Colorectal cancer Flashcards
Describe the distribution of colorectal cancers by site
- 66% rectum, rectosigmoid and sigmoid
- 20% right colon
- Remainder in left and transverse colon
In what ages is colorectal cancer the most common
Above 60
When staging colorectal cancer, what does the T tell us
Depth
Using the DIAPERS MD acronym, name the risk factors for colorectal cancer
- Diet (low fibre, high cured meat)
- Irritable bowel disease
- Age
- Polyps (neoplastic)
- Ethanol
- Relative (family hx)
- Smoking
- Male
- Diabetes and obesity
What cancers are associated with colorectal cancer
Small bowel
Breast
Endometrial
Ovarian
When should there be an instant referral
- Under 55 with PR bleed and persistent change in bowel lhabit. If over 55, either one or the other is enough
- Palpabale abdo mass
- Unexplained iron deficiency
How do you decide whether to use a colonoscopy or a flexi-sigmoidoscopy?
If the blood is fresh, flexi
What surgical treatment is suggested if the tumour is in the rectum/ low sigmoid
Anterior resection
What surgical treatment is suggested if the tumour is at the anal verge
AP resection
When is a loop colostomy used
Emergencies
What happens in a loop colostomy
Loop of bowel pulled out, 2 openings created (one for the stool and one for the mucus)
What happens in an end colostomy
Stoma is created from one end of the bowel and the other is sewed shut
What is a double barrel colostomy
Bowel is severed and both ends bought out into the abdomen
What are some early problems of surgery for colorectal cancer
- Haemorrhage
- Ischaemia
- High output
- Hernia
What are some late problems of surgery for colorectal cancer
- Infection
- Stenosis
- Obstruction
- Psychologial issues
