Colorectal cancer Flashcards
1
Q
What can cause colorectal cancer?
A
• Genetic
- mutations in the APC
- Mutations of the p58 gene
• Pre disposing conditions – long standing IBD
2
Q
What is the emergency presentation of colorectal cancer?
A
bowel obstruction or bleeding
3
Q
What is the chronic presentation of colorectal cancer?
A
(2/3 months)
- Change in bowel habit
- Colicky abdominal pain
- Iron deficiency anaemia – non explained = INVESTIGATE
- Rectal bleeding
- Weight loss
- Abdominal mass
- Low rectal bleeding – bright and red
4
Q
What are the investigations for colorectal cancer?
A
- barium enema – less used
- Sigmoidoscopy (to sphlenic flexture) v colonoscopy (to caecum) – gold standard
- CT colonography (requires bowel prep and faecal tagging) – use buscopan IV for pain relief
5
Q
Where does cancer originate from?
A
polyps
6
Q
What size of polyp has an increased incidence of cancer?
A
2cm or more
7
Q
What are the screening mechanisms for colerectal cancer?
A
- CEA (blood test – over 5) – but also raised in smoking and pregnancy so not good
- Flexible sigmoidoscopy v colonoscopy
- FOBT/FIT test
8
Q
What are the next steps once cancer is diagnosed?
A
- Histopathy conformation
- Cancer staging – CT chest/abdo/pelvis, MRI for rectal cancers
- MDT
- Surgery
- FOU
9
Q
What are the appropriate surgery choices for colorectal cancer?
A
right hemicolectomy Extended right hemicolectomy Transverse colectomy Sigmoid colectomy Anterior resection Abdominal perianal resection (results in a stoma)
10
Q
What is the treatment for advanced colorectal cancer?
A
- chemo + surgery
- Cancer + liver + lung management
- HIPEC
11
Q
What is the palliative treatment for colorectal cancer?
A
- Stenting
- Palliative radio/chemotherapy
- Defunctioning
- Bypass
