colorectal cancer Flashcards
presentation of colorectal cancer
change in bowel habits
rectal bleeding
abdo pain and discomfort
unexplained weight loss
anaemia
bowel obstruction
when to do a FIT to guide referral
aged 40 > with unexplained weight loss and abdominal pain
aged < 50 with rectal bleeding and either: abdo pain, weight loss
aged 50 and over with: rectal bleeding or abdo pain or weight loss
aged 60> with anaemia
who does need a FIT before colonoscopy referral
rectal mass
unexplained anal mass
unexplained anal ulceration
next step after FIT test
positive: suspected cancer pathway
negative: still refer if ongoing concern
staging done for newly diagnosed colorectal cancer
CEA
CT chest abdo pelvis
colon evaluated with colonoscopy or CT
type of surgery for caecal, ascending or proximal transverse colon cancer
right hemicolectomy
ileo-colic anastomosis
type of surgery for distal transverse, descending colon cancer
left hemicolectomy
colo-colon anastomosis
type of surgery for sigmoid colon cancer
high anterior resection
colo-rectal anastomosis
type of surgery for upper rectum cancer
anterior resection (TME)
colo-rectal anastomosis
type of surgery for low rectum cancer
anterior resection (low TME)
type of surgery for anal verge cancer
abdomino-perineal excision of rectum
what is HNPCC
lynch syndrome
autosomal dominant condition
most common form of inherited colon cancer
most common genes involved in HNPCC
MSH2 (60%)
MLH1
what other cancer is patients with HNPCC at risk of
endometrial
what is familial adenomatous polyposis
autosomal dominant condition which leads to the formation of hundreds of polyps by age of 30-40
management of familial adenomatous polyposis
total proctocolectomy with ileal pouch anal anastomosis
Gardner’s syndrome
rare variant of FAP and can feature osteomas of the skull and mandible, retinal pigmentation, thyroid carcinoma and epidermoid cysts on the skin
