Colorectal Cancer Flashcards

1
Q

Define colorectal cancer?

A

Malignant adenocarcinoma of the large bowel

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2
Q

What is the distribution of colorectal cancers?

A

60% - rectum and sigmoid
30% - descending colon
10% - rest of colon

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3
Q

What are the causes of colorectal cancer?

A

Environmental and genetic

There is a sequence of genetic changes that go from normal bowel epithelium to cancer (e.g. APC, K-Ras)

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4
Q

What are the risk factors for colorectal cancer?

A
Western diet (e.g. red meat + alcohol)
Colorectal polyps 
Previous colorectal cancer 
Family History 
IBD
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5
Q

What is the epidemiology of colorectal cancer?

A

Second Most Common cause of cancer death in the WEST
UK: 20,000 deaths per year
Average age of diagnosis: 60-65 years

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6
Q

What do the presenting symptoms of colorectal cancer depend on?

A

Size and location of the tumour

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7
Q

What are the presenting symptoms of left-sided colon and rectum?

A

Change in bowel habit
Rectal bleeding (blood or mucus mixed with the stools)
Tenesmus (due to a space-occupying tumour in the rectum)

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8
Q

What are the presenting symptoms of right-sided colon cancer?

A
Presents later
Anaemia symptoms (lethargy)
Weight Loss 
Non-specific malaise 
Lower abdominal pain (rare)
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9
Q

What’s important to remember with colorectal cancers?

A

20% of tumours will present as an emergency with pain and distention due to:
Large bowel obstruction
Haemorrhage or peritonitis due to perforation

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10
Q

What are the signs of colorectal cancer on physical examination?

A

Anaemia
Abdominal Mass
Low-lying rectal tumours may be palpable on DRE

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11
Q

What are the signs of colorectal cancer on physical examination if it’s metastatic?

A

Hepatomegaly

Ascites (shifting dullness)

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12
Q

What bloods would you do for colorectal cancer?

A

FBC - anaemia
LFTs
Tumour markers (CEA)

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13
Q

What investigation would you do with a person’s stool in colorectal cancer?

A

FOBT - used as a screening test

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14
Q

Why do we Endoscopy in colorectal cancer?

A

Sigmoidoscopy
Colonoscopy
This can be used to biopsy the tumour

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15
Q

What might we see if we do a Double-Contrast Barium Enema in colorectal cancer?

A

May show ‘apple core’ strictures

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