Colorectal Cancer Flashcards
What population does colorectal cancer most commonly affect?
> 75 year old males
Where is colorectal cancer most commonly found in the body?
Sigmoid and rectum
What are the non modifiable risk factors for colorectal cancer?
Age
Being male
IBD
Genetics- HNPCC, FAP
What are the modifiable risk factors for colorectal cancer?
Alcohol Lack of exercise Smoking Highly processed red meat intake Lack of fibre Use of NSAIDs is said to be protective
How does colorectal cancer screening work?
Over the age of 55 patients are invited for a one off sigmoidoscopy
65-74 patients are invited to carry out FOBT every 2 years
Over the age of 75 patients can request to do FOBT
How do patients with colorectal cancer present?
Specific symptoms- PR bleed, abdo pain, change in bowel habit, iron deficiency anaemia, tenesmus
Non specific- weight loss, cachexia, nigh sweats, fatigue
Symptoms of metastasis- palpable abdominal mass, intestinal mass, perforation.
Liver mets- abdominal distension, ascites, hepatomegaly
Lung mets- dyspnoea, cough, haemoptysis, pleural effusion
What signs will a colorectal cancer patient present with?
Abdomen- mass, distension, hepatomegaly, caput medusa Chest- spider naevi Raised lymph nodes Hands- liver flap, clubbing, leukonychia Face- signs of anaemia, jaundice abnormal mass on DRE
What is the 2WW criteria for colorectal cancer?
60 and over with iron deficiency anaemia and alteration in bowel habit
40 and over with weight loss and abdominal pain
Altered faecal occult blood test
50 and over with unexplained rectal bleeding
What is DUKES A?
What is the prognosis?
The cancer is in the inner lining of the bowel or slightly growing into the muscle layer
Prognosis in 95% survive after 5 years
What is DUKES B?
The cancer has grown through the muscle layer.
Prognosis- 80% alive after 5 years
What is Dukes C?
Cancer has spread to at least 1 lymph node
Prognosis is 65% alive at 5 years
What is dukes D?
Cancer has metastasised to other organs such as liver, lung or bones.
Prognosis-5% alive at 5 years
What investigations will you order if you suspect colorectal cancer?
DRE, FOBT
Colonoscopy/ siogmoidoscopy
CT CAP- staging
What are the treatment options for colorectal cancer?
Medical- chemotherapy and radiotherapy- depending on site of cancer
Surgical- depending on site- right hemi/ extended right hemi, left hemi, anterior resection. Adjuvant chemo
