The Digestive System - colorectal cancer Flashcards
tumour histology is the small intestine?
adenocarcinoma
carcinoid
sarcoma
lymphoma
presetning sysptoms of small bowel cancer?
abdominal obstruction
anaemis
weightloss
diarrhoea
what investigations are used for the small bowel?
barium e-rays, colonoscopy, FBC, biopsy, CT, MRI
identify the staging 2-4 of small bowel cancer
T1 - invades submucosa
T2 - invades muscularis
T3 - invades through muscularis
T4 - invades other structures
what managemet options are there?
surgery
no RT used - radioresistant
chemotherapy - 5FU (little response
highlight the anatomy of the large intestine?
appendix, ascending colon, transverse colon. descending colon, rectum
3 epidemiology and 3 aetiology facts about large intestinal cancer?
2nd most common cancer in UK 20,000 deaths per year more common in western countries diet crohns disease benign polyps
main histology type in the large intestine?
adenocarcinoma spread directly, though lymphatics or blood
presenting symptoms of large bowel cancer
rectal bleeding, abstruction, weightloss, anaemia
investigations used for large bowel cancer ?
physical examination sigmoidoscopy colonoscopy barium x-ray blood tests
what staging system is used for large intestine cancer
Dukes staging system
A - submucosa, congined to bowel wall (80% survival)
B - penetrated beyond muscularis (60%)
C - regional lymph nodes are positive (25%)
D-distant mets
management options for large bowel cancer?
radical -mainly surgery
adjuvant chemotherapy if nodes are positive
palliative - targeted therapy + chemo
RT reduces local recurrance
what dose and technique is used for large bowel RT
single # or up to 30Gy in 10#, 6-10Mv
position - prone, full bladder
3 field technique - post & 2 laterals
what RT doses are used for rectal cancer
3DCRT pre-op 25Gy in 5#
post-op & inoperable tumours - 40-45Gy in 20-25#
palliative - 20-30Gy in 5-10#
side effects of RT?
cystitis, lethergy, fatigue, diarrhoea
small bowel obstruction
impotence
