Colorectal Cancer Flashcards
Epidemiology
Colorectal
Affects men and women equally.
Older than 50.
More common in rectum or distal colon.
Second leading cause of cancer death.
Etiology
Colorectal
Diet high in fat, low in fiber. Obesity Smoking Alcohol Minimal physical activity Chronic ulcerative colitis FAB, HNPCC (Lynch), Gardner's syndrome
Colon components
Cecum Ascending, descending, transverse Splenic flexure Hepatic flexure Sigmoid Rectum
Layers of the bowel wall
Mucosa (innermost)
Submucosa
Muscularis propria
Serosa
LN drainage
Colorectal
Internal iliac Perirectal Lateral sacral Presacral Inguinal
Clin. Pres. for rectum
Rectal bleeding (hematochezia) Change in bowel habits Diarrhea vs constipation Change in stool caliber Tenesmus (locally advanced)
Clin. Pres. for left colon
Blood in stool
Change in stool caliber
Obstructive symptoms
Abdominal pain
Clin. Pres. For right colon
Abdominal pain
Abdominal mass
Nausea and vomiting
Blood in stool
When does screening start for colorectal
50
Pathology
Colorectal
Adenocarcinoma
Mets
Colorectal
Liver (1)
Lung (2)
Low ant resection
Tumor plus margin
Adjacent LNs
Bowel is reanastomosed
Used for colon and upper, middle 3rd of rectum.
Abdominoperineal resection
Used for lower 3rd rectum Colostomy is created Rectum Anus Draining LNs Reperitonealization of the pelvic floor.
Sphincter preservation
Colorectal
Neoadjuvant RT plus chemo so that a LAR can be used instead of a APR.
Chemo drug
Colorectal
5-FU
OAR
Colorectal
Small bowel 45Gy
Doses
Colorectal
45Gy to whole pelvis
50-55Gy to tumor bed
Acute SE
Colorectal
Diarrhea Abdominal cramps Bloating Proctitis Bloody or mucus discharge Dysuria Leukopenia Thrombocytopenia
Chronic SE
Colorectal
Persistent diarrhea Increased bowel frequency Proctitis Urinary incontinence Bladder atrophy Enteritis, adhesions, obstruction
Antidiarrheal meds
Diphenoxylate (Lomotil)
Loperamide (Imodium)
