Therapeutics of Colorectal Cancer (Weddle) Flashcards
Patients of what disease state(s) are at 5-10x higher risk of developing colorectal cancer?
UC and Crohn’s
People with which syndrome have nearly a 100% lifetime risk of developing colon cancer?
familial adenomatous polyposis (FAP)
What tests can be used for the primary detection of colorectal cancer?
FOBT and FIT
What tests can be used for the detection of colorectal cancer and advanced lesions (NOT primary detection)?
endoscopic and radiologic exams
What’s the definite drawback of using FOBT to detect colorectal cancer?
high false negative rate
How can you avoid a false negative with FOBT?
- < 250 mg in vitamin C supplements, citrus juices and fruits for 3 days prior
- avoid aspirin/NSAIDs for up to 7 days prior
- delay test until 3 days after end of period
How can you avoid a false positive FOBT?
- avoid red meat/vegetables with peroxidase for 3 days prior
- avoid enemas, rectal medications, and digital rectal exams for 3 days prior
- avoid testing if blood from hemorrhoids is present
The fecal immunochemical test (FIT) detects __________.
hemoglobin
Which primary detection test would be preferred for colorectal cancer screening: FOBT or FIT?
FIT
What is the difference between a flexible sigmoidoscopy and a colonoscopy?
flexible sigmoidoscopy only examines the lower 60% of the bowel, colonoscopy examines the entire bowel
Which organization recommends screening for colorectal cancer starting at age 45?
American Cancer Society
What screening practices are recommended if you have HPNCC?
colonoscopy at 20-25 or 10 years younger than the youngest age at first familial diagnosis (whichever comes first)
What diet considerations can be made to prevent colorectal cancer?
- high fiber
- low fat
- high calcium
What medications have been shown to help with colorectal cancer prevention?
- COX inhibitors
- NSAIDs/aspirin
>95% of colorectal cancers are ______________.
adenocarcinomas
What are the eight warning signs of colon cancer?
- constipation
- diarrhea
- blood in stools
- narrow stools
- unexplained anemia
- tender abdomen/abdominal pain
- unexplained weight loss
- weakness/fatigue
Where may a colorectal tumor be located if they find occult blood in the stool?
transverse colon
Where may a colorectal tumor be located if a patient is complaining of dull abdominal pain?
ascending colon
Where may a colorectal tumor be located if a patient states they have noticed increased cramps and flatulence?
descending colon
Where may a colorectal tumor be located if a patient is producing low-caliber stools?
descending colon
Where may a colorectal tumor be located if a patient is experiencing weight loss?
ascending colon
Where may a colorectal tumor be located if the patient complains of tenesmus (feeling of rectal fullness)?
sigmoid colon/rectum
How is colorectal cancer staged?
TNM
In most cancers’ staging, the “T” in TNM is for tumor size. What does the “T” stand for in colorectal cancer?
the level of invasion into the colon
dMMR or MSI-H tumors predict a ________ benefit from adjuvant 5-FU for stage ___ disease.
decreased; II
Stage ____ patients with dMMR or MSI-H ________ from adjuvant 5-FU.
III; benefit
Is stage IV colorectal cancer curable?
no
