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NURS 220 > LEC 10: Colorectal Cancer > Flashcards

LEC 10: Colorectal Cancer Flashcards

1
Q

Where dose the small and large intestine join?

A

Join at the cecum

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2
Q

What is the etiology and pathophysiology for colorectal cancer?

A
  • Cause remains unclear
  • No single use
  • Some at high risk than others
  • Mix of genetic and environmental factors can cause cells in the lining of the bowel to turn cancerous
  • Most colon cancers typically arise from polyps
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3
Q

What do most colon cancers arise from?

A

Most colon cancers typically arise from polyps

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4
Q

What is polyps?

A

Small bulges of abnormal cells from bowel wall

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5
Q

What are the non-modifiable risk factors for colorectal cancer?

A
  • Age: > 50 years
  • Personal history of colorectal polyps
  • Family history of colorectal cancer
  • Personal history of IBD, particularly ulcerative colitis
  • Family/ personal history of familia adenomatous polyposis (FAP)
  • Ethnicity: African Americans, Eastern European Jewish
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6
Q

What are modifiable risk factors for colorectal cancer?

A
  • Diet high in fats and calories
  • Sedentary lifestyle
  • Type 2 diabetes
  • Obesity
  • Smokin
  • Heavy alcohol consumption
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7
Q

Clinical Manifestations of Colorectal Cancer

A
  • No symptoms in early stages
  • Vary depending on cancer location
  • Blood in/on stool
  • Change in bowel habits
  • General abdominal discomfort
  • Feeling of bowel not emptying
  • Urgency with BMs
  • Weight loss, tiredness
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8
Q

Saskatchewan Colorectal Screening

A
  • Age 50 to 74
  • Stool sample (FIT test)
  • Completed at home
  • Completed every 2 years
  • Results sent to family doctor
  • If positive result, further diagnostics test performed
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9
Q

What are the diagnostic studies done for colorectal cancer?

A
  • DRE: Digital rectal exam
  • Fecal occult blood test (FOB)
  • Sigmoidoscopy
  • Colonoscopy
  • Biopsy
  • Barium enema (causes constipation for the patient)
  • Blood tests- CNC, LFTs, CEA
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10
Q

What kind of treatment do patients with colorectal cancer undergo?

A
  • Polyp removal
  • Surgical therapies
  • Chemotherapy and radiation
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11
Q

Polyp Removal

A
  • Colon cancer typically arises from polyps
  • Early detection and removal is key to eliminating the risk
  • Remove during colonoscopy
  • Done if caner is in early stages: Only on colon surface
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12
Q

What are the 4 surgical therapies for colorectal cancer?

A
  1. Right hemicolectomy
  2. Left hemicolectomy
  3. Lower anterior resection
  4. Abdominal perineal resection
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13
Q

Surgical Therapies: Right Hemicolectomy & Left Hemocolectomy

A

Go in through the abdomen or laparoscopically and remove some portion of the bowel and some fo the healthy tissue. Would then reconnect the large intestine to the small intestine

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14
Q

Where is the cancer located for a right hemicolectomy therapy to take place?

A

Cancer is in:

  • Cecum
  • Ascending colon
  • Hepatic felxure
  • Part of right transverse colon
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15
Q

Where is the cancer located for a left hemicolectomy therapy to take place?

A

Cancer is in:

  • Left transverse colon
  • Splenic flexure
  • Descending colon
  • Sigmoid colon
  • Upper portion of the rectum
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16
Q

Surgical Therapies: Lower Anterior Resection

A

Cut the portion of the bowel away and reconnect it. Patient would still be able to have a bowl movement out of their anus like they normally would

17
Q

Where is the cancer located for a lower anterior resection therapy to take place?

A

Cancer is in:

  • The rectosigmoid area
  • Mid-upper rectum
18
Q

Surgical Therapies: Abdominal Perineal Resection

A

Have to remove the cancer and sew the anus shit, will have a permanent ostomy and will not be able to have a bowel movement through the anus and rectum. Because there are nerves in the anus and rectum, the patient may still feel like they need to have a bowel movement out of their anus and it is not uncommon for the patient to sit on the toilet to have a bowel movement.

19
Q

Where is the cancer located for a abdominal perineal resection therapy to take place?

A

Cancer within 5cm of anus

20
Q

Ostomies

A
  • Surgical procedure where the bowel is brought through an opening in the abdominal wall
  • Edges sutured (dissolvable), inner lining of bowel exposed (stoma)
  • Not every surgical IBD requires an ostomy
  • Can be temporary or permanent
21
Q

What are the 5 different types of ostomies?

A
  1. Ascending colostomy
  2. Descending colostomy
  3. Ileostomy
  4. Sigmoid colostomy single-barrel
  5. Transverse colostomy double-barrel
22
Q

Ostomy Post Op Care

A
  1. Assess stoma
    - Want the stoma to be beefy red
    - Do not want it to be black, means it is dead
  2. Protect peristimal skin
    - The skin around the stoam can get irritated if the stool sits around the stoma
    - Want to protect the stoma skin area and not characteristic of the skin
    - Ostomy is going to be quite inflamed, not uncommon for stoma to be quite larger then with it will be 6 weeks post-ops
  3. Containment of odour and effluent
    - An ostomy will not produce stool right away, for at least 3 days (not uncommon)
  4. Characteristics and amount of effluent
    - Patients with an ostomy cannot have a high fiber diet or mushrooms
23
Q

Chemotherapy

A

Can be done pre-op or for palliative purposes

24
Q

Radiation Therapy

A
  • Most commonly used fro rectal cancer, but can be used for both colon and rectal cancer
  • Can be done pre-op, post-op, or for palliative purposes
25
Q

Key Points for Colorectal Cancer

A
  • Most colon cancers arise from polyps
  • Symptoms cary depending on cancer location: Change in bowel habits and stool
  • Remember to think about nursing care post-op for these patient: what are the priorities?

NURS 220 (41 decks)

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