Colorectal Cancer Flashcards
What are the risk factors of colorectal cancers?
- Family history
- Other cancers
- Increased age
- IBD
- Diet
What dietary factors can increase the risk of colon cancers?
- Red meats
- Low fibre
How does a colon cancer present?
- Change in bowel habit (usually to more loose and frequent stools)
- Weight loss
- PR bleeding
- Tenesmus
- Iron Deficiency Anaemia (microcytic anaemia with low ferritin)
- Bowel obstruction
What investigations should be done in an iron-deficient anaemia without an explanation?
Top and Tail:
- OGD
- Colonoscopy
(2WW)
What can be done on endoscopy for colon cancer?
- Biopsy
- ‘Tattooing’ to mark surgical site
What investigation should be done if a patient is unfit for colonoscopy?
CT Colonography
- CT with bowel prep and contrast to visualise the colon
How should one look for metstases?
CT CAP
What is the tumour marker for colon cancer?
CEA
(Carcinoembryonic Antigen)
Name two classifications for colon cancer.
- Duke’s
- TNM
Outline Duke’s Staging?
Dukes A – confined to mucosa and part of the muscle of the bowel wall
Dukes B – extending through the muscle of the bowel wall
Dukes C – lymph node involvement
Dukes D – metastatic disease
What is the maximum value of each TNM value?
T4
N2
M1
(Halves)
How are decisions on colon cancer made?
MDT
What are the complications of colon resection?
- Bleeding
- Infection
- Pain
- Ileus
- Anastamosis leak/failure
- Tumour not removed
- Hernias
What is a right hemicolectomy used to treat?
Tumours of the caecum, ascending and proximal transverse colon.
What is a left hemicolectomy used to treat?
Tumours of the distal transverse and descending colon.
What is a sigmoid colectomy used to treat?
Tumours of the sigmoid colon.
What is an anterior resection used to treat?
Tumours of the low sigmoid colon or higher rectum.
What is an abdominoperineal resection used to treat?
Tumours of the lower rectum.
