Gastrointestinal Malignancies Flashcards
define colorectal cancer
adenocarcinomas arising from polyps that form malignant tumours within the bowel
risk factors of colorectal cancer
increased age hereditary syndromes increased alcohol intake smoking obesity IBS
clinical features of colorectal cancer (right sided)
weight loss
anaemia
occult bleeding
RIF mass
clinical features of colorectal cancer (left sided)
colicky pain rectal bleeding bowel obstruction tenesmus LIF mass bowel habit changes
investigations in colorectal cancer
colonoscopy with biopsy
bloods (FBC, CRP, LFTs, U+Es and CEA)
CT/MRI abdomen and pelvis
Duke’s Classification of colorectal cancer
A: limited to bowel wall
B: extending through bowel wall
C: regional lymph node involvement
D: distant metastases
when are those > 40yrs referred for urgent 2wk colonoscopy if suspected colorectal cancer
unexplained weight loss AND abdominal pain
when are those > 50yrs referred for urgent 2wk colonoscopy if suspected colorectal cancer
unexplained rectal bleeding
when are those > 60yrs referred for urgent colonoscopy if suspected colorectal cancer
iron deficiency anaemia
changes in bowel habit
when are those < 50yrs referred for urgent colonoscopy if suspected colorectal cancer
rectal bleeding plus abdominal pain changes in bowel habit weight loss iron-deficiency anaemia
additional indications for urgent 2wk referral for suspected colorectal cancer
proven faecal occult blood on testing
rectal or abdominal mass
management of colorectal cancer in those with stage I-III
surgical resection +/- post-operative chemotherapy
management of colorectal cancer in those with stage III and lymph involvement
surgical resection and post-operative adjuvant chemotherapy
management of colorectal cancer stage IV
pre-operative chemotherapy
staged colectomy with resection of mets
post-operative adjuvant chemotherapy
management of colorectal cancer in those unfit for surgery
FOLFOX or FOLFIRI chemotherapy
cetuximab (anti-EGFR)
