Colorectal Cancer Flashcards
colorectal cancer becomes much more common after what age?
65
risk factors for bowel cancer?
older age low fibre diet diet high in fat, sugar, alcohol, red meat, processed meat obesity smoking lack of exercise long term constipation
how can bowel cancer be genetic?
inheritance of APC gene mutation causing familial adenomatous polyposis (FAP) which results in a 100% lifetime risk of developing bowel cancer
can also have P53 gene mutation
what condition can predispose to bowel cancer?
long standing UC
higher risk the longer you have it so more chance of developing cancer if diagnosed as a child
how can bowel cancer spread?
direct spread
lymphatic spread
blood borne spread to liver and lung
transcoelomic spread (rare)
in which 3 ways can bowel cancer present?
screening
urgent via surgical outpatients or endoscopy (most common)
emergency presentation
scotland screening programme?
stool sample every 2 years in 50-72 year olds
if positive a colonoscopy is offered
how might patients present urgently via surgical outpatients or endoscopy?
urgent referral from GP with red flag symptoms
referral then vetted by gastroenterologist to decide if patient needs to go to surgical outpatients or straight to endoscopy
how might bowel cancer present as an emergency?
obstruction
rectal bleeding
palpable mass
perforation etc
bowel cancer red flags?
bleeding
change in bowel habit
weight loss
signs and symptoms of right sided bowel cancer?
unexplained iron deficiency anaemia (cancer bleeds) persistent tiredness (due to anaemia?) persistent and unexplained change in bowel habit (>6 weeks) unexplained weight loss abdominal pain (colicky) lump in abdomen
signs and symptoms of left sided bowel cancer?
rectal bleeding
feeling of incomplete emptying
worsening constipation
important questions to ask if suspicious of bowel cancer?
any recent change in bowel habit? any bleeding? and what colour? mixed with stool or seperate? any weight loss? any abdo pain? and abdo swelling? any family history? any previous surgery?
how is bowel cancer investigated?
colonoscopy is best (visualises whole colon, can do biopsy and polyp removal at same time)
sigmoidoscopy visualises less, done if less red flags?
CT colonography done if cant toelrate colonoscopy or for completeion if entire colon cant be seen on colonoscopy due to obstruction
features of cancer on colonoscopy?
rolled edges
central necrosis
just looks bad basically