Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MS1 Exam Two > Colorectal Cancer > Flashcards

Colorectal Cancer Flashcards

1
Q

What is colorectal cancer?

A

Term used for cancer that starts in the colon or rectum. These cancers can also be referred to separately as colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer have many features in common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Etiology of Colorectal cancer

A
  • 3rd most commonly diagnosed cancer in the US
  • Over 102k new cases of colon cancer diagnosed in the US in 2013, in addition to more than 40,000 new cases of rectal cancer
  • 1 in 20 people will develop in their lifetime, men>women
  • incidence is declining
  • most common over age 50, incidence rises with increasing age
  • Early diagnosis has 90% 5 year survival rate however early diagnosis is rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathophysiology

A
  • Nearly all start as polyps
  • Most tumors develop on sigmoid colon or rectum
  • spreads by direct extension of the entire bowel circumference, submucosa, and outer bowel walls, neighboring structure also may be involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Polyps

A
  • small vascular growths on the mucous membrane (in the glandular tissue of intestinal lining)
  • Size of polyps correlates with development ( than 1% chance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of Polyps

A

-Hyperplastic, generally harmless, small,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Polypsosis Syndromes

A

hereditary conditions which cause polyps. Usually rare, occur in young people.

**high chance of becoming cancerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk Factors for Colorectal Cancer

A
  • Personal or family hx of colorectal cancer and/or polypsosis disorders, inflammatory bowel disease
  • Hereditary nonpolyposis (Lynch syndrome) - autosomal dominant disorder - increases occurrence of all cancers
  • over 50 yo
  • Smoking
  • Obesity
  • Alcohol
  • Radiation exposure
  • Diets high in calories, fats, and meat proteins
  • Presence of anaerobic but bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prevention of Colorectal Cancer

A
  • Early detection is key (SCREENING)
  • Look for signs/symptoms generally
  • For individuals over 50: yearly fecal occult blood test, stool DNA test, Flexible sigmoidoscopy every 5 years, double contrast barium enema every 5 years, colonoscopy every 10 years, CT colonography every 5 years

MAY reduce incidence: exercise, MVI, ASA, NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical Manifestations of Colorectal Cancer

A
  • Typically few if any until progression (5-15 yrs in some cases due to slow growth)
  • Rectal bleeding-often initial manifestation to seek care
  • Changes in bowel habits
  • Pain
  • Anorexia/weight loss
  • Abdominal mass
  • Fatigue
  • Anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diagnosis

A
  • Endoscopy
  • Full colonoscopy better than sigmoidoscopy. Can detect 50-65%
  • Tissue for biopsy
  • Fecal blood tests
  • CBC
  • Carcinoembryonic Antigen (CEA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Carcinoembryonic Antigen (CEA)

A
  • used to monitor course of treatment, prognosis, etc. as well
  • others to detect possible areas of metastasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TNM Staging System for Colorectal Cancer

A

T: how far primary tumor has grown into the intestinal wall & whether it has grown into nearby areas

N: the extent to nearby (regional) lymph nodes

M: whether the cancer has spread (metastasized) to other organs of the body (most common in colorectal cancer-liver and lungs)

**Numbers or letters appear T, N, & M to provide more details. 0 through 4 indicate increasing severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Medical Treatments for Colorectal Cancer

A
  • Surgical resection with anastomosis of tumor
  • Excision of tumor
  • Laser photocoagulation
  • Abdominal resection with permanent colostomy
  • Fulguration
  • Chemo & EBR post-op
  • Brachytherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Surgical resection with anastomosis of tumor

A

Treatment of Choice

-adjacent colon and regional lymph node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Excision of tumor

A

sometimes done during endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Laser photocoagulation

A

beam of light to generate heat, destroys small tumors, palliative-obstructions

17
Q

Abdominal resection with permanent colostomy

A

attempt to preserve anal sphincter and avoid colostomy

18
Q

Fulguration

A

uses electrical current to kill cancer tissue similar to cauterization

19
Q

Fluoroutacil (5-FU) / Folonic Acid (Leucovorin)

A
  • combined with radiation therapy
  • reduces rate of tumor recurrence & prolongs survival for stage 2 and stage 3
  • used for both to reduce spread and recurrence
  • Antimetabolite, used to disrupt DNA replication
  • Given IV (usually) or sometimes topically
  • Neutropenia, thrombocytopenia peak 1-2 weeks after treatment
20
Q

Fluoroutacil (5-FU) / Folonic Acid (Leucovorin) Side Effects

A
  • N/V/D
  • alopecia
  • Photosensitivity
  • cardiotoxicity
  • CNS damage (short term, long term)
21
Q

Bowel Resection

A
  • Surgery (high cure rate for early stage tumors)
  • AKA Colectomy
  • Remove all or part of large intestines
  • Often leads to creation of a colostomy (can be permanent or temporary depending on factors)
  • May be open or larascopic
22
Q

Colostomy

A
  • diversion of fecal contents
  • temporary or permanent
  • name based on colon affected
23
Q

Sigmoid Colostomy

A

MOST COMMON

  • permanent
  • cancer of the rectum
24
Q

Doube-barrel colostomy

A
  • two separate stomas are created
  • Distal stoma: colon is bypassed, expels mucus
  • Proximal stoma: functional, diverts feces to abdominal wall
25
Q

Transverse Loop colostomy

A

emergency to relieve obstruction or address perforation, temporary

26
Q

Hartman procedure

A
  • temporary colostomy
  • distal portion left in place
  • oversewn for closure
  • trauma
  • Followup 3-6 months with reanastamosis
27
Q

Sites of Colostomies

A

Ascending: fluid feces, semifluid towards transverse

Transverse: mushy feces
and semimushy feces towards descending

Descending: semisolid feces and solid feces toward rectum

Rectum: Hard, solid feces

28
Q

Colostomy Patient Education

A
  • Promote quality of life “live your life”
  • Monitor meds, changes in bowel habits
  • Well-balanced diet, avoid certain foods
  • colostomy irrigation, enema through stoma
29
Q

Colostomy Care

A
  • clean with soap and water, pat dry
  • post surgery, watch for incision
  • check for leaks
  • cut wafer slightly larger than stoma
  • stoma paste-various products
  • “burp” bag if full of gas

**wound care nurses

30
Q

Survival Rates

A
  • Higher stages=more serious and worse prognosis
  • Stage 1 colorectal cancer, 5 yr survival rate of 74%-94%
  • Stage IV: 6%

Emphasis on screening and patient education

31
Q

RNs role

A

-focuses on promoting the need for regular screening as well as reporting the early warning signs of the disease in order to reduce occurrence and improve outcomes

32
Q

Lynch Syndrome

A

hereditary nonpolypsosis colorectal cancer

  • autosomal dominant disorder that significantly increases the risk of developing colorectal and other cancers
  • Tumors of lynch tend to be in the ascending colon and occur earlier in age
33
Q

Inflammatory Bowel Disease

A

increases risk of colorectal cancer

34
Q

What kind of diet reduces risk of colorectal cancer?

A

-fruits, veges, high calcium, high folic acid

EVIDENCE-BASED PRACTICE DENIES CEREAL FIBER AS BEING HELPFUL AS PREVIOUSLY THOUGHT

35
Q

Diet high in fats, calories, and meat proteins is thought to be harmful because…

A

increased anaerobic bacteria in the gut which converts bile acids into carcinogens

MS1 Exam Two (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions