Colorectal Cancer Flashcards

1
Q

What type of cancer is Colorectal Cancer usually?

A

Adenocarcinoma

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2
Q

What are the risk factors for Colorectal Cancer? (9 things)

A
  1. Age
  2. FHx
  3. FAP / HNPCC
  4. IBD (UC / Crohn’s)
  5. Diet (red + processed meat / low fibre)
  6. Obesity + sedentary lifestyle
  7. Smoking
  8. Alcohol
  9. Previous cancer
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3
Q

What do the CF of CRC depend on?

A

Side (R / L)

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4
Q

What are the GENERAL CF of Colorectal Cancer? (3 things)

A
  1. Often asymptomatic (diagnosed in screening)
  2. Anaemia (iron deficiency anaemia in elderly = CRC until proven otherwise)
  3. Weight loss
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5
Q

What are the CF of LEFT CRC? (5 things)

A
  1. Bleeding / mucus
  2. Mass
  3. Obst
  4. Alt bowel habit
  5. Tenesmus (feeling like u wan poo)
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6
Q

What are the CF of RIGHT CRC? (2 things)

A
  1. Low Hb
  2. Abd pain

Obstruction less likely

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7
Q

What are the CF of EITHER SIDE CRC? (4 things)

A
  1. Abd mass
  2. Perfortion
  3. Haemorrhage
  4. Fistula
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8
Q

Why is Obstruction less common in RIGHT sided CRC? (2 things)

A
  1. Poo is still liquid in RIGHT
  2. RIGHT lumen is larger
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9
Q

What are the NICE referral criteria for CRC?

A

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
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10
Q

What investigations should you do for sus CRC? (6 things)

A
  1. Sigmoidoscopy / colonoscopy (+ biopsy) (GOLD STANDARD)
  2. CT colonography
  3. FBC
  4. Faecal immunochemical tests (FIT) / Faecel occult blood (FOB)
  5. LFT
  6. MRI / US Liver
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11
Q

What would a FBC of CRC show?

A

Microcytic anaemia

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12
Q

What is the difference between Faecal immunochemical tests (FIT) and Faecal occult blood (FOB)?

Why is FIT more recommended?

A

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)

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13
Q

Which sus CRC pt would you do CT colonography for?

What’s the disadvantage?

A

If not fit for Colonoscopy

Can’t do biopsy

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14
Q

Why would you do LFTs and MRI / US Liver?

A

To check for liver metastasis

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15
Q

What is the tumour marker for CRC?

What is it used for?

A

CEA (CarcinoEmbryonic Antigen)

To monitor disease + treatment effectiveness

(NOT SCREENING / DIAGNOSTIC)

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16
Q

What is the staging system for CRC?

A

TNM

17
Q

How does CRC spread? (4 things)

A
  1. Local
  2. Lymphatic
  3. Blood (liver, lung, bone)
  4. Tanscoelomic
18
Q

What are the management options for CRC? (4 things)

A
  1. Surgical resection
  2. Chemotherapy
  3. Radiotherapy
  4. Palliative care
19
Q

What does Surgery for CRC involve? (3 things)

A
  1. Identifying tumour (maybe tatooed @ endoscopy)
  2. Removing bowel sections w tumour
  3. Creating anastomosis (sewing ends bk together) / Creating Stoma (hole in abdomen to bring end of bowels out and sewed onto skin)
20
Q

What are the complications of CRC Surgery? (7 things)

A
  1. Bleeding / Infection / Pain / DVT / PE
  2. Damage to: Nerves / Bladder / Ureter / Bowel
  3. Post-op ileus (lack of movement)
  4. Leakage / anastomosis failure
  5. Alt bowel habit
  6. Incisional hernias
  7. Intra-abd adhesions
21
Q

What are the Surgical management options for Palliative care of CRC?

A

Endoscopic stenting

22
Q

What are the benefits of Endoscopic stenting in palliative care of CRC? (4 things)

A
  1. Reduces need for colostomy
  2. Less complications
  3. Shortens ITU stay
  4. Prevents unecessary operations
23
Q

When is Radiotherapy used in CRC? (3 things)

A
  1. Palliative care
  2. Pre-op for RECTAL cancer
  3. Post-op for RECTAL cancer w high risk of reccurence
24
Q

When is Chemo used in CRC? (2 things)

A
  1. Stage 3 disease (sometimes stage 2)
  2. Palliative care of metastatic disease
25
Q

What is the Chemo used for CRC?

A

FOLFOX regimen (FOLinic acid, Fluorouracil, OXaliplatin)