Test #2 Flashcards
Where is colon cancer
In the large intestine
What cancer is the 2nd leading cause of cancer deaths and the 3rd most common form of cancer
Colorectal cancer
What are the majority of causes of Colorectal cancer
DNA mutations are more common (inheriting the cancer is less common)
What are risk factors for Colorectal cancer (a lot)
- Having a first degree relative with colorectal cancer and/or inflammatory bowel disease, such as Crohn’s, ulcerative colitis or polyps.
- Increase in age
- Having a relative who was diagnosed under 50
- Having two or more family members diagnosed with Colorectal cancer
- Family history of lynch syndrome
- Having an abnormal (mutation) KRAS gene (gene helps control growth, under normal function)
- Familial adenomatous polyposis (family member with Colorectal cancer)
- Minority groups are often diagnosed in later stages (access to care)
- Smoking
- Obesity
- Processed meats like salami and low fiber diet (processed meats can be carcinogenetic, and fiber is needed to help clear these out)
- Two or more alcoholic drinks per day.
What is the most common type of Colorectal cancer and what causes it
Adenocarcinoma caused by adenomatous polyps
Where are the most common sites of metastasis for adenocarcinoma 5
- Regional lymph nodes
- Liver
- Lungs
- Bones
- Brain
What are some common clinical manifestations of Colorectal cancer 6
- Change in bowel habits like diarrhea or constipation, snake like bowel movements, because stool is trying to pass through the cancer
- Feeling like you need to evacuate after you’ve already gone poop
- Bright red rectal bleeding or dark, tarry stools (so acute and chronic bleeding)
- Abdominal cramping or pain
- Weakness and fatigue
- Unintended weight loss
If Colorectal cancer is in the ascending colon, what might be some symptoms 4
- Pain
- Mass
- Change in bowel habits
- Anemia
If Colorectal cancer is in the Transverse colon, what might be some symptoms 4
- Pain
- Obstruction
- Change in bowel habits
- Anemia
If Colorectal cancer is in the descending colon, what might be some symptoms
- Pain
- Change in bowel habits
- Bright red blood in stool
- Obstruction 4
If Colorectal cancer is in the rectum, what might be some symptoms 3
- Blood in stool
- Change in bowel habits
- Rectal discomfort
What ages should you be screened for colorectal cancer
45-75.
75-85 decide between you and your doctor if you need the screenings.
85 and older, no screenings.
What types of screenings might they do
- Flexible sigmoidoscopy every 5 years (only goes into the sigmoid colon)
- Colonoscopy every 10 years
- Double-contrast barium enema every 5 years
- CT colonography every 5 years
- Test of blood in the stool using a high sensitivity fecal occult blood test (FOBT) yearly or fecal immunochemical test (FIT) yearly
Who are going to need earlier screenings for colorectal cancer before the age of 45 2
- If they have a first degree relative who was diagnosed with colorectal cancer before age 60
- If they have two or more first degree relatives with colorectal cancer
How can we diagnosis colorectal cancer
Perform a diagnostic colonoscopy and obtain a tissue biopsy during the colonoscopy (may also remove a polyp during the colonoscopy).
What illness do we often find with colorectal cancer? Why?
Anemia, because they usually have bleeding in their colon. (check CBC)
When evaluating a patient with colorectal cancer, what function test do we want to look for? What levels should this be at?
Liver function test - because it often metastases to the liver.
AST: 7-56
ALT: 5-40
What does a tumor marker tell us? What is the name of the tumor marker that can indicate that a person has colorectal cancer?
They can tell us if cancer is happening. It is called carcinoembryonic antigen (CEA).
Why are tumor markers not a good screening method
Because there are a large number of false positives - biopsy is the only definitive tool to diagnosis.
What are the other types of diagnostic studies we can use to help diagnosis and monitor cancer? 5
- CT guided needle biopsy to help guide to get a biopsy (can help detect in lymph nodes, liver and lungs)
- Ultrasound (look at abdominal endorectal, intraoperative (liver))
- MRI (Liver, brain, spinal cord)
- Chest xray (lungs)
- Angiography (shows arteries that supply the tumor)
What scan is not routinely done for colorectal cancer
PET scan
Why is it so important to get colorectal cancer screenings?
Because in the early stages it is often asymptomatic (usually symptoms will appear, like rectal bleeding, in the later stages)
What are the stages of colorectal cancer
0: cancer has not grown beyond the inner layer of the colon wall
1: cancer has grown to the outer layer
2: tumor is through the wall, but has not spread to lymph nodes
3: cancer has spread to lymph nodes
4: cancer has spread to distant sites in the body
What is one of the biggest interventions for colorectal cancer
Surgery