Colorectal Cancer

Question 1

Description: What is colorectal cancer, by what proportion is each organ affected and what type of histological type is most common.

Answer 1

• Cancer of the colon (2/3) and rectum (1/3)

- Adenocarcinoma

Question 2

Aetiology/Risk Factors: What are the aetiology and risk factors for colorectal cancer?

Answer 2

• Sporadic
• Familial risk (FAP)
• Inherited conditions (HNPCC)
• Inflammatory Bowel Disease

Question 3

Risk factors: What are the specific risk factors for sporadic cases of colorectal cancer?

Answer 3

• Male
• Age
• Smoking
• Diabetes mellitus
• Previous colorectal cancer
• Obesity
• Lack of exercise

Question 4

Pathology: XXX

Answer 4

Colorectal polyps and dat tbc

Question 5

Symptoms and Signs: Describe the clinical presentation of colorectal cancer (both left and right).

Answer 5

• Rectal bleeding (left)
• Altered bowel opening/habit (left)
• Palpable rectal or right lower abdominal mass
• Iron deficiency anaemia (right)
• Systemic symptoms of malignancy (weight loss and anorexia) (right)
• Tumour (stenosing) causes acute colonic obstruction (left and right)

Others:

Left:
- Napkin ring lesion

Right:

• Vague pain
• Exophytic
• Weakness

Question 6

Investigations: What investigations do we do for colorectal cancer:

(a) Initial investigations (2)
(b) Radiological Imaging (2)
(c) Radiological staging imaging (3)
(d) Staging for prognosis (2)

Answer 6

(a) Colonoscopy and biopsy

(b) Radiological imaging:
- Barium enema
- CT colonography

(c) Radiological staging imaging
- CT of the chest, abdomen and pelvis
- MRI for rectal tumours
- PET scan/rectal endoscopic ultrasound

(d) TNM staging and Duke’s staging

Question 7

Treatment: AAA

Answer 7

AAA