Colorectal cancer Flashcards
What kind of cancer are colorectal cancers usually?
Adenocarcinomas as from the epithelial cells lining the colon or rectum
How do colorectal cancers usually begin and progress?
progression of normal mucosa to colonic adenoma (colorectal polyps) to invasive adenocarcinoma
What genetic mutation predispose people to colorectal cancer?
adenomatous polyposis coli gene, hereditary non-polyposis colorectal cancer
What are some risk factors for colorectal cancer?
age, family history, IBD, Low fibre diet, high processed meat intake, smoking, high alcohol intake
What are the clinical features of colorectal cancer?
change in bowel habit, rectal bleeding, weight loss, abdominal pain, iron deficiency anaemia
What are the clinical features of right sided colon cancer?
abdominal pain, occult bleeding, mass in right iliac fossa
What are the clinical features of left sided colon cancer?
Rectal bleeding, change in bowel habit or tenesmus, mass in left iliac fossa
What are the differential diagnosis of colorectal cancer?
IBD, haemorrhoids, Diverticulitis
When is colorectal cancer screening offered to people in the UK?
every 2 years for men and women between 60-75 years
What test is used for colorectal cancer screening in the UK?
Faecal immunochemistry test
What laboratory tests are done if colorectal cancer is suspected?
routine bloods including a FBC (looking for microcytic anaemia) U And E, LFTs and coagulation screening, carcinoembryonic Antigen is used just to monitor the disease
What is the gold standard imaging for colorectal cancer?
colonoscopy with biopsy
If a colonoscopy is not suitable for a patient, what other imaging can be done for a patient with suspected colorectal cancer?
flexible sigmoidoscopy, CT colography
Once a diagnosis of colorectal cancer is made, what imaging can be done for staging?
CT scan to look for distant metastasis and invasion, MRI rectum, Endo-anal ultrasound
What is Dukes staging?
the stages of the colorectal cancer according to the depth of the invasion into the bowel wall, spread of lymph nodes and distant metastasis
What is the management for Colorectal cancer?
chemotherapy and radiotherapy, regional colectomy
When a regional colectomy is done, what is done to restore bowel function?
Primary anastomosis or formation of a stoma
What surgery is preformed for Cacal or ascending colon tumours?
Right semicolectomy and extended right hemicolectomy
What is the surgery approach for a descending colon tumour?
Left hemicoloectomy
What is the surgery approach for a sigmoid colon tumour?
sigmoidcolectomy
What is an anterior resection?
This is for high rectal tumours, leaves the rectal sphincter intact and functioning so an anastomosis can be preformed
After an anterior resection what stoma is put in and why?
defunctioning loop ileostomy to protect the anastomosis and reduce complications, this is reversed 4-6months later
What is an abdominoperineal resection?
low rectal tumours, excise distal colon, rectum and anal spinsters so gives a permanent colostomy
What is a hartmans procedure?
Emergency bowel surgery, complete resection of sigmoid colon with the formation of an end colostomy and closure of the rectal stump
What is an example of a chemotherapy regime for patients with metastatic colorectal cancer?
FOLFOX
Colonic acid, Fluorouracil, Oxaliplatin
What is some examples of palliative care for colorectal cancer?
Endoluminal stenting, stoma formation, resection of secondaries
