Colorectal cancer Flashcards
local spreading
peritoneum
surrounding GI organs
pathophysiology
- grow on surface of colon
- too big- may not be able to remove during colonoscopy
- adenocarcinomas are most common
- develop slowly
- highly curable if detected early
Most common place for metastasis
LIVER
lungs
brain
bones
adrenal glands
risk factors
- family hx
- increasing age
- obesity
- presence of polyps
- diet- high fat, high protein, low fiber
- alcohol consumption
- smokiong
- hx of ibd- crohns, ulcerative colitis
- infectious organisms
- african american males
clinical manifestations
- CHANGE IN BOWEL HABITS/STOOL
- RECTAL BLEEDING
- anemia
- c/o gas pains, cramping
- constipation/ straining
- narrowing of stool
- may see abd mass
- hypoactive or absent bowel sounds (need to listen 5 mins each quad)
- bowel obstruction
Diagnosis- ask routine history plus:
- change in bowel habits
- blood in stool
- fatigue
- recent weight loss
- complaints of abd fullness and pain
Diagnosis- labs
- fecal occult blood
- decreased hgb and hct
- increased CEA (shows growth)
- barium enema- liquid containing barium into rectum then use xray
- ct scan/liver scan
- colonoscopy (gold standard)
Metastasis
peritoneal seeding during surgery
tumors can invade neighboring blood vessels: bleeding
pressure on neighboring organs: uterus, urinary bladder, ureters-mask symptoms
treatment
depends on stage:
- radiation- controls area, reduction of symptoms- pre op or post op, palliative therapy, rectal cancer almost always includes rads
- chemo
surgical intervention
- colon resection- remove part of colon and lymph
- colectomy- partial of colon= colostomy, total= ileostomy
- colostomy
- abdominoperineal resection- ileostomy
Ascending colostomy
right sided tumors
Descending colostomy
Left sided tumors
Sigmoid colostomy
rectal tumors
transverse colostomy
intestinal blockage or perforation- temporary colostomy
Post op care
- NG tube care
- ostomy/wound care
- routine care for abd surgery
- fluid balance
- nutrition
