Colorectal Cancer Flashcards
What type of cancer is Colorectal Cancer usually?
Adenocarcinoma
What are the risk factors for Colorectal Cancer? (9 things)
- Age
- FHx
- FAP / HNPCC
- IBD (UC / Crohn’s)
- Diet (red + processed meat / low fibre)
- Obesity + sedentary lifestyle
- Smoking
- Alcohol
- Previous cancer
What do the CF of CRC depend on?
Side (R / L)
What are the GENERAL CF of Colorectal Cancer? (3 things)
- Often asymptomatic (diagnosed in screening)
- Anaemia (iron deficiency anaemia in elderly = CRC until proven otherwise)
- Weight loss
What are the CF of LEFT CRC? (5 things)
- Bleeding / mucus
- Mass
- Obst
- Alt bowel habit
- Tenesmus (feeling like u wan poo)
What are the CF of RIGHT CRC? (2 things)
- Low Hb
- Abd pain
Obstruction less likely
What are the CF of EITHER SIDE CRC? (4 things)
- Abd mass
- Perfortion
- Haemorrhage
- Fistula
Why is Obstruction less common in RIGHT sided CRC? (2 things)
- Poo is still liquid in RIGHT
- RIGHT lumen is larger
What are the NICE referral criteria for CRC?
Refer for 2ww urgent cancer referral for:
- 40+ yrs w Abd pain + Unexplained Weight Loss
- 50+ yrs w Unexplained Rectal bleeding
- 60+ yrs w Alt bowel habit / Iron deficiency anaemia
What investigations should you do for sus CRC? (6 things)
- Sigmoidoscopy / colonoscopy (+ biopsy) (GOLD STANDARD)
- CT colonography
- FBC
- Faecal immunochemical tests (FIT) / Faecel occult blood (FOB)
- LFT
- MRI / US Liver
What would a FBC of CRC show?
Microcytic anaemia
What is the difference between Faecal immunochemical tests (FIT) and Faecal occult blood (FOB)?
Why is FIT more recommended?
FIT = looks for human Hb in stool
FOB = looks for blood in stool
Bc FOB gives false positive w blood in stools from food (e.g red meat)
Which sus CRC pt would you do CT colonography for?
What’s the disadvantage?
If not fit for Colonoscopy
Can’t do biopsy
Why would you do LFTs and MRI / US Liver?
To check for liver metastasis
What is the tumour marker for CRC?
What is it used for?
CEA (CarcinoEmbryonic Antigen)
To monitor disease + treatment effectiveness
(NOT SCREENING / DIAGNOSTIC)