Colorectal Cancer

Question 1

What are the symptoms of colorectal cancer

Answer 1

• Change in bowel habit (usually to more loose and frequent stools)
• Weight loss
• PR bleeding
• Tenesmus (feeling of full rectum even after opening bowels)
• Iron Deficiency Anaemia (microcytic anaemia with low ferritin)
• Bowel obstruction

Question 2

what is tenesmus

Answer 2

feeling of full rectum even after opening bowels

Question 3

Why does IDA on its own without any other explanation indicate a two week wait cancer referral

Answer 3

need colonoscopy and OGD to look for GI malignancy as bowel cancer can cause microscopic bleeding that eventually leads to IDA

Question 4

What is the gold standard investigation for bowel caner

Answer 4

colonoscopy

Question 5

What investigation can you suggest is the patient is less fit for colonoscopy

Answer 5

CT colonography

Question 6

What antigen is a tumour marker blood test for bowel cancer that is useful in predicting relapse of previously treated bowel cancer

Answer 6

Carcinomembryonic antigen (CEA)

Question 7

What is the name of the classification system used to stage bowel cancer

Answer 7

Dukes classification

Question 8

What does Dukes A mean

Answer 8

cancer is confined to mucosa and part of the muscle of the bowel wall

Question 9

What does Dukes B mean

Answer 9

cancer is extending through the muscle of the bowel wall

Question 10

what does Dukes C mean

Answer 10

there is lymph node involvement

Question 11

what does Dukes D mean

Answer 11

that it is a metastatic disease

Question 12

which operation out of the following are used to remove tumours of the caecum, ascending and proximal transverse colon; 
Right hemicolectomy 
Left hemicolectomy 
Sigmoid colectomy 
Anterior resection 
Abdominoperineal resection (APR)

Answer 12

Right Hemicolectomy

Question 13

which operation out of the following are used to remove tumours of the distal transverse and descending  colon; 
Right hemicolectomy 
Left hemicolectomy 
Sigmoid colectomy 
Anterior resection 
Abdominoperineal resection (APR)

Answer 13

Left hemicolectomy

Question 14

which operation out of the following are used to remove tumours of the sigmoid colon  
Right hemicolectomy 
Left hemicolectomy 
Sigmoid colectomy 
Anterior resection 
Abdominoperineal resection (APR)

Answer 14

sigmoid colectomy

Question 15

which operation out of the following are used to remove tumours of the low sigmoid colon or higher rectum 
Right hemicolectomy 
Left hemicolectomy 
Sigmoid colectomy 
Anterior resection 
Abdominoperineal resection (APR)

Answer 15

anterior resection

Question 16

which operation out of the following are used to remove tumours of the lower rectum 
Right hemicolectomy 
Left hemicolectomy 
Sigmoid colectomy 
Anterior resection 
Abdominoperineal resection (APR)

Answer 16

Abdominoperineal resection (APR)

Question 17

In someone who has had bowel cancer how long are they followed up with various tests

Answer 17

CEA blood test 6 monthly for 3 years
CT T.A.P at 1 and 2 or 3 years
Colonoscopy at 1 and 5 years