Colorectal Carcinoma Flashcards
What are the main causes of colorectal cancer?
Pre-existing polyps Inflammatory conditions Genetics Diet Smoking and alcohol
What inflammatory conditions can cause colorectal cancer?
Ulcerative colitis
Crohn’s disease
Lymphoid hyperplasia
Which genetics can increase the risk of developing colorectal cancer?
FAP
HNPCC
Which aspects of the diet can increase the risk of developing colorectal cancer?
Low fibre
High red meat
What are the main symptoms of colorectal cancer?
Change in bowel habits Weight loss PR bleeding Iron deficiency anaemia Tenesmus
What type of anaemia is associated with colorectal cancer?
Iron deficiency anaemia
What are red flags in someone who is 40-60?
Rectal bleeding
Change in bowel habits
–For more than 6 weeks
What are red flags in someone who is more than 60?
Rectal bleeding
OR
Change in bowel habits
–For more than 6 weeks
What are 2 general red flag symptoms?
Palpable abdominal or rectal mass
What is the gold standard investigation for colorectal cancer?
Endoscopy- to visualise the colon
What would you do if a colonoscopy can’t be preformed?
CT colonoscopy
What would you use to stage colon cancer?
CT of chest, abdomen and pelvis
What would you use to monitor response to intervention of colorectal cancer?
Carcinoembryonic antigen (CEA)
What would you carry out before a colonoscopy?
Faecal occult blood test
Why would you carry out a FOB in someone over 50?
Unexplained abdominal pain
Or
Unexplained weight loss
Why would you carry out a FOB in someone younger than 60?
Changes in bowel habits
OR
Iron deficiency anaemia
Why would you carry out a FOB in someone over 60?
Iron deficiency anaemia
What is used to classify colorectal cancer?
Dukes criteria
What is Dukes A?
Confined to mucosa and part of the muscle of the bowel wall
What is Dukes B?
Extending through the muscle of the bowel wall
What is Dukes C?
Lymph node involvement
What is Dukes D?
Metastatic disease
What does the TNM classification stand for?
Tumour
Node
Metastasis
What does Tx mean?
Unable to assess size
What does T1 mean?
Submucosa involvement
What does T2 mean?
Involvement of muscularis propria (muscle layer)
What does T3 mean?
Involvement of the subserosa and serosa (outer layer), but not through the serosa
What does T4 mean?
A)spread through the serosa
B) reaching other tissues or organs
What does Nx mean?
Unable to assess nodes
What does N0 mean?
No nodal spread
What does N1 mean?
Spread to 1-3 nodes
What does N2 mean?
Spread to more than 3 nodes
What does M0 mean?
No metastasis
What does M1 mean?
Metastasis
What is the management of colorectal cancer?
Colectomy
What can a colectomy be?
Curative or Palliative
What does a colectomy involve?
Removal of tumour and create end to end anastomosis
Tumours in which areas are treated with a right hemicolectomy?
Caecum
Ascending colon
Transverse colon
Tumours in which areas are treated with a left hemicolectomy?
Distal transverse colon
Descending colon
Tumours in which areas are treated with a sigmoid colectomy?
Sigmoid colon
Tumours in which areas are treated with an anterior resection?
Low sigmoid colon
High rectum
Tumours in which areas are treated with an abdominoperineal resection?
Lower rectum
