Colorectal Cancer Flashcards
Name three modifiable risk factors for colorectal cancer.
- Diet: Low fibre, high animal fat (red meat) and low protein diet
- Gut microbiome
- Smoking
- Alcohol
- Obesity
- Lack of exercise
What are non-modifiable risk factors for colorectal cancer?
- IBD (inflammatory bowel disease)
- Genetic conditions: FAP, HPNCC, Peutz-Jeghers, MSH2/MLH1
- Age (60+)
- Male
What is the recommended screening method for colorectal cancer in 54-74 year olds?
At home Faecal Immunochemical Test (FIT) screening to look for blood in stool
What type of cancer accounts for 95% of colorectal cancer cases?
Adenocarcinoma
What are the precursors to colorectal cancer?
- Colonic Adenoma
- Classification: Tubular, villous, frivilous
What is the presentation of colonic adenomas?
Usually asymptomatic; large polyps can bleed and cause anaemia + fatigue
Where is the primary location of colorectal cancer?
- ** Rectum (35%)**
- Sigmoid (25%)
- Cecum and ascending colon (20%)
- Transverse colon (20%)
- Descending colon (5%)
What are the symptoms of a right-sided colorectal tumor?
- Persistent anaemia
- IDA
- Alternating bowel habits
- Right iliac fossa mass
- Bowel obstruction
- Acute appendicitis
What are the symptoms of a left-sided colorectal tumor?
- PR bleeding
- Alternating bowel habits
- Tenesmus
- Weight loss
- Left iliac fossa mass
- Bowel obstruction (most common)
What symptoms are associated with rectal tumors?
- PR tumour
- Tenesmus
- Morning diarrhoea
- Perforation
- Haemorrhage
- Fistula
What blood tests are commonly performed for colorectal cancer investigations?
- FBC
- LFT (liver mets)
- U&Es (AKI + electrolyte imbalacne - malabsorption)
- CEA - tumour marker
What imaging techniques are used to investigate colorectal cancer?
- AXR
- CXR
- CT abdomen pelvis
- CTC (CT Colonography)
- Colonoscopy
What is the macroscopic appearance of right-sided colorectal cancer?
- Exophytic cauliflower growth
- Ulcerating lesions
What is the macroscopic appearance of left-sided colorectal cancer?
- Annular constricting growth
- Tubular growth
What factors influence the management of colorectal cancer?
- Grade
- Stage
What are the grades of differentiation for colorectal cancer cells?
- Grade 1: well differentiated
- Grade 2: moderately differentiated
- Grade 3: poorly differentiated
What is the DUKES staging used for?
Staging colorectal carcinoma
What is the most common treatment for colorectal cancer?
Surgery - resection +/- anastomosis
What chemotherapy regimens are used in colorectal cancer management?
- FOLFOX
- FOLFIRI
What type of cancer is radiation predominantly used for?
Rectal cancer
Name two targeted therapies for colorectal cancer.
- Bevacizumab (anti-VEGF)
- Cetuximab (anti-EGFR)
