Sporadic Colon Cancer

Question 1

what is more common? hereditary or sporadic colon cancer?

Answer 1

Sporadic

Question 2

how many patients with a proven colon cancer, will have normal hemoglobin level and negative stool test for occult blood?

Answer 2

approximately one third of patients

Question 3

Cancers located in the left colon are often characterized by…

Answer 3

Often constrictive in nature

Change in bowel habit, most often reported as increasing constipation.

Question 4

which disease sigmoid cancers can mimic?

Answer 4

diverticulitis, presenting with pain, fever, and obstructive symptoms.
Sigmoid cancers can also cause colovesical or colovaginal fistulas. Such fistulas are more commonly
caused by diverticulitis, but it is imperative that the correct diagnosis be established because the treatment of colon cancer is substantially different from treatment of diverticulitis.

Question 5

how many patients with sigmoid cancer will also have diverticular disease?

Answer 5

At least 20% of patients with sigmoid cancer also have diverticular disease, making the correct diagnosis difficult at times.

Question 6

which area of colon cancer is manifested with melena, fatigue associated with anemia, or, if the tumor is
advanced, abdominal pain.

Answer 6

Right colon

Question 7

right colon cancer is manifested with

Answer 7

melena, fatigue associated with anemia, or, if the tumor is advanced, abdominal pain. Although obstructive symptoms are usually associated with cancers of the left colon, any advanced colorectal cancer can cause a change in bowel habits and intestinal obstruction

Question 8

what is the gold standard for establishing the diagnosis

of colon cancer?

Answer 8

Colonoscopy.
it permits biopsy of the tumor to verify the diagnosis while allowing inspection of the entire colon to exclude
metachronous polyps or cancers;

Colonoscopy is generally performed even after a cancer is detected by barium enema to obtain a biopsy
specimen and to detect (and remove) small polyps that may be missed by the contrast study

Question 9

colon cancer staging - T1 - T3

Answer 9

T1 Tumor invades submucosa
T2 Tumor invades muscularis propria
T3 Tumor invades through the muscularis propria into pericolorectal tissues

Question 10

colon cancer staging - T4

Answer 10

T4a Tumor penetrates to the surface of the visceral peritoneum†
T4b Tumor directly invades or is adherent to other organs or structures

Question 11

colon cancer staging - Tis

Answer 11

Carcinoma in situ—intraepithelial or invasion of lamina propria*

Question 12

colon cancer staging - N1

Answer 12

N1 Metastasis in one to three regional lymph nodes
N1a Metastasis in one regional lymph node
N1b Metastasis in two or three regional lymph nodes
N1c Tumor deposit(s) in the subserosa, mesentery, or nonperitonealized pericolic or perirectal tissues without regional nodal metastasis

Question 13

colon cancer staging - N2

Answer 13

N2 Metastasis in four or more regional lymph nodes
N2a Metastasis in four to six regional lymph nodes
N2b Metastasis in seven or more regional lymph nodes