rectal cancer Flashcards
name 2 types of radical surgery for rectal cancer
trans anal endoscopic microsurgery- removal of tumour via colonoscopy for small well differentiated tumours
total mesorectal excision - split into superior rectal surgery = large intestine reconnected to remaining rectum - unlikely stoma
medial rectal surgery = large intestine recconented to anus as whole rectum removed and possible stoma required
inferior rectal surgery = removal of whole rectum and anus function reduced meaning stoma required
name 2 roles of EBRT for rectal cancer
PRE-OP RT = short course - 25gy in 5# to improve local control, with surgery delivered few days later
long course (chemorad) - 45Gy in 25# for large inoperable tumours that require debunking, surgery delivered 6-12 weeks later to allow full RT recovery
POST-OP = 45Gy in 25# after partial resectomy or mesolectal surgery to reduce recurrence but only a small gain so consider RISK vs BENEFIT (elderly)
explain role of BT for rectal cancer
HDR Brachy used instead of EBRT or for pre-op debunking for pts that reject or cannot have surgery as initial tx.
pavilion low energy contact brachy
explain role of chemo for rectal cancer tx
if tumour contained within rectum = no chemorad
if tumour invaded outside rectum = chemorad for both short and long course
