with complete excision of tumor, elevated levels of CEA should return to normal within __ hours
*tumor markers are used to monitor recurrence
48
removal of the tumor and portions of the bowel on either side of the growth, as well as the blood vessels and lymphatic nodes (to determine stage)
Segmental Resection with Anastomosis
Guidelines for Irrigating a Colostomy
*before the procedure, pt. sits on a chair in front of the toilet or on the toilet itself
*irrigating reservoir containing 500 to 1500 ml of lukewarm tap water is hung 45 to 50cm (18—20 in) above the stoma (shoulder ht. when the pt. is seated)
*dressing or pouch is removed
*apply an irrigating sleeve to the stoma
*allow solution to flow through the tubing and catheter/cone
*lubricate the catheter/cone and gently insert it into the stoma
*if the catheter does not advance easily, allow water to flow slowly while advancing the catheter
*allow tepid fluid to enter the colon slowly
*if cramping occurs, clamp off the tubing
Guidelines for Irrigating a Colostomy
*before the procedure, pt. sits on a chair in front of the toilet or on the toilet itself
*irrigating reservoir containing 500 to 1500 ml of lukewarm tap water is hung 45 to 50cm (18—20 in) above the stoma (shoulder ht. when the pt. is seated)
*dressing or pouch is removed
*apply an irrigating sleeve to the stoma
*allow solution to flow through the tubing and catheter/cone
*lubricate the catheter/cone and gently insert it into the stoma
*if the catheter does not advance easily, allow water to flow slowly while advancing the catheter
*allow tepid fluid to enter the colon slowly
*if cramping occurs, clamp off the tubing
TYPE OF SURGERY
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removal of the tumor and a portion of the sigmoid and all the rectum and anal sphincter
Abdominoperineal Resection with Permanent Sigmoid Colostomy
cancer stages
bowel mucosa
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