Colorectal carcinoma Flashcards
1
Q
Who does it affect
A
F>M
>60 years
2
Q
What are the risk factors
A
Neoplastic polyps IBD Genetic - FAP + HNPCC \++ alcohol Smoking Previous Ca Diet - low fibre, high red meat - Aspirin reduces incidence + mortality --> inhibits polyp growth
3
Q
What type of cancer is it + how does it spread + how do you stage
A
- Adenocarcinoma
- Locally, lymphatically, haematogenically (liver, lungs, bone), transcoelomically
- TMN staging
4
Q
How does it present
A
Left-sided: bleeding/mucus PR, altered bowel habit or obstruction, tenemus, mass PR.
Right-sided: decreased weight, Hb, abdo pain, obstruction less likely.
Either: abdo mass, perforation, haemorrhage, fistula.
5
Q
How do you treat
A
- Surgery - endoscopic stenting considered in palliation in malignant obstruction
- Radiotherapy –> mostly palliative
- Chemo
6
Q
What types of polyps are there
A
- Polyps are lumps that appear above the mucosa.
- Inflammatory: UC, Crohn’s, lymphoid hyperplasia
- Hamartomatous: juvenile polyps, Peutz-Jeghers
- Neoplastic: tubular or villous adenomas, malignant potential, esp if >2cm.
