CRC

Question 1

epidemiology of CRC

Answer 1

3rd MCC of cancer,

Question 2

RF of CRC

Answer 2

genetic (FAP, and HNPCC) Hx of sporadic CRC or polyyp. FHx of sporadic CRC, UC (IBD), DM, obesity, alcohol, cigarett smoking, meat consumption, Hx of radiation theapy of prostate cancer

Question 3

screening CRC

Answer 3

start at 50 yrs and every 10 years, if FHx, start 10 yrs before cancer. can do sigmoidoscopy every 5 yrs.

Question 4

what is the preferred screening test

Answer 4

colonoscopy

Question 5

can CEA be used as a screening test

Answer 5

NO

Question 6

ssx of CRC

Answer 6

abd pain, change in bowel habit, hematochezia or melena, weakness, weight loss, anemia, NV abd distention.

Question 7

DX of CRC

Answer 7

colonoscopy + HP

Question 8

at what stage are most diagnosed with CRC

Answer 8

stage 3

Question 9

most common hisology of CRC

Answer 9

Adenocarcinoma.

squamous = anal canal.

Question 10

metastatic spread of CRC

Answer 10

local: radial, intraperitoneal, Distant: liver, lung, bone (not in rectal cancer), kidney and brain

Question 11

staging

Answer 11

TNM

Question 12

types of TNM

Answer 12

C = clinical 
P = pathological 
y = after neoadjuvant therapy
R = recurrent 
A= autopsy

Question 13

TX colon cancer

Answer 13

surgery + adjuvant chemo in all stage 3. 12 cyccles of FOLFOX (5-FU. leucovvorine + oxaliplatin) and stage 2 high risk (5-FU and leucovorine) Do NOT treat with radiotherapy

Question 14

Resection margins in colon cancer

Answer 14

5 cm distal and proximal. take at least 12 LN for assessment and correct staging.

Question 15

Tx of metastatic CRC

palliative vs curative

Answer 15

Palliative: multiorgan involvement. only chemo.
Curative: limited organ metastatic disease (only either lung or liver): surgery + chemo..

Question 16

Tx of rectal cancer

Answer 16

surgery: 2 cm distal, 5 cm proximal margins.

neoadjuvant chemo + RADIATION, adjuvant