WEEK 4 - Colorectal Cancers

Question 1

What are symptoms of colorectal cancer?

Answer 1

Blood in stool (and/or mucous) 
Disordered bowel habits (constipation/diarrhoea/both)
Unsatisfied defaecation 
Pain or discomfort in rectum or anus 
Bloating, fullness, cramps 
Tiredness, anaemia 
LOW

Question 2

When does bowel cancer screening occur?

Answer 2

50-74 years, 2nd yearly by 2020

Family Hx: 10yrs prior to youngest member being diagnosed - colonoscopy

Question 3

How is bowel cancer investigated ?

Answer 3

Rectal examination, sigmoidoscopy
Colonoscopy
Blood test - FBE, LFT’s and CEA (carcinoembryonic antigen)
CT, MRI (for staging), ERUS, PET scan

Question 4

What are the treatment pathways for colon cancer?

Answer 4

Surgery
Adjuvant chemotherapy
Commenced as soon as patient is well enough post surgery
Radiotherapy is not used as it is a risk to non cancerous tissue

Question 5

What are the treatment pathways for rectal cancer?

Answer 5

Neoadjuvant chemotherapy and radiotherapy
Starts as soon as possible after diagnosis
Ideally wait after last chemotherapeutic and commenced before surgery

Question 6

What must be done in preparation for surgery?

Answer 6

Bowel prep
Fast
Improve fitness
Stop smoking and drinking alcohol

Question 7

What are commonly performed operations to removed bowel cancer?

Answer 7

Anterior resection (ULAR, low or high)
\+/- stoma
covering loop ileostomy
APR or APE - permanent colostomy
R) hemicolectomy
L) hemicolectomy

Question 8

Where does colon cancer/polyps commonly occur?

Answer 8

30% caecum
25% ascending colon
20% rectum