colorectal cancer Flashcards
where are the common locations for colorectal cancer from most –> least common (5)
rectal // sigmoid // ascending colon + caecum // transverse // descending
what are the 3 types of colorectal cancer
sporadic // HNPCC (lynch syndrome) // FAP
what is the most common form of inherited colon cancer
HNPCC - lynch syndrome
what cancer are patients with HNPCC also at risk for
endometrial
what criteria can aid diagnosis of HNPCC + what is in it (3)
amsterdam: 3 family with colon cancer // 2 generations // 1 case before 50
what inheritence is FAP + HNPCC
autosomal dominance
what is FAP
lots of polyps aged 30-40 –> carcinoma
what other cancer are FAP patients at risk of
duodenal
what symptoms does a 40year need for urgent colorectal referral
unexplained weight loss + abdo pain
what symptoms does a 50year need for urgent colorectal referral
unexplained rectal bleeding
what symptoms does a 60year need for urgent colorectal referral
iron deficiency anaemia OR change in bowel habit
what test at any age would warrant urgent colorectal referall
occulut blood in faeces (from screening)
when should urgent colorectal referalls be considered (3)
rectal or abdo mass// anal mass or ulcer // 50+ with PR bleed + abdo pain OR change bowels OR weight loss OR anaemia
what test is used to screen for colorectal cancer
faecal immunochemical test (FIT)
who is screened for colorectal cancer
every 2 years from 50-74 // 74+ can rquest screening
if patients do not meet 2 week criteria what test can be done
FIT stool test
what is the most common anal cancer
SCC
what node do tumours closer to the anal margin spread (distal anus)
inguinal nodes
where do more proximal anal tumours spread
pelvic lymph node
what is the cause RF for anal cancer
HPV
what are other RF for anal cancer (5)
anal intercourse // MSM // HIV // cervical cancer // smoking
presentation anal cancer
perianal pain // PR bleed // legion // faecal incontinence // rectovesical fistula
initial invx anal cancer
PR + biopsy // virus tests eg HPV + HIV
imaging for anal cancer
CT // MRI // USS
what is a T1 anal canccer
tumour <2cm
what is a T2 anal canccer
<2 but >5
what is a T3 anal canccer
5cm+
what is a T4 anal canccer
invades adjacent organs
what are villous adenomas
colonic polyps that can be malignant –> secrete lots of mucous
surgery caecal, ascending, proximal transverse colon cancer
right hemi-coloectomy
surgery distal transverse or descending colon cancer
left hemicolectomy
surgery sigmoid colon cancer
high anterior resection
surgery rectum cancer
anterior resection
surgery anal verge
Abdomino-perineal excision of rectum
what risk is increased with perforated bowel cancer and what surgery is performed
high risk anastomosis –> end colostomy
what is a Hartmanns
sigmoid colostomy + end stoma
