Colorectal cancer Flashcards
main type of colorectal cancer
adenocarcinoma
where is colorectal cancer normally found
2/3 colon, 1/3 rectum
what percent of colorectal cancer are sporadic
85%
what percent of cancer are familary
10%
what percent ofcaner is inheritable
5
wher to colorepati polyps origin form
epithelual or mesenchymal
risk factors for colorectal cancer
age, male gender, previous adenoma, enviromental influces, die,(high alcho, low fibre and fruit and veg, low calcium) , obesity, lack of exercise, smoking, diabetes mellitus
main hisotoloyg types of colorecal poplys
tubular, villous, indermeinate tubulovillous
what is the differnt ypes of mopthay of cnacer
pendunculated (gorw from stem)
sessile - attached to a wide base
stages of adeno carniioma growth
noramal epitsm,to small adenoma to large adenoma to invasie adenocari to metatses
what mucation cause a small adeno caroin to change to a large ademas
k ras muation
what matuion cuase a large adenoato change to an invase admocar
p53
activation of okogene exampels
k ras and c myc
loss of tumor supprpesion gene exapes
apc, p53, dcc
defective dna repair patheawy exaples
microsatelatie instabilty
what is the typlica symptosn of colorecla cancer
recatla beleed
altern bole
bowl pain form obsution
weight loss and anorexia
signs of colorectal cancer
iorn deficicy anemia
palpable rectal or right lower abdominal mass
what is benficit of colopsy for diagnosi
colonospcy
allows bipogy and can remove pollpys
down side of colonospcy
need laxative
sedatino
risk of bleeding
who cannot tolate laxatives in colorecla caner
those who ahve renal or cardiac disease
what radiolgo8h scan can be done for colorectal cancer
barium enema, ct colongoratphy, ct abdo/ pelivs
is berium eneuma accureate
no
downsdie of ct abdo/ pepliv
not likley to pick up anything
how to stage colorecal caner
ct scahn, mir, pet scan and renal endocpai ultaound
duke a, b, c and d
a - confied to subcumos
b - invasie though muscarl without lymph involment
c - invasion though mcuclar with lymph in volvent
(c1) - less than 4 nodes
c2 - roe than 4 nodse
D - present of distan emtatiosn
tumor stage t1 - t4
t1 - confied to submucoas
t2 - confjied to muscalria
t3 - confied to serosa
t4 - breached seros , invaide ovehr stuces
nodes n0,n1, n2
N0 - no nodes
n1 - up to 3 regiona nodes
n3 - more than 4 regioan nodes
m0 and m1
m0 no menatios
m1 disatn mestaions
teatment of duke a paitens
endocpaic or loac restion of poplys
who sould have adjuvar chmooather
duke sc and b
what is hte patliative treatmfne for pallite paiteins
colonic stening, chemoathery,
ajvarent
alongside main treatment
what is the neoadjvulart etreatmnt for cancer
radial tharpy fo rrecat cancer only
screeening test for cooorecal caner
faecal occult blood test
faecal immunochemica tsets
colonsopy
ct colopsy
flexible signoidocspy
feacualr immunothcemial tesing progaio look for what
human haemoglon
who is elig for fit screing progaio
anyone over 54 -70
what is fap
familayr adneomatose paolyposi
what is map
mutyh assoiced polypois
wha tis hnpcc
herediay non poplypnoi colocreal cancer
what condions are assoiced with colorecl cnear
ibd, family reisk
is fap autosomadl dominal or recesive
dominant
main caraceriset of fap
mulitple adnomas though the colon
screening for fap
anal colospy form 10 years old
treatmen for fap
prohpaly procoolecomy betwen 16 -25
what are the extracolonic manifestatiosn
benign gastic fundic cystic hyperplasia
duodenal adnoemas in 90% with periampullary cancer
medical treatmf or fap
nsaids chemoprevionts using sulindac
is map autosomal regsisive or domiant
dominat
cuas eof map
varitnes in mutyph base gnee
wher is map norally ofund
rihgt sided
when to start survane for polpys in map
18 - 20 years old
is hnpcc recessive or dominat
dominat
cuase of hnpcc
lynch sydnroem = certain genes whihc cause a range of cancers incluing;
mutiaon in dna mismatic repair genes e.g mlh1 and msh2
thus hae micosstale instability
what side is hnpcc assoiced with
right side
screeing for hnpcc freaqyc
form 25 every 2 years
creiats for hnpcc diagnosi
amsterdam and bethesda genetic testing
ago of onsent of cancer in hnpcc
40s
who should be screen for colopsy
fmaily risk goup s, ie. tehso whihc relatives and they agethat they develed the cancer
ibd - every 1-5 years 10 years after diagbes
previous crc - 5 year colonspcy - 1 year after and every 3 years
previous admonas - dependent on no. of po;olys
main test to deterin wheter a colonopcy is required
fit test
