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Alimentary System > Colorectal Cancer > Flashcards

Colorectal Cancer Flashcards

1
Q

What are the majority of colorectal cancers?

A

95% adenocarcinomas

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2
Q

What is the distribution of colorectal carcinomas?

A

2/3 colonic
1/3 rectal

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3
Q

What are the predisposing factors to colorectal carcinoma?

A

Neoplastic polyps
IBD
Genetic predisposition
Diet
Alcohol intake
Smoking
Previous cancer

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4
Q

What are polyps?

A

Growths that appear above the mucosa and can be inflammatory, hamartomatous or neoplastic.
Left in situ, polyps carry a risk of malignant transformation

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5
Q

What is the presentation of colorectal carcinoma?

A

Rectal bleeding
Altered bowel habits
Colonic obstruction
Tenesmus
Palpable mass
Weight loss
Anaemia
Abdominal pain

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6
Q

What are the tests for colonic cancer?

A

Bloods: FBC, FOBT, LFT
Sigmoidoscopy/Colonoscopy
MRI/CT

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7
Q

What are the 2 methods of staging colorectal cancer?

A

Dukes Criteria
TNM staging

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8
Q

What is Dukes A?

A

Confined to submucosa

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9
Q

What is Dukes B?

A

Invasion through muscularis mucosae without lymph node involvement

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10
Q

What is Dukes C?

A

Invasion of regional lymph nodes

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11
Q

What is Dukes D?

A

Presence of distant metastases?

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12
Q

What is the Tumour part of staging?

A

Tx- tumour can’t be assessed
Tis- in situ
T1- submucosa
T2- muscularis propria
T3- Serosa
T4- Invasion of adjacent structures

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13
Q

What is the Nodal part of staging?

A

N0- no node spread
N1- metastases in 1-3 regional nodes
N2- metastases in >3 regional nodes

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14
Q

What are the surgical treatments of CRC?

A

Right hemicolectomy
Left hemicolectomy
Sigmoid colectomy
Anterior resection
Abdomino-perineal resection

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15
Q

What is right hemicolectomy done for?

A

Caecal tumours
Ascending colon tumours
Proximal transverse colon tumours

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16
Q

What is left hemicolectomy done for?

A

Distal transverse colon tumours
Descending colon tumours

17
Q

What is sigmoid colectomy?

A

Sigmoid tumours

18
Q

What is anterior resection done for?

A

Low sigmoid tumours
High rectal tumours

19
Q

What is abdomino- perineal resection done?

A

Low rectal tumours

20
Q

When is endoscopic stenting used in CRC?

A

Palliation in malignant obstruction
Bridge to surgery in acute obstruction

21
Q

Describe an ileostomy stoma

A

Right iliac fossa
Liquid, looser stools
Spouted

22
Q

Describe a colostomy stoma

A

Left iliac fossa
Solid stools
No spout

23
Q

When is radiotherapy used in CRC?

A

Palliation
Pre-op in rectal cancer

24
Q

When is chemotherapy used in CRC?

A

Adjuvant
Palliation of metastatic disease

25
Q

What tests are involved in population screening for CRC?

A

FOBT
qFIT
Flexible sigmoidoscopy
Colonoscopy

26
Q

What is FOBT?

A

Faecal occult blood test (FOBT)
uses a chemical indicator that shows a colour change in the presence of blood in the stool

27
Q

What is qFIT?

A

Quantitative Faecal Immunochemical Test (FIT)
Uses antibodies directed against human haemoglobin to detect blood in the stool

28
Q

What groups are at high risk of CRC?

A

Heritable conditions
IBD
Familial risk
Previous adenocarcinoma
Previous Colorectal cancer

29
Q

What are the genetic conditions associated with CRC?

A

HNPCC (Lynch syndrome)
FAP
MAP
Peutz- Jeghers syndrome

30
Q

What is HNPCC?

A

Hereditary non-polyposis colorectal cancer
Autosomal dominant
Due to mutations in mismatch repair genes
1-3% of CRC

31
Q

What is FAP?

A

Familial adenomatous polyposis
Autosomal dominant
Due to mutations in APC tumour suppressor gene
Causes multiple colorectal adenomas (>100) which undergo malignant transformation

32
Q

What is MAP?

A

MUTYH- associated polyposis
Autosomal recessive
Due to variants in MUTYH base excision repair gene

33
Q

What is Peutz- Jeghers syndrome?

A

Hamartomatous polyps

Alimentary System (24 decks)

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